1. THE UNITED REPUBLIC OF TANZANIA
HEALTH INFORMATION SYSTEMS (HIS):
HERMES SOTTER RULAGIRWA
Presented at 2017 PEPFAR data and systems applied learning Summit September 18-21, 2017

2. ABOUT TANZANIA 50+ Million (NBS, 2017) Total Area: 883,600 sq km
Life Expectancy: 61.8 years
Health Facilities: 7,616
Mobile Penetration: 79%
Internet Penetration: 45%
100% of National, Zonal, Specialized and Regional Hospitals connected to National ICT backbone
Districts connected to National ICT backbone: 85%
National Data Centers

3. Benefits of Digital Health
HIS
Increased revenue collection
Cost Efficiencies
Improved Quality of Health at HF
Patient Satisfaction
The Ministry through its ongoing health sector reforms aims at
Improving the quality of healthcare
Improving operational effectiveness and efficiency
Improving resource utilization (e.g. costs)
Implementation of HSSP III has produced many positives, however realizing the best health outcomes requires a fundamental transformation.
The role of ICT in supporting such a transformation has widely been accepted across the globe, but the challenge is how to do this well!

4. Benefits Cont
The use of eHealth shown positive impact within health sector. E.g.
At the National Hospital revenue collection increased by 350%
At one of the Zonal Hospital (Mbeya) revenue increased by 300%
Some Regional Referral Hospital revenue increased by 150%
Record keeping at the National Hospital has improved from 70 personal files lost per day, to 15personal files lost per week. However during computerization period physical files lost, but the information is still available. Appointment cancelation were 150/day now its down to 15/day. Average waiting time to get appointment was 7 weeks, now is 1.4 weeks
Today No Record Loss, Appointments are made by the Doctors right away.

5. Tanzania Digital Health Strategies
Health policy 0f 2007, now under review
National ICT Policy 2016,
HSSP IV
eHealth Strategy
An Integrated Health Facility Electronic Management System (iHFeMS)-2016
ICT policy guideline specific for health sector
Digital Health Investment Roadmap – , recently launched on 2016
M&E strategy
ALL documents available in the MoH and eGA Website ( and

6. Tanzania Digital Health Strategies

7. Overview HIS DHIS2 Journey began since 2007
MoHCDGEC working with multiple stakeholders (eg. Global Fund, NORAD, CDC, USAID, Netherlands, UN Agencies)
Technical support from University of Oslo and University of Dar es Salaam (HISP)
The actual implementation started in 2010 after agreeing on implementation approach
National Rollout was completed in 2013
Integration with Vertical Programs Initiative started in 2014

8. Integrated programs Data needs within DHIS2
HMIS Data (OPD, IPD etc.)
RCHS Data
HIV/AIDS and PMTCT Program data
Malaria Program Data
TB and Leprosy Data
Result based Financing (RBF)

9. Information flow Data aggregation MOHCDGEC
Regional Medical Office (RMO/RHMT)
IPs
Programmes
National DHIS 2 Database
District Medical Office (DMO/CHMT)
Facility
Data aggregation
Patient/Client
Client recording form

10. Electronic Systems Integration
eLMIS/VIMS
HRHIS
DHIS2 (HMIS)
eIDSR
HFR
CTC2
eLIS (Viral Load)
CTC3

11. Facility Level Data Systems
Program quality,
Clinical monitoring
Reporting
CTC Card
CTC3
CTC2
Aggregate
Client Level
HTC Register
National Report
Count test
RDE
Pharmacy TB
ERR (TB)
Lab
New CTC2
Introduces automated reporting from CTC2 to CTC3
Automated reporting to DHIS2 via CTC3
HTC Now integrated to CTC2
RCH ?

12. Data Quality Assessment
Frequency of Data Quality
National – at least once annually for selected indicators
Regional Level – semi annually.
District level – Quarterly
Data Quality Methods
Spot Checking
Cross checking
DHIS2 is used to assist DQA teams to identify gaps.

13. Data Use and Dissemination
Program specific Dashboards within DHIS2
Dissemination of data to public through HMIS portal (hmisportal.moh.go.tz)
Result based Financing Module (RBF)
Performance monitoring of different interventions e.g. Score cards App
Quantification Process (e.g. Quantification of ARV drugs and HIV commodities)
Tracking of availability of health commodities (e.g. essential medicine)

14. Achievements Linkage to online Health Facility Registry (HFR)
Improved data availability at all levels to support evidence based decision making.
Single source of Health data.
Integration of vertical programs
One to One Integration eg. DHIS2-HRHIS, HFR-DHIS2, HFR-CTC3 etc.

15. Achievements Cont.
More than 1,400 Health Facilities already implementing EMR & ERP at different stages (Fully computerized, partial and ongoing)
Health Facility Registry, DHIS2 (as data warehouse), HRHIS/TIIS, eLMIS, VIMS, TIMR all web based centralized at National Level
Report of quality of care from citizen, Wazazi nipendeni code Pregnancy mother Registration
eIDSR/DHIS2 85% reporting from HF using mobile across the country
Infrastructure: 100% of National, Zonal and specialized hospitals, 93% (26 out of 28) regional hospitals connected in the national backbone, 85%

16. Achievements: Data We Have

17. We know which commodities are available at HF (DHIS2/eLMIS)

18. Challenges
Inadequate computing infrastructure at health facility level
Track patients for Referral cases at different HFs
Inadequate ICT infrastructure for easy scaling of HIS
Inadequate ICT expertize/staff especially at Regional/and Districts Hospitals and Health Centres

19. Way forward Computerisation at primary health care
Implementation of EMR – Ongoing
Implementation of Health Information Exchange (HIE)
Capacity building at all levels
Performance Contracts at all levels
Continue implementation of Digital Health Investment Recommendation Roadmap

20. Health Information Exchange Conceptual Model

21. Road map
This slide shows how we have grouped the investment recommendations into foundational, high impact and quick win.
It also shows us the timing and costing of all the recommendations in one place
Main menu

22. Asante Sana &