1. Global Infrastructures www. mn. uio. no/ifi/forskning/grupper/gi/index
Global Infrastructures head of group: Kristin Braa -

2. Who are we? Faculty 20% Postdocs/researchers App. 40 Ph.D. students
Sundeep Sahay, Jørn Braa, Ole Hanseth, Margunn Aanestad, Jens Kaasbøl, Kristin Braa, Lars Groth
20%
Petter Nielsen Telenor, Eric Monteiro (NTNU), Ola Henfridson (Victoria Instituttet (Gøteborg)), Magne Jørgensen (Simula), Bente Anda (Skattedirektoratet)
Postdocs/researchers
Miria Grisot, Knut Staring, Lars Helge Ødegård, Ola Titlestad
App. 40 Ph.D. students

3. Focus
Information infrastructures is a concept describing large scale, complex, and networked technologies
such as the Internet (or e.g. DNBNor and OUS with 3500 integrated applications)
Include both the technical components and also the interconnected social and organizational elements such as work practices, organizational arrangements, human resources, politics, and other institutional conditions.
Complexity
Scaling/growth
Integration strategies, architectures
Standardization-flexibility
Organizing/governance/collaboration
Understanding, knowing how-to, doing
Empirical Studies & Software development

4. Broad areas of projects
Technology development
Implementation related – in real contexts of use
Health systems strengthening
Contributing to data quality improvements
Strengthening evidence based decision making
Policy related issues around integration, decentralization, standards etc
ALL IN CONTEXT

5. Health Information Systems Program
HISP is a global network headed and initiated at the Department of Informatics, University of Oslo since 1994.
Responsible for the development of the open source District Health Information Software (DHIS2) implemented in 16 African countries and India, Bangladesh and Vietnam
National standard for intra state HMIS in India. Implemented in 21 states
WAHO collaboration
Health Information Software (DHIS) is developed, customized and used for reporting, analysis and presentation of aggregated health data for analysis at all levels catering for the various programs (HIV, ANC, Malaria, EPI etc)
WHO is adopting DHIS as part of their standard

6. The map shows the use of DHIS 2 as of February 2011, varying from nation-wide systems to pilots projects:

7. Mobile phones for effective data exchange and communication in public health
Mobile-based data reporting with seamless integration with DHIS
HMIS monthly reports sent from facilities at the lowest level where no computers nor Internet exist
Pilots in 5 States in India with 1 block selected in each state: Total of 300 sub-centers from May 2009
Nigeria pilots in 2 states
Punjab scaled to whole state health workers provided phone for daily, weekly and monthly reporting
Pilot in Coastal region in Tanzania

8. Supporting all layers of healthcare
DHIS2
National
Budgeting, Planning
Evaluation
District / Facility / Hospitals
Data entry
Make reports
Local Health Management
Patient Journals
Some PC based systems
Community Level
Follow up programs
Vaccinations, School,
Mother/Child health
Paper based processes
Introducing mobiles

9. Mobile browser based reporting
Current mobile projects use J2ME based clients with state-bought phones (controlled)
New trial in India will use a mobile browser based solution to support more handsets
”Traditional” aggregate reporting forms
Investigate introduction of mobile activity based solutions (following up programs on specific named beneficiaries/patients)
Contact: Lars Kristian Roland -

10. Messaging & Social Networking
Simple messaging functionality has been introduced into DHIS2 web solution
But mobile solution does not have have messaging
How can mobile messaging enhance DHIS functions?
Browser based, apps based, and SMS
Can be linked to master thesis on feedback
Contact: Lars Kristian Roland -

11. Processed Data Feedback
How can we utilize mobile phones for feedback and information dissemination to outreach health workers on key health indicators, geographical comparisons and community health trends over time?
What kind of technical solutions are more suitable from the perspective of the health workers e.g. mobile Java applications/mobileWeb/SMS?
What kind of graphical representations are suitable on low-end handsets?
What are the implications of information push and information pull solutions?
The topic can be approached both from a mobile Java client/HTML5 programming centered approach as well as a social science study of outreach health workers data needs and data use.
Contact: Terje Aksel Sanner-

12. Data quality improvement in health information systems
A study found that more than 40% of data values change from the point of collection to it was in an electronic database. What influence data quality, and how can data quality be improved? This research will include a data quality assessment in one or more developing countries, and research related to analysis of the results, and reasons for these.
Contact: Johan Ivar Sæbø

13. From information access to information use
The HISP project has managed to improve data quality and access in a range of countries. However, the use of information for public health administration is still an area whith little progress in most of these countries. What are the constraints for developing an information culture, and how can these be overcome?
Contact: Johan Ivar Sæbø

14. Birth and death registries in developing countries
40 million births and deaths are unrecorded each year. How can developing countries improve vital registration (birth and death), and build these registers within a comprehensible health information architecture? Work will require research and implementation in West Africa
Contact: Johan Ivar Sæbø

15. Interoperability of Health Information Systems in Sierra Leone
What are the technological and institutional challenges in sharing data across health information platforms? What are appropriate strategies to overcome these challenges? Work will require research and implementation in Sierra Leone, or other country.
Contact: Johan Ivar Sæbø

16. Specific thematic areas
Statistics based health information systems for primary health sector – Using DHIS2
Community focused name based tracking systems – Using DHIS Tracker
Mhealth based reporting systems – for both statistical and name based data
OpenMRS based hospital information systems – for tertiary hospitals
iHRIS based human resources for health information systems

17. Some potential sites
DHIS 2 – India, West Africa, Tajikistan, Bangladesh, Sri Lanka, Peru etc
OpenMRS – India, Sri Lanka, Zanzibar
Mhealth – India, Malawi, Kenya, Tanzania
iHRIS – India, Sri Lanka
DHIS Tracker – India, Tanzania, Malawi, Tajikistan
etc etc etc

18. Some potential projects: OpenMRS
How can integrated district hospital systems built in one context be scaled to other sites in the same country, abroad, and move towards a more generic global product – for district hospitals in developing countries?
Contact: Sundeep Sahay

19. Some potential projects: iHRIS
While human resources is a most crucial area for health systems strengthening, is most neglected in terms of information support. How can effective HR for Health systems be designed and developed using iHRIS which is suitable to the complex HR needs of health systems in developing countries?
Contact: Sundeep Sahay

20. Renewable energy for communication and health
A pilot project of UiO and Grameenphone
Develop a robust and cost effective decentralized grid infrastructure based on renewable energy
Develop business models that are tailored to fit the societal context
Using health information as one of the drivers for renewable energy

21. Health information work practices and external infrastructural challenges
Qualitative research of health information work practices in a remote Bangladeshi village
Who provide health services in the village?
Informal as well as formal
What are their information gathering/communication practices?
To which extent and how do they report health data?
The village does not have basic infrastructure like electricity and roads. To which extent and how is this a problem for the provision of health services in the village (with a special focus on information gathering/communication/reporting)?
Are there local solutions/work arounds to these challenges, in that case, which?
Contact: Hanne Cecilie Geirbo -

22. User learning 1. The navigation problem 2. The understanding problem
Users know functionality exists
don’t know how to trigger it
Causes
Users have other names for the functionality
The interface has a multitude of items
Suggested help
User generated texts
Web
In the software
Research questions
Does it work?
What are the limitations?
Users misinterprets
Causes
Poor interface
Users have inadequate mental models
Suggested help
Illustrations with accompanying texts
Developed with user interaction
Research questions
Does it work?
What are the limitations?
3. How to make users experiment and troubleshoot themselves?
HISP or other settings 6466

23. Courses INF5210 Information Infrastructures (H)
INF Empiriske metoder og evidensbaserte beslutninger i systemutvikling (H)
INF5750 Open Source Software development and Java frameworks in global networks (H)
INF5780 Open source, open collaboration and innovation (H)
INF Health Management Information Systems (V)
INF5930 Action Research Workshop (V)
INF?? Master seminar in Information Systems (H)

24. The HISP Enviroment Vibrant multi-cultural global environment
Opportunity to work with cutting edge open source technologies in globally distributed environments
All applications HISP works with are WHO endorsed global standards
Make a real impact – contribute to strengthening public health systems in the developing world
Open up opportunities in domains of both research and practice – Global Health a fast growing area around the world

25. DHIS 2 software Open Source Software (free to change and use)
Built with Java Frameworks and tools (Spring, Hibernate, Struts, Maven)
Globally distributed development
Norway (the HISP lab), Ireland, Vietnam, India, Tanzania, and growing
Active community on launchpad.net/dhis2 and mailing list
Global use (Asia and Africa)
INF 5750 (Open source Software Development)
Students take part in DHIS 2 distributed development and use open source tools and methods (launchpad.net/dhis2-academy)