Sierra Leone’s New Digital Health Reporting System: Greater Accuracy and Timeliness

Taylor M. Snyder, MPH

eHealth Africa | Senior Technical Advisor
eIDSR training group

As eIDSR’s intended users are mostly new to smartphone use, eHA simplified the user interface and designed it to closely resemble familiar paper reporting forms. Photo: Les de Wit, Software Project Manager, eHealth Africa

eHealth Africa (eHA) is collaborating with the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and other partners to support Sierra Leone’s Ministry of Health and Sanitation (MoHS) to strengthen surveillance for all priority diseases and improve preparedness for potential public health emergencies.

eHA’s main role in the eIDSR Technical Working Group set up by the MoHS is developing and implementing a mobile electronic Integrated Disease Surveillance and Response (eIDSR) application for health care workers (HCWs). The eIDSR app improves the entire health system by allowing data to be more accurately captured at facilities, and then allowing this improved data to be shared with the district and national levels.

eIDSR was built on DHIS2, which supports the MoHS’ decision to utilize DHIS2 as the preferred health data collection tool. eHA used an open-source native app from DHIS2 and expanded its functionality to improve the submission capabilities and user interface. Each of these expanded functionalities was based on understanding the Sierra Leonean health and HCW context.

eIDSR app’s intended users are predominantly first-time smartphone technology users, so eHA simplified the user interface and designed it to closely resemble familiar paper reporting forms. Following initial trainings, members of eHA’s Global Health Informatics Team go into the field and mentor HCWs on the use of their Android phones and the eIDSR app.

eIDSR training individual

Each Android device has a practice eIDSR app that HCWs can use during training. Photo: Les de Wit, Software Project Manager, eHealth Africa

As these HCWs are typically working in areas with inconsistent access to the Internet, the application is built to automatically submit data through SMS when the connection is bad, as opposed to waiting for Internet connectivity.

Additional technical mechanisms to help users avoid mistakes include the following

  1. Mandatory Completion: The forms can’t be submitted until all areas of the form are completed.
  2. Validation: A prompt is provided to verify every entry for the immediate reportable diseases.
  3. A Practice App: Each device was designed with a practice eIDSR app that HCWs can use to gain skills without fear of submitting an actual report.

Making the eIDSR app easy to use and providing post-training mentorship is improving users’ understanding and acceptance of the tools, decreasing the frequency of reporting mistakes, and increasing the near-real-time submission of health data.

To find out more about eHA’s work building stronger health systems through the design and implementation of data-driven solutions, check out eHA’s blog!