DHIS2

Millions of dollars are spent on procuring and maintaining Cold Chain Equipment (CCE), yet few tools support holistic management of these big investments. The DHIS2 Cold Chain Equipment (CCE) Lifecycle Management tool allows for tracking and maintaining equipment from installation to decommissioning. This includes web and mobile based data entry, built-in analytics and alerts to support health professionals and technicians to register and maintain equipment.

The HISP Centre at University of Oslo invites you to join us for a webinar on DHIS2 for Cold Chain Equipment Lifecycle Management on Wednesday, 11 December from 14:00-15:00 CET. In this webinar, the DHIS2 platform and the CCE tool will be presented along with a recent implementation in Malawi by Digital Health Division and integration of Remote Temperature Monitor (RTM) from Nexleaf Analytics. Join us to learn more!

This webinar is organized by HISP UiO with support from Gavi. Le webinaire disposera d’une interprétation simultanée en français.

Register here: https://us06web.zoom.us/meeting/register/tZMrcu-sqjojHtzJS50foc3m_-1S_PvpNgm0

Get ready for four days of learning and inspiration as you experience the world-changing impact of the global DHIS2 community!

The HISP Centre is excited to announce the 2025 DHIS2 Annual Conference, scheduled to take place on 10 - 13 June 2025 at the University of Oslo, Norway.

The DHIS2 Annual Conference—the biggest annual DHIS2 event—brings together decision-makers, ministries and other governmental institutions, donors, implementers and innovators under one roof.

During four days of presentations, technical demonstrations, interactive discussions, and networking sessions, you’ll discover how DHIS2 is leveraged for data-driven solutions responding to some of the most pressing challenges in health, education, climate impacts, logistics, and beyond. This in-person gathering provides the opportunity to share experiences, models and new perspectives, and interact with peers from the around the world.

Early bird registration will open in January 2025 and we invite you to follow #dac2025 on the DHIS2 Community of Practice (CoP) and follow us on social media (Facebook, LinkedIn or Twitter/XTwitter/X) to get the latest event updates and announcements. If you sign up now, you’ll also be among the first to know about our Call for Abstracts, which will open in the coming weeks!

We invite you to save the date for the 2025 DHIS2 Annual Conference, and we hope you will join us next year in Oslo!

• Event webpage: https://dhis2.org/events/webinar-dhis2-mpox/
• Community discussion: https://community.dhis2.org/t/upcoming-webinar-on-mpox-surveillance-and-immunization-9-octobre-2024-14-00-cet-english-francais/61231
• Registration: https://us06web.zoom.us/meeting/register/tZ0qcO6trDIsE91oFKkGQqahplaaaCM4WkYh

Malawi’s Ministry of Health used DHIS2 Tracker to register and manage its vaccine cold chain equipment, cataloging more than 300 pieces of equipment across 20 districts in only four weeks, and reducing inventory reporting time from years to minutes.

Cold chain equipment and vaccine stock data—two cornerstones of effective nationwide immunization programs—have represented key challenges for Malawi in recent years. Storms have damaged existing cold chain equipment and weakened the electric grid and transportation infrastructure in some areas, and disease outbreaks have further strained cold storage capacity. Additionally, cold chain equipment records in Malawi have commonly used a patchwork of non-standardized, web-based spreadsheets, email messages, and paper forms, which complicate data consolidation and analysis, as well as equipment allocation and maintenance.  

Because of its previous success using DHIS2 for Covid-19 surveillance and response, Malawi’s health officials decided in 2022 to use the platform to modernize its vaccine cold chain equipment (CCE) management and monitoring. Staff from the Expanded Programme on Immunization (EPI) and the Digital Health Division–with support from UNICEF Malawi–designed and tested a new CCE system in DHIS2, and trained technicians to register and manage CCE items in Tracker. Technicians then registered and tracked more than 300 total pieces of equipment across 20 districts in the span of four total weeks. The improved CCE monitoring in these districts has supported informed resource allocation and maintenance planning as technicians can now view inventory, equipment status, and transactions on their DHIS2 dashboards in real time. Inventory data that once took five years to generate is now available within five minutes.

“The cold chain equipment management system has helped us to access the cold chain inventory, know every transaction that has happened, and help in planning the next due CCE service.” Lucius Future Chisale, cold chain technical assistant, Central East Zone

Identifying workflows and key metadata inform Tracker configuration and CCE technician training 

Management of cold chain equipment in Malawi has been paper based, with some standalone electronic spreadsheet files, until very recently, according to Blessings Kamanga, a product manager with the Ministry’s Digital Health Division. He said some cold chain managers made early progress by moving to web-based spreadsheets, but that approach presented challenges as well. “For example, if you want to know stock levels, or maybe operational status, that was very difficult because it means you have to consolidate those individual files and make sure that you can do the analysis on your own in Excel. So, that was a gap,” he explained. Previously, national EPI team members would need to travel to each of the CCE facilities to generate a thorough inventory—a process that typically occurred once every five years—and now that same information can be accessed within five minutes. “Now, within five minutes, we can log in to the system and pull out the data, update the functionality status, or sync data back to the server,” Kamanga said.

An important first step to digitizing and standardizing its workflows for cold chain equipment monitoring and management, the Digital Health Division conducted a thorough review of the hard-copy forms and the various electronic spreadsheets in use. They worked to establish exactly which data items were being collected, and pinpointed the management stages of the existing workflow, which included equipment transactions, operational status, temperature monitoring, and more. “Once you’ve registered the equipment, you may need to dispatch it to some other facility, or you may need to carry out planned or corrective maintenance,” Kamanga said of the CCE processes. “We also need to know if the equipment has triggered an alarm to indicate the temperature has gone beyond the threshold, which would require some action to be taken.” 

Based on these requirements, the national team designed a process for registering and managing the equipment, and two DHIS2 technicians from the Digital Health Division developed a Tracker program, now called “eVax Cold Chain Guard,” within the national electronic vaccination (eVax) module on Malawi’s One Health Surveillance Platform. After the EPI team completed testing, staff from the Digital Health Division and EPI provided training for cold chain technicians from two targeted districts—Lilongwe and Ntchisi. They gave a brief orientation, demonstrating how to register, monitor, and manage CCE items in the system, and distributed labels with unique identifier quick response (QR) codes to support faster data entry and equipment tracking. 

National team provides oversight and support for district-level technicians for successful implementation

Following their orientation with the eVax Cold Chain Guard system in March 2024, CCE technicians from the two districts began registering equipment in their facilities—attaching the QR code labels and entering the corresponding data on mobile devices. In only three weeks, the technicians in these two districts were able to register 200 pieces of equipment in 105 facilities. A week later, those first technicians provided mentoring to technicians in 18 additional districts, who then registered another 100 pieces of equipment in one week, for a combined result of 300 items registered in a total of four weeks.

Throughout the equipment registration process in the first two districts, the national team used a group chat on a popular text messaging app for live troubleshooting and other kinds of implementation assistance, and members of the Digital Health Division  and EPI traveled to many of the CCE facilities to monitor progress and resolve any ongoing issues with equipment registration. In one case, the team discovered that some technicians using their own mobile devices for data entry were not able to upload data because of problems with a required field, and took quick action to resolve this by editing the data collection form. 

In addition to the use of personal devices for data entry, the team encountered challenges with internet connectivity at some of the more remote facilities. “We used the DHIS2 Android Capture app extensively to make sure the data is collected in those areas,” Kamanga said. While it was not possible to get real-time data in these areas due to lack of connectivity, using this app meant that users could capture the data electronically on site, then upload it to the server as soon as they had network coverage again.

Custom dashboards provide partner transparency and support data-driven resource decisions

As part of the implementation of this CCE system, the Ministry’s Digital Health Division team created dashboards and line lists within eVax Cold Chain Guard to view and analyze various data—including operational status by district, available equipment by facility, types of equipment deployed, equipment with remote temperature monitoring devices, and more. These dashboards provide new functionality for cold chain managers, with real-time insights into equipment availability, maintenance requirements, and cold chain capacity versus actual stored volume. 

“For each district, we are able to see how many pieces of equipment are functional, how many require maintenance, and how many are not functional,” Kamanga said. “If there’s a need to procure some equipment, we can easily see what kind of equipment to procure.” Because the dashboards also show the funding source for each piece of equipment, “we are able to show transparency and accountability in terms of the equipment that our donors and partners provide to the country,” Kamanga explained. This information can help donors such as Gavi, Unicef, and USAID monitor the effectiveness of their support to Malawi’s health system and prioritize areas for additional funding.

“Data inventory management is now kept in a simple and easily accessed [location] for analyzing and viewing, like CCE models, CCE volume, power usage, etc.” Anock Sinkhonde, Zonal Cold Chain Technical Assistant, South West Zone

Next steps: Expanding to other districts, integrating additional data sources, and onboarding more equipment

Since the initial stages of this CCE management digitization project, the Ministry has continued rolling out the eVax Cold Chain Guard system as part of a new, broader modernization roadmap to be implemented from 2025 to 2027. According to Kamanga, the roadmap supports the expansion of eVax Cold Chain Guard to other districts, as well as the integration of other types of data, including remote temperature monitoring data. “We are looking at carrying out orientations in those other districts, so that we can make sure all of the cold chain equipment is registered,” Kamanga said. “Some of the CCE items are equipped with remote temperature monitoring devices provided by Nexleaf, [and] the idea is to integrate that with the system we have created, so that it is automated.” Additionally, the Ministry hopes to transition the CCE monitoring system to reverse billing, and is considering expanding to include other types of equipment within the healthcare sector. 

This article is based on a presentation by Blessings Kamanga at the DHIS2 2024 Annual Conference. Watch the recording on YouTube (begins at 24:26) and view the slides on Google Drive. Hear his perspectives on this project in the video below. To learn more about DHIS2 for Logistics, visit our website.

The HISP Centre at University of Oslo invites you to join us for this quarter’s Gavi-supported DHIS2 for Immunization webinar, which focuses on leveraging DHIS2 for new and emerging vaccine deliveries. As of October 2023, WHO recommends the programmatic use of malaria vaccines for the prevention of P. falciparum malaria in children living in malaria-endemic areas, prioritizing areas of moderate and high transmission.

This webinar will feature real implementation examples demonstrating how countries are approaching these new activities and integrating the new components into their DHIS2-based Expanded Program on Immunization (EPI) programs and DHIS2 national Health Management Information Systems (HMIS) platforms.

This webinar will be conducted in English and French:

• English: Tuesday, 28 May, 14:00 CET: Registration
• French: Wednesday, 29 May, 14:00 CET: Registration

We hope that you are able to join us for this online event!

Max Krafft
Lead, DHIS2 Training & Communication group
HISP Centre
University of Oslo
dhis2.org | hisp.uio.no

The HISP Centre at the University of Oslo is pleased to invite you to join the next webinar in our DHIS2 for Immunization webinar series, delivered in partnership with Gavi. *DHIS2 for Immunization webinar: Enhancing Data Utilization and Effective DHIS2 Implementation* Join us for an informative webinar that aims to explore strategies to improve data utilization and provide practical resources for effective implementation of the DHIS2 at various administrative levels. This webinar will delve into the experiences of Rwanda and Tanzania, showcasing their successful data use initiatives, achievements, and the challenges they have encountered over the past two years. Attendees will gain valuable insights into practical approaches for improving data utilization, guidelines for effective DHIS2 implementation, and discover actionable strategies to enhance data utilization in your own healthcare systems from real-world experiences.

English: Tuesday 11 July, 14:00 – 15:30 (CEST) Register here: https://us06web.zoom.us/meeting/register/tZ0rfuitqzopEtz_-wTRXt6j-M23oLilBXpv#/registration - French: Jeudi 13 juillet 13:00 – 14:30 (T.U) Inscriptions disponibles ici: https://us06web.zoom.us/meeting/register/tZ0lfu2hpz4qGtwVQJPAZooBXVhW7yauA_vR#/registration

We hope that you are able to join us!

The HISP Centre at the University of Oslo invites you to join us for the next webinar in our Gavi-supported DHIS2 for Immunization webinar series: DHIS2 Webinar on Data Use, Denominators and Immunization In this webinar, we will highlight how the HISP groups are addressing some of the less used approaches to obtaining population denominator data for use in immunization programs.

Presentations will include:

-- HISP researchers will share findings from a systematic review of how denominator data is used in practice, with a focus on less frequently used approaches that are the most likely to identify the excluded/zero dose populations

-- HISP Rwanda will present an update on their work linking CVRS and DHIS2 for vaccination in Rwanda

-- HISP Vietnam will share how the household community survey is used in DHIS2 in Laos to identify the excluded

This webinar will be hosted separately in English and French.

English: Wednesday, 28 September, from 14:00-15:00 CET (GMT+2) - Register here: https://forms.gle/M9g4tRozhKkBH1s3A

Français: Lundi 3 octobre de 14h00 à 15h30 (T.U) - Inscrivez-vous ici: https://forms.gle/nDhVyR7GWcn2WmrbA

We hope you can join us for this online event!

Would you like to know more about using DHIS2 for disease surveillance, early warning and outbreak detection? We invite you to join us for a high-level introduction to Disease Surveillance organized by the University of Oslo which will take place on 28 April (in French) and 4 May (in English). This event is part of the DHIS2 for Immunization webinar series coordinated by the HISP Centre at UiO with support from Gavi, The Vaccine Alliance.

The webinar will feature an introduction to the design, implementation and use of WHO-approved configuration packages for integrated disease surveillance & response (IDSR) and case-based surveillance for vaccine preventable diseases (VPD) like polio, measles and meningitis. DHIS2 experts will explain key functionalities, implementation considerations and lessons learned from countries.

DHIS2 for Immunization webinar: Disease Surveillance - French - Thursday 28 April, 14-15:30 UTC. Registration form: https://docs.google.com/forms/d/e/1FAIpQLSfQhcidDgNH6EsrwBScZE0enGu1ntaKPQlXdAPgutqFn3jc9A/viewform -

English - Wednesday 4 May, 12-13:30 UTC. Registration form: https://docs.google.com/forms/d/e/1FAIpQLSdlJdqfG4oEd0KqejhIrwZvAGPqQ3KM6RN9e1JFPwE3l1nfPQ/viewform

We look forward to welcoming you to this online event.

Max Krafft Lead, DHIS2 Training & Communication group HISP Centre University of Oslo