Retrieving and Using Legacy Health Data to Make Evidence-Based Decisions in Ethiopia’s Amhara Region

Ethiopia’s health information management tools and practices have evolved as the health environment shifts and technology advances. One example was the standardization of the routine health management information system (HMIS), which was the primary source of information from 2008 to 2014. With the target to digitalize health data, the Ministry of Health (MOH) replaced the paper-based HMIS with an electronic version (eHMIS) that was used until 2017, when District Health Information Software 2 (DHIS2) was developed and launched.

Similar progress was made at the regional levels, including in Amhara, where the eHMIS was deployed in all 13 zonal health departments, 152 woreda health offices, 46 hospitals, and 642 health centers. Following the introduction of DHIS2, however, eHMIS stopped functioning, and remained deactivated and locked without migrating the historical health data to the DHIS2. It deprived the regional health bureau an opportunity to access previous years’ data, completely curtaining their capacity to make evidence-based decision and planning.

To fix the problem, the Ethiopia Data Use Partnership (DUP), a joint initiative between JSI Research & Training Institute, Inc. (JSI) and the MOH to implement the Information Revolution (IR) agenda, which is transforming the country’s health data management and use, in collaboration the Amhara Regional Health Bureau (RHB), started working on recovering and transferring the historical health data from the old source to the DHIS2.

A team of experts led by DUP was established and tasked to bridge the two systems. The team first extracted four years’ (2014–2017) worth of data from the regional eHMIS server using different elements, such as organization unit and period. This generated 64 (48 monthly and 16 quarterly) reports. These data then went through a series of intensive cleaning, converting, and mapping processes (see figure below).

Steps of the Migration

In January 2020, after a careful and concerted six-month process, the legacy data were migrated, allowing health managers and other health system staff across the region to readily access the data on the DHIS2 online server. The team also set up selected indicators in a dashboard displayed on TV screens installed at the RHB. Moreover, the DHIS2 dashboard mobile app allows easy access from anywhere.

The tedious and intensive process has ensured access to the legacy data through DHIS2. Getaneh Zewudie of the RHB’s Medical Service Directorate says, “Getting both the legacy and the recent data in one database simplified our access and saved our time and energy!” Teklehamanot Gebrehiwot, director at Planning, Monitoring and Evaluation Directorate, hopes that other regions will learn from this experience.

RHB heads and officers frequently consult the legacy data for different actions and health program planning. For example, the RHB used them to prepare trend data analytics for immunization, child health, and tuberculosis programs, which will ultimately help staff improve community health outcomes.

Written by Birhanu Taye