Maryam Bibi

FEBRUARY 2025 KP PAKISTAN REGIONAL MEETING: DISCUSSION AND OUTCOMES MEETING REPORT // FEBRUARY 2025 02 TABLE OF CONTENT INTRODUCTION 03 MEETING OBJECTIVES 04 CHANGES IN DHIS2 REPORTING FORMS 05 Specialty Section 05 Outpatient Department (OPD) Section 06 Indoor Services Section 06 Case Attending Indoor (CAI) Section 07 Maternal, Newborn, and Child Health (MNCH) Section 07 Immunization Section 07 Diagnostic Section 08 Laboratory Section 08 Afghan Refugee Section 08 Physiotherapy Section 08 Financial Report Section 08 Water, Sanitation, and Hygiene (WASH) Section 08 MEETING OUTCOMES & IMPLEMENTATION PLAN 09 Form Consolidation 09 Disease Up gradation 09 Data Elements Adjustments 10 ACTION POINTS & WAY FORWARD 10 CONCLUSION 11 List of Participants 12 MEETING REPORT // FEBRUARY 2025 03 TWO-DAY TECHNICAL WORKSHOP ON DHIS2 FORMS CUSTOMIZATION OF FORMS WITH KP DHIS CELL AT HISP PAKISTAN INTRODUCTION The KP DHIS Cell, in collaboration with the Health Information Systems Program (HISP) Pakistan and with support from UNICEF, conducted a two-day meeting to do necessary changes in the DHIS2 reporting forms. This initiative was undertaken as part of an ongoing effort to improve the accuracy and efficiency of health data reporting. The decision to revise these forms were based on a comprehensive system review conducted by the DHIS Cell KP, which identified areas for improvement in data collection and reporting. Feedback from the quarterly review meeting, along with insights from monitoring and evaluation visits to various districts and health facilities, further highlighted redundancies and gaps in the reporting structure. Field staff raised concerns about these challenges, prompting the KP DHIS team to engage in discussions with the Director General (DG) Health and UNICEF representatives. This collaboration ensured that the proposed changes align with public health reporting needs and enhance the efficiency of data collection processes. The meeting focused on refining the structure of the reporting forms by incorporating essential elements, and enhancing usability for frontline health workers. Moving forward, continuous monitoring and technical support will be critical to ensuring the seamless integration of these updates into the health information system and improving overall data quality for evidence-based decision-making. MEETING REPORT // FEBRUARY 2025 04 MEETING OBJECTIVES Implement system updates to support the revised forms, ensuring compatibility and seamless functionality. Establish mechanisms for continuous monitoring and troubleshooting during the transition phase. Review and finalize necessary changes in DHIS2 reporting forms based on field feedback and monitoring visits. Remove redundancies, standardize data elements, and incorporate essential indicators to enhance reporting efficiency. Ensure smooth integration of updated forms into the DHIS2 system with necessary technical adjustments. Align reporting form changes with national and provincial health priorities for better datadriven decision-making. MEETING REPORT // FEBRUARY 2025 05 CHANGES IN DHIS2 REPORTING FORMS The following Changes have been incorporated into the DHIS2 reporting forms to enhance data accuracy, streamline reporting, and improve alignment with national health priorities. These changes include additions, modifications, renaming, reordering, and section shifts to optimize data collection and usability. 1. Specialty Section Changes: The following specialties have been change to improve data focus: Pediatric Cardiology Pediatrics Neurology Dermatology Trauma MLC and RTA Rheumatology Medicine/Gastroenterology Chest Additions: Separate reporting for MLC Cases Tuberculosis (TB) categorized separately for enhanced monitoring Modifications: Dialysis and Emergency/Casualty will now be excluded from the Grand Total and placed separately below it for clarity. MEETING REPORT // FEBRUARY 2025 06 2. Outpatient Department (OPD) Section Text Modifications: Pluralize all disorders and diseases (e.g., “Disease” to “Diseases”). Additions: Introduction of “Suspected Cases” category in data elements. New conditions included: Eye Diseases: Diabetic Retinopathy, Hypertensive Retinopathy, Squint. Gynecological Diseases: "Other Diseases" category added. Occupational Lung Disease: Pneumoconiosis included. General Surgery: Prostatitis added. Antimicrobial Resistance (AR) Data to be reported separately below the Grand Total of OPD. Changes: Removal of outdated or less relevant conditions: Dental Section: Acute Ulcerative Gingivitis, Root Canal Treatment (RCT). ENT Section: Deep Neck Abscess, Vertigo, Head and Neck Tumors. Endocrine Disorders: Hyperthyroidism and Hypothyroidism. Communicable Diseases: Bacterial and Meningococcal Meningitis, Severe Acute Respiratory Infections. Neurological Infections: Encephalitis, Botulism, Rabies, Salmonellosis. Medico-Legal Cases (MLCs): Entire section removed from OPD Diseases. General Orthopedics Diseases: Section removed. Renaming: Nosocomial Infections renamed to Health Care-Associated Infections (HCAI) for standardization. Reordering: Chickenpox has been repositioned below Mumps in the Communicable Diseases section for consistency. 3. Indoor Services Section Additions: Dialysis will now be reported separately below the Grand Total. New Indicators: Bed Occupancy Rate (BOR) and Average Length of Stay (ALS) added at the end of the Indoor Services section. Changes: IPD services from Basic Health Units (BHUs)changed due to irrelevance. MEETING REPORT // FEBRUARY 2025 07 4. Case Attending Indoor (CAI) Section Additions: New conditions added for better classification: Heart Diseases: Congenital conditions included. Surgical: Hemorrhoids added. Orthopedic: "Others" category introduced. Eye Diseases: Squint, Diabetic, and Hypertensive conditions added. Newborn Services: "Others" category included, along with Low Birth Weight. Kangaroo Mother Care (KMC) services will be reported under OPD data only. Changes: Extra Pulmonary TB changed. Gynecological Section: Infertility and Menstrual Disorders eliminated. Sexually Transmitted Diseases (STDs): Removed from CAI. Kangaroo Mother Care (KMC): Entire section removed from CAI. Renaming: Obstetrical Complications renamed to Other Obstetrical Complications. Neonatal Infection renamed to Neonatal Sepsis for precise classification. 5. Maternal, Newborn, and Child Health (MNCH) Section Additions: Hypothermia included under Neonatal Deaths for better newborn health tracking. Changed: Birth Trauma changed from the "Delivering in the Facility" section. 6. Immunization Section Shifted to Monthly Form: All immunization data will now be captured in the monthly report instead of the regular OPD form. MEETING REPORT // FEBRUARY 2025 08 7. Diagnostic Section Additions: New diagnostic procedures added: Dental X-rays OPG for better dental imaging. Changes: Total PCR changed to the Monthly Report for consolidated reporting. 8. Laboratory Section Additions: Rapid Diagnostic Tests (RTDs) included for improved laboratory diagnostics. Shifted to Monthly Report: Entire laboratory section will now be reported monthly. 9. Afghan Refugee Section Additions: Age-wise breakup for OPD and IPD categorization. Changes: Entire Afghan Refugee section removed. cases added for better 10. Physiotherapy Section Shifted to Monthly Report: All physiotherapy-related data will now be captured on a monthly basis. 11. Financial Report Section Shifted to Quarterly Report: Financial reporting frequency revised to quarterly instead of monthly. 12. Water, Sanitation, and Hygiene (WASH) Section Shifted to Quarterly Report: WASH data collection will now be integrated into the quarterly reporting framework for better trend analysis. These changes aim to enhance the efficiency of DHIS-2 reporting by ensuring data consistency, reducing redundancy, and aligning the system with evolving health sector needs. The integration of these changes will require structured training and technical support to ensure smooth adoption by health facilities and field staff. MEETING REPORT // FEBRUARY 2025 09 MEETING OUTCOMES & IMPLEMENTATION PLAN The two-day meeting successfully brought together key stakeholders from KP DHIS Cell and HISP Pakistan, with the support of UNICEF Pakistan, to address existing inconsistencies in the DHIS2 reporting system. The discussions led to a series of critical updates aimed at improving data accuracy, enhancing system efficiency, and ensuring alignment with health sector priorities. 1. FORM CONSOLIDATION To streamline data entry and eliminate redundancy, Categories A, B, C, and D have been merged into a single unified form (Cat A-D). -This consolidation will simplify reporting, reduce errors, and enhance data consistency across all reporting levels. 2. DISEASE UP GRADATION The total number of diseases tracked in the OPD section has been revised to 124, ensuring a more comprehensive and precise classification of cases. This enhancement aligns with evolving healthcare needs and facilitates better epidemiological tracking. MEETING REPORT // FEBRUARY 2025 10 3. DATA ELEMENTS ADJUSTMENTS a. Identifying Facilities with Prolonged Blank Data A system has been developed to use pivot tables to identify facilities that consistently report blank data over extended periods. This approach will help pinpoint potential data entry issues, inactive reporting sites, or operational gaps requiring intervention. b. Introduction of Three New Data Elements To improve data clarity, three new reporting elements have been added: 1. Holiday To track public holidays when the facility remains closed. 2. Sunday Automatically recorded as a non-working day in weekly reports. 3. Days when the facility remained open but recorded zero patient visits. This will differentiate between inactive facilities and those with legitimate zero-patient days. c. Auto Population Feature for Holidays & Weekends Sundays and pre-designated national holidays will be autopopulated in the system to reduce manual workload. Islamic calendar holidays, which vary each year, will require manual adjustments by system administrators to ensure accuracy. ACTION POINTS & WAY FORWARD HISP Pakistan, in collaboration with KP DHIS Cell and UNICEF Pakistan, will implement the finalized DHIS2 reporting enhancements and conduct a pilot test in selected facilities to assess feasibility, user adaptability, and technical challenges before full-scale deployment. A dedicated monitoring team will track data quality, system performance, and user feedback to ensure a smooth transition, with key performance indicators (KPIs) established to measure the impact on reporting efficiency and data reliability. Additionally, quarterly review meetings will be conducted to evaluate progress, address emerging challenges, and refine the system based on user feedback, fostering continuous improvement and cross-learning among stakeholders. MEETING REPORT // FEBRUARY 2025 11 CONCLUSION THE MEETING EFFECTIVELY ADDRESSED FORM INCONSISTENCIES AND FINALIZED CRITICAL DHIS2 REPORTING ENHANCEMENTS THROUGH JOINT EFFORTS BY KP DHIS CELL, HISP PAKISTAN, AND UNICEF PAKISTAN. FIELD-LEVEL CHALLENGES WERE REVIEWED AND INTEGRATED INTO SYSTEM REVISIONS TO IMPROVE DATA ACCURACY AND USABILITY. THESE ENHANCEMENTS WILL STRENGTHEN DATA RELIABILITY, FACILITATE INFORMED DECISIONMAKING, AND IMPROVE PUBLIC HEALTH OUTCOMES ACROSS KP. MOVING FORWARD, SUSTAINED MONITORING, CONTINUOUS USER SUPPORT, AND STRUCTURED TRAINING WILL BE ESSENTIAL TO ENSURE SMOOTH ADOPTION AND MAXIMIZE THE IMPACT OF THESE IMPROVEMENTS. MEETING REPORT // FEBRUARY 2025 12 LIST OF PARTICIPANTS s.no. Name Designation 1 Dr. Muhammad Saleem Director DHIS, KP 2 Sye Qasim Shah Deputy Director DHIS, KP 3 Hameed Iqbal Data Analyst 4 Muhammad Mateen Data Analyst 5 Muhammad Waseem Data Entry Officer 6 Muhammad Asim Data Manager 7 Dr. Murtaza DHIS2 Implementer 8 Arslan Mughal DHIS2 Developer 9 Muhammad Usman DHIS2 Developer 10 Maryam Bibi DHIS2 Implementer Organization DHIS cell, KP HISP, Pakistan MEETING REPORT 13 // FEBRUARY 2025