Information Systems for Emergency Diseases Emergency Response to the Covid-19 Pandemic – supporting global and national surveillance

This project had the central objective of supporting Low and Middle-Income Countries (LMICs) with appropriate health information systems, empowering them to respond to rapidly changing information needs during the COVID-19 pandemic and later disease outbreaks. The project was centred on DHIS2, the world's largest HMIS platform, used by ministries of health in 73 LMICs with 58 national-scale deployments. One of the countries in the consortium, Ghana, adopted the Surveillance Outbreak Response Management and Analysis System (SORMAS). The project consisted of a study of HMIS for COVID-19 tracing in Sri Lanka, Mozambique, Kenya, Ghana and Norway, with the following objectives: (1) assessment of the experience of using HMIS for COVID-19 surveillance among contact tracers, health managers and national HIS administrators; (2) elaboration and use of a data quality evaluation protocol; (3) comparison of HMIS use experiences across countries; (4) elaboration of recommendations for strengthening and improving HMIS for COVID-19 surveillance. This research led us to understand the appraisal of COVID-19 surveillance platforms across five countries, four of which used the DHIS2 system and one, Ghana, using SORMAS. Working across Norway, Ghana, Sri Lanka, Mozambique and Kenya, the project drew important insights on how contact tracers, health managers and national health implementers used digital platforms for disease surveillance, noting features and patterns associated with key variables including simplicity, acceptability of the technology and quality of the data collected. Findings on the two platforms have high value for disease surveillance, especially as technologies are increasingly participating in the conduct of contact tracing in low-resource settings.

This research led us to understand the appraisal of COVID-19 surveillance platforms across five countries, four of which used the DHIS2 system and one, Ghana, using SORMAS. Working across Norway, Ghana, Sri Lanka, Mozambique and Kenya, the project drew important insights on how contact tracers, health managers and national health implementers used digital platforms for disease surveillance, noting features and patterns associated with key variables including simplicity, acceptability of the technology and quality of the data collected. Findings on the two platforms have high value for disease surveillance, especially as technologies are increasingly participating in the conduct of contact tracing in low-resource settings. Our research has developed important insights on the role of digital platforms in disease surveillance, and on how this may vary across countries. The research has produced findings on digital contact tracing that enhance future pandemic preparedness, by unpacking the role of digital technologies within disease surveillance and illuminating how different actors perceive the same technologies.

During epidemics from emerging diseases, WHO guidelines and local circumstances change rapidly. Hence, information systems for operative health workers as well as epidemiological managers should change at the same speed. A consortium for supporting less developed countries with a COVID-19 information system, funded by NORAD, has been set up and is working with 40+ countries. The consortium delivers updated versions every week based on new requirements from the countries and WHO. The research project will generate knowledge on how a consortium can manage such rapid changes to be carried out effectively when there are thousands of end-users, travel restrictions, a high-performance pressure, and in countries where there is a shortage of skilled health workers, health information systems specialists, unstable electrical power and internet. The research will investigate the system and its development and change process in three countries; Ghana, Kenya, and Sri Lanka, representing different cultural regions. The project will have partners in these countries. Also, the global consortium will be studied. The first evaluation will address all direct users with a survey and all members of national and global teams with qualitative interviews. Based on this data and computer logs, an assessment of the system and of the rapid development process will be carried out. Research papers and reports to the consortium and countries including recommendations for changes in the system and in the development process. will be written. This assessment will also be presented to the consortium national teams and selected users after 6 months. A repeated evaluation will take place month 12-18, and a second round of dissemination back to the developers and users will take place. Since no research of such rapid system development cycles has been found in the literature, the conclusions from two evaluations will constitute new knowledge.