CELEBRATING INNOVATION AND SUPPORTING PROVEN PRACTICES AT SCALE Title: From point to point systems integration to extensible Health Information Exchange Background The health sector in Tanzania, as in many other developing countries is characterized by multiplicity of fragmented health information systems silos, uncoordinated business processes, limited sharing and exchange of information across different systems and healthcare domains. While there is a number of country-wide systems serving important purposes in the health sector, but each one has been driven by needs within a particular domain of the health system, rendering it difficult to address cross-cutting needs. The overarching goal as espoused on the national eHealth strategy is to achieve a uniform national HIS application architecture built on the principle of standards for integration and interoperability that would ultimately improve data quality, increase accessibility to drive informed decision making, and thereby encourage evidence-based planning and problem solving at all levels of the health system. Rationale: Over the past three years, Tanzania made some progress in an effort to integrate various domain specific health sector-wide systems using point to point (system to system) approach., But as more and more systems are added, it becomes very complex and costly to scale and maintain. Results: In 2015, Tanzania started the implementation of her Tanzania Health information exchange, using Enterprise Architecture approach with the focus of replacing point to point integration, from client level routine health services data, to aggregated service level data, where by May 2019, total of sixteen (16) National and specialized Hospital Systems, Supply chain, Service level, Human Resources, Vaccines and Immunization health information systems were integrated through extensible health information mediator. PRESENTERS: 1. Mr. Silvanus Ilomo ICTo - MOCDGEC) Tanzania 2. Mr. Nsaghurwe Alpha Senior HIS Advisor JSI - Tanzania

With funding from the Human Development Innovation Fund (HDIF) , Dimagi implemented mLabour in eight private health facilities in Tanzania from July 2016 - January 2019. mLabour is a digital decision-support tool that helps skilled birth attendants to deliver timely and efficient evidence-based intrapartum care in low-resource settings and to quickly identify women and newborns needing closer monitoring. One of the key lessons learned through Tanzanian implementation is the benefit of leveraging private-sector approaches and champions to establish a pathway for successful sustainability and scale in the public sector, particularly in countries where the public sector and ministries of health depend on proven solutions as they move further from pilot programs. Building on this lesson, through the United States Agency for International Development, Development Innovation Ventures (USAID/DIV), Dimagi has partnered with Saatva Consulting to design and carry out a market research and analysis of the potential private and public sector markets for mLabour in Kenya, Malawi and Tanzania. This work will determine which new markets to enter, how the public health sector can effectively leverage lessons learned and adapt business models from the private sector, and will examine how the private sector can play a pivotal role in the pathway to scale in both the public and private health sectors. Dimagi will share the private sector approach designed for mLabour in Tanzania under HDIF, as well as the results of the market assessment conducted with Saatva, which will be released at the end of September.

The Kenyan health sector has numerous health information systems (HIS) innovations that lack orchestration towards integration and require robust structures and processes based on standards. To sustain gains made beyond the project life, a USAID funded project (Health Informatics Governance and Data Analytics - HIGDA) HIGDA supported the creation of Digital Health Applied Research Centre (DHARC ) within a local and indigenous higher learning institution in Kenya – Jomo Kenyatta University of Agriculture and Technology (JKUAT).as a HIS support system for the MOH to provide technical support in implementation of systems and use of health data for program management. This mechanism will contribute to efficiencies along the healthcare value chain and improve health outcomes. The presentation will discuss the journey of setting up DHARC. The MOH identified in its strategic plan 2018-2023, the need to establish two digital labs within local learning institutions to act as long term innovation centers. Support to DHARC included infrastructure, governance structures, marketing and resource mobilization, and curriculum development for skills building. JKUAT has formalized partnership with Council of Governors ((COG) the intergovernmental forum that plays a liaison role between the national and 47 county governments)), Kenya School of Government ((KSG) leadership and management training institution for public servants))., Private Sector (Huawei and Phillips), and MOH. The COG is the intergovernmental forum that plays a liaison role between the national and 47 county governments. The KSG is the leadership and management training institution for public servants. The services offered at the DHARC include skills strengthening and mentoring (Informatics, Data Analytics, Data Demand & Information Use, and Geographic Information Systems - GIS), Webinar, GIS, Systems Testing, compliance, and certification evaluation, and systems interoperability demonstration. The DHARC is a central reference lab for the MOH and will reduce further overall costs in HIS investments.