IPROC iproc Iproceedings 2369-6893 JMIR Publications Toronto, Canada v4i1e10547 10.2196/10547 Abstract Abstract Use of District Health Information System (DHIS-2) for Real Time Surveillance: Lebanon 2017 Khader Yousef Youssef Dalal Khoury C Allouch G Haydar K Jouny A Zreik H Ghoussaini F Yaghi A Corresponding Author: Dalal Youssef dalalyoussef.esu@gmail.com Jan-Dec2018 29 03 2018 4 1 e10547 29 3 2018 29 3 2018 ©Dalal Youssef, C Khoury, G Allouch, K Haydar, A Jouny, H Zreik, F Ghoussaini, A Yaghi. Originally published in Iproceedings (http://www.iproc.org), 29.03.2018. 2018

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 Background

The Ministry of Health in Lebanon is in the process of migrating surveillance reporting from a cumbersome paper-based system to a web-based electronic platform (DHIS-2).

 Objective

The aim of the project is to have real-time information flows in order to timely detect alerts and outbreaks in order to take quickest action.

 Methods

DHIS-2 tool was initially piloted in Lebanon in 2014 for school-based surveillance. In May 2017, the tool was extended progressively for other surveillance programs collecting aggregate data from hospitals, medical centers, dispensaries and laboratories. As part of the roll-out process, the online application was developed: customized aggregated-based datasets, organization units, accounts users and generic dashboards. 80 training sessions targeting 1290 users were conducted throughout the country. Those trained included 35 district and province health officers, 150 focal persons working in all public and private hospitals, 140 focal persons in laboratories and 800 in medical centers and dispensaries. To assess improvements in surveillance reporting, we compare completeness and timeliness for reporting for the period before and after the implementation of DHIS2. Challenges and lessons learned during the roll-out process are documented.

 Results

For laboratory-based surveillance, completeness of reporting increased from 70.8% in May to 89.6% in October. Timeliness has improved from 25% to 74%. For medical centers an improvement of 8.1% in the reporting and 9.4% in the timeliness is recorded before and after training sessions. For zero reporting, completeness remains the same (88%) and timeliness has improved from 74% to 87%. There was also increase in the reporting of communicable diseases. Implementation challenges included limited access to internet (29%) and limited workforce (21%).

 Conclusions

Implementation of DHIS2 resulted improvement in timeliness and completeness for aggregated data reporting. Continued onsite support, monitoring and system enhancement included internet connectivity are needed to enhance the performance of DHIS2.