J.5_Appendix_5.0_-_Software_Requirement_Analysis_for_eCHIS.pdf

eCHIS Requirement Analysis Document 2018 eCHIS Page 1

FEDERAL MINISTRY OF HEALTH (FMOH)

Software Requirements Analysis for electronic Health Information System(eCHIS)

[Draft] eCHIS Page 2

Contents

Document control sheet

Acronyms and definitions

1) Executive summary

2) Purpose of the document

3) Scope of the document

4) Audience

5) Reference document

6) Document structure

Part One: Review of Existing situation

7) Legal frameworks ............................................................ Error! Bookmark not defined.

8) Institutional arrangement ................................................. Error! Bookmark not defined.

9) IT Applications and Infrastructure Platform ...................... Error! Bookmark not defined.

9.1 HealthNet ................................................................. Error! Bookmark not defined.

9.2 IT applications .......................................................... Error! Bookmark not defined.

9.2.1 System one.... ...................................................... Error! Bookmark not defined.

9.2.2 System two.... ....................................................... Error! Bookmark not defined.

9.2.3 System n.... .......................................................... Error! Bookmark not defined.

Part two: Business domain of eCHIS Management System

10) Organizational structure

11) Workflows and their description

11.1 WF01 – Health Post Registration

11.2 WF02 – Kebele Profile Registration

11.3 WF03 – Gote/Village/ Registration

eCHIS Page 3

11.4 WF04 – Household Registration

11.5 WF05 – Registration of Household HEP package trainings

11.6 WF06 – Graduation Verification of Model Household

11.7 WF07 – Member Association registration

11.8 WF08 – ANC Service

11.9 WF09 – Labour and Delivery Service

11.10 WF10 – PNC Service

11.11 WF11 – Immunization Service Registration

11.12 WF12 – Immunization Defaulter Tracer Service

11.13 WF13 – Family Planning Service

11.14 WF14 – Nutrition and Growth Monitoring Service

11.15 WF15 – HIV/AIDS Service Provision

11.16 WF16 – Malaria Case Detection and Treatment Service

11.17 WF17 – Tuberculosis (TB) Detection and Treatment Service

11.18 WF18 – Neglected Tropical Diseases (NTD) Mass Drug Administration (MDA). 58

11.19 WF19 – NTD Screening and Referral

11.20 WF20 – None Communicable Disease (NCDs) Risk Assessment

11.21 WF21 – None Communicable Disease (NCDs) Screening and Management

11.22 WF22 – Logistic supply and Management

12) Details of transaction

12.1 TRN-01: Registration of Health Post

12.2 TRN-02: Registration of Health Post Staff

12.3 TRN-03: Registration of School

12.4 TRN-04: Registration of Religious Institute

eCHIS Page 4

12.5 TRN-05: Registration of Agricultural Department Agent

12.6 TRN-06: Registration of slaughter houses

12.7 TRN-07: Registration of market place

12.8 TRN-08: Registration of Youth Centre

12.9 TRN-09: Registration of Association

12.10 TRN-10: Registration of trained traditional birth attendants

12.11 TRN-11: Registration of community health worker

12.12 TRN-12: Registration of Communal Latrine

12.13 TRN-13: Registration of Gote/Village/

12.14 TRN-14: Registration of House Identification

12.15 TRN-15: Registration of Household Member

12.16 TRN-16: Registration of Household Characteristics

12.17 TRN-17: Household HEP package training Registration

12.18 TRN-18: Graduation Verification of Model Household

12.19 TRN-19: Member Association Registration

12.20 TRN-20: Pre-follow up information registration

12.21 TRN-21: Pregnancy ANC follow up information registration

12.22 TRN-22: Birth Preparedness plan

12.23 TRN-23: General information about labouring mother

12.24 TRN-24: Follow up of Labour

12.25 TRN-25: Delivery outcome

12.26 TRN-26: PNC Service Registration

12.27 TRN-27: EPI Service Registration

12.28 TRN-28: HPV Service Registration

eCHIS Page 5

12.29 TRN-29: TT Service Registration

12.30 TRN-30: Immunization Defaulter Tracer Service

12.31 TRN-31 Family Planning Service Registration

12.32 TRN-32 Family Planning method Switch

12.33 TRN-33 Long Acting Family Planning (LAFP) Removal

12.34 TRN-34 Growth Monitoring for under two age of children

12.35 TRN-35 Nutrition screening for under age of Five Children

12.36 TRN-36 Nutrition screening for Pregnant and Lactating Women

12.37 TRN-37 Nutrition Treatment

12.38 TRN-38 HIV Testing and Counselling (HTC) registration

12.39 TRN-39 ART Follow Up registration

12.40 TRN-40 PLHIV Care and Support registration

12.41 TRN-41 Orphan Care and Support registration

12.42 TRN-42 Post Exposure prophylaxis registration

12.43 TRN-43 Malaria case detection and Treatment Registration

12.44 TRN-44 Malaria Larva Control Registration

12.45 TRN-45 Adult Mosquito Control Registration

12.46 TRN-46 TB Screening and Referral

12.47 TRN-47 TB Diagnosis and Medication

12.48 TRN-48 TB Treatment and Follow up

12.49 TRN-49 IPT Follow up

12.50 TRN-50 Mass Drug administration (MDA)

12.51 TRN-51 LF and Podoconiosis Screening and Referral

12.52 TRN-52 Trachomatous Trichiasis Screening and Referral

eCHIS Page 6

12.53 TRN-53 Schistosomiasis (SCH) Screening and Referral

12.54 TRN-54 Soil transmitted helminthiasis(STH) Screening and Referral

12.55 TRN-55 Visceral leshmaniasis(VL) Screening and Referral

12.56 TRN-56 Cutaneous Leshamniasis Screening and Referral

12.57 TRN-57 Scabies Screening and Referral

12.58 TRN-58 Guinea worm Screening and Referral

12.59 TRN-59 NCD Risk Assessment

12.60 TRN-60 CVDs Screening and Referral

12.61 TRN-61 Diabetes Screening and Referral

12.62 TRN-62 Asthma and COPD Screening and Referral

12.63 TRN-63 Breast Cancer Screening and Referral

12.64 TRN-64 Cervical Cancer Screening and Referral

12.65 TRN-65 Mental illness Screening and Referral

12.66 TRN-66 Epilepsy Screening and Referral

12.67 TRN-67 Eye Health Screening and Referral

12.68 TRN-68 Requisition of pharmaceutical Items

12.69 TRN-69 Pharmaceutical Item distribution and Stock at hand management

Part Three: eCHIS Software Requirements

13) General requirements to eCHIS

13.1 Security of transactions

13.2 Consistency and Reliability

13.3 Handling of transaction status

13.4 Language support

13.5 Local time support

eCHIS Page 7

13.6 Local date support

13.7 Linking and integration

13.8 Navigation options

13.9 Clear messages

13.10 Constructive messages

13.11 Integrated help

13.12 Field for notes and comments

13.13 Integration with external systems

14) Functional Requirements

14.1 Family Household functionality

1.1.1 functionality xxxx

1.1.2 yyyyy

14.2 Maternal, Child health and Nutrition functionality

1.1.3 functionality xxxx

1.1.4 yyyyy

14.3 Disease Prevention and Control functionality

1.1.5 functionality xxxx

1.1.6 yyyyy

14.4 Logistic supply and Management functionality

1.1.7 functionality xxxx

1.1.8 yyyyy

15) Federal, Regional and Zone level requirements

1.2 Publication of information in the web portal at federal level

1.3 Publication of information in the web portal at regional level eCHIS Page 8

1.4 Publication of information in the web portal at zone level

1.5 Publication of information in the web portal at woreda level

1.6 Audit tools at federal level

1.7 Analytics

16) Security requirements

1.1 Access control

1.2 Directory browsing

1.3 User authentication

1.4 Systems Authentication

1.5 Password complexity

1.6 Password expiration period

1.7 Password changing process

1.8 Password usage and storing method

1.9 Change password at first login

1.10 User management

1.11 User Account Management

1.12 Groups

1.13 Access control list

1.14 List of online users

1.15 Automatic logout

1.16 Number of login attempts

1.17 Input Validations

1.18 Data Security

1.19 Logging

eCHIS Page 9

1.20 Event Management methodology

1.21 Audit trials

List of tables

Table 1: responsibilities and tasks of the different roles

List of figures

Document control sheet Project Details

Project Name: Electronic Community Health Information System(eCHIS)

Date: 20/12/2017 Release: Draft

Author: Federal Minister of Health (FMOH)

Client:

Document Number: eCHIS-RAD-01

Revision History

Revision Date Document version

Change summary

16/01/2018 1.0

20/01/2018 1.1

Approvals

This document requires the following approvals.

Name Signature Title Date of Issue Version

------ 1.0

------ Project manager 1.0 eCHIS Page 10

Acronyms and definitions ARI Acute Respiratory Infection ANC Antenatal Care API Application Programming Interface ARM Annual Review Meeting ART Antiretroviral Therapy BCG Bacilli Calmette-Guerin BMI Body Mass Index BP Blood Pressure BPR Business Process Reengineering CPR Contraceptive Prevalence Rate CSA Central Statistical Authority DFF Digital Family Folder DOB Date of Birth DQA Data Quality Assessment EC Emergency Contraception eCHIS Electronic Community Information system eHMIS Electronic Health Management Information System EMR Electronic Medical Records EPI Expanded Program on Immunization FeC Female Condom FHB Fetal Heart Beat FHT Family Health Team FMOH Federal Ministry of Health FP Family Planning GTP Growth and Transformation Plan GUI Graphical user Interface HC Health Center HCO Health Center Officer HEP Health Extension Program HEPD Health Extension Program Directorate HEW Health Extension Workers HF Health Facility HI Health Institution HITD Health Information Technology Directorate HIV/AIDS Human Immune Virus/ Acquired Immune Deficiency Syndrome HMIS Health Management Information System HP Health Post HRIS Human Resource Information System HSDP Health Sector Development Program eCHIS Page 11

HSEP Health Sector Extension Program IDSR Integrated Disease Surveillance and Response Inj Injectable IRS Indoor Residual Spray IRT Integrated Refresher Training ITNs Insecticide Treated Nets KPI Key Performance Indicator LLIN Long-lasting insecticidal nets LLIT Ns Long Lasting Insecticide Treated Nets LMP Last Menstrual Period LQAS Lot Quality Assurance Sampling M&E Monitoring and Evaluation MaC Male Condom MD Medical Director MDG Millennium Development Goal MFR Master Facility Registry MUAC Mid Upper Arm Circumference NCD Non-Communicable Disease NGO Non Governmental Organization NR Non Reactive OC Oral Contraceptive OPD Out Patient Department OPV Oral Polio Vaccine Penta Pentavalent PHCU Primary Health Care Unit PIHCT Provider-Initiated HIV Counseling and Testing PLWHA People Living With HIV/AIDS PMTCT Prevention of Mother to Child Transmission PPD Policy and Planning Directorate PRT Performance Review Team R Reactive RDQA Routine Data Quality Assessment RHB Regional Health Bureau STD Sexually Transmitted Disease STI Sexually Transmitted Infections TB Tuberculosis TIN Tax Identification Number TT Tetanus Toxoid TWG Technical Working Group UN United Nations eCHIS Page 12

VCT Voluntary HIV Counseling and Testing VF Verification Factor VIP Ventilated Improved Pit WHO World Health Organization WorHO Woreda Health Office ZHD Zonal Health Department eCHIS Electronic Community Health Information System eCHIS Page 13

1) Executive summary The main aim of the project is to deliver an Electronic Community Health Information

System, called eCHIS. This document provides the specification for the Electronic

Community Health Information System.

The main objective of the requirements analysis of eCHIS is to analyze the existing system and define the future system. The future system definition contains the organizational structure of concerned sectors (like Health Posts), the business processes to be implemented in such sectors (like Health Posts offices) as well as the software related requirements. In other words the requirements analysis document covers issues at the organizational level and software level.

The document contains the result of the requirements analysis work package. The document is organized into three parts. The first part covers the existing situation. The second part of the document provides the business solution for the eCHIS in terms of organizational structure and business processes. The third and final part of the document contains issues related to the software specific requirements.

2) Purpose of the document The requirements analysis document has the following purposes.

• To define and create common agreement on the workflows and transactions supported by eCHIS

• To define and create common agreement on the functionalities provided by eCHIS

• To create a specification document for the product/solution called eCHIS.

Once the requirements analysis document (RAD) is accepted any change to its contents will be handled through a formal change management procedure.

3) Scope of the document The document covers the following issues

• The organizational structure of the service deliverer offices eCHIS Page 14

• Workflows and transactions supported by Rural eCHIS

• Technical requirements of eCHIS

4) Audience The document is intended to be read and used by:

• FMOH

• System architects

• Software developers

• QA/QC personnel

• Project Manager

5) Reference document During the preparation of the requirements analysis the following documents have been reviewed and used as an input.

• Rural PHC Reform Guideline, Federal Ministry of Health

• Community Health Information System Data Recording and Reporting User’s

Manual, FMOH ,2011

• HMIS Indicator Reference Guide: Technical Standards Area 1, FMOH, Aug 2017

• CHIS user's Manual 2nd Generation HEP Package Indicator formats FMOH ,2017

• Software Requirements Specification for electronic Health Information

System(eCHIS) (Draft) ,Aug 2016

• Urban PHC Reform Guideline, Federal Ministry of Health

6) Document structure For ease of readability purpose the document has been structured as follows.

• Part One: contains a review of the existing situation.

eCHIS Page 15

• Part Two: contains the business domain of eCHIS, which includes the organizational structure, workflows and transactions supported by eCHIS.

• Part Three: contains the requirements of eCHIS, which includes functional requirements and security requirements.

eCHIS Page 16

Part One: Review of Existing situation To be added later eCHIS Page 17

Part two: Business domain of eCHIS Management System The following section describes the organizational structure and business processes to be followed in the health service offices. The business domain description will be the basis for defining the system requirements of eCHIS.

7) Organizational structure <what are the beneficiaries of eCHIS? Are the existing organizational structure enough for the intended objective? >.

• It helps to know the different roles that will exist in community health service offices.

These roles will participate in a workflow and their associated transactions that support the different services provided by such offices.

• It helps to define the competencies and qualification of the people that will be assigned to each role.

• It helps in defining the training modules and evaluation schemes.

• It helps in localizing the eCHIS to a given process flow and structure

The community health service office organizational structure looks like the following diagram.

Figure 1: Community Health Service organizational structure

The tasks and responsibilities of the different roles described in the diagram above are described in the table here below.

Role Responsibility

Table: responsibilities and tasks of the different roles xxx yyy kkk rrr ccc sss eCHIS Page 18

8) Workflows and their description This section contains all the workflows and associated transactions supported by eCHIS.

8.1 WF01 – Health Post Registration

Technical Details

Workflow Code WF01

Workflow Name Health Post Registration

Type of workflow Primary

Purpose:

Health posts are the primary health care units and the first level for the provision of health care for the community, emphasizing preventive and promotive care. They are the operational centre for HEP. This workflow describes the process of registering Health Post data using eCHIS.

Supported Transactions:

• Registration of Health Post data

Participants

• Woreda Health Office (WorHO)

Preconditions

• Facility information (Health Centre) already available for eCHIS, i.e, Health Centre information will be offered by other Facility Management System.

• Address information (Kebele, Woreda, Zone, and Region) already available for eCHIS, i.e, necessary address information will be offered by other system.

Flow of activities

1) WorHO Collects detail information about the Health Post.

2) WorHO will verify that the Kebele and Health Centre information where the newly

Health Post belongs is available.

3) WorHO enters detail data for the Health Post using eCHIS.

eCHIS Page 19

Variants

Exceptions

• At step 2, if Kebele information is not available, then the WorHO will stop the registration and notifies the concerned body for the registration of Kebele information.

• At step 2, if Health Centre information is not available, then the WorHO will stop the registration and notifies the concerned body for the registration of Health Centre information.

• At step 3 if the HP is already available in eCHIS, the HEW will update its data.

Links to other workflow

Input

Output

• Detail of Health Post information is recorded in to eCHIS.

BPMN2.0 diagram

Business Process Health Post Registration WF

W or ed a

H ea lt h

O ff ic e

Fa ci lt y an d

A dd re ss

Sy st em

Start

Collect HP Necessary Data

Verify completeness of data

GetParent Facility Information

Get Parent Kebele Information

Is complete?

Record HP Detail data eCHIS

End

Reject

No

Yes eCHIS Page 20

8.2 WF02 – Kebele Profile Registration

Technical Details

Workflow Code WF02

Workflow Name Kebele Profile Registration

To capture data on potential resources in the kebele that can be useful for provision and promoting health and health related activities. This workflow shows the steps needed to identify and document possible Kebele resources, their associated characteristics and record their data using eCHIS.

Supported Transactions:

• Registration of Schools

• Registration of Religious institutes

• Registration of agricultural department agents

• Registration of trained traditional birth attendants

• Registration of community health workers

• Registration of slaughter houses and market places

• Registration of Youth Centres

• Registration of Associations

• Registration of Communal Latrine

Participants

• Kebele administration personnel

• HEW

• Kebele Institutions (Schools, Associations, Youth Centres, Religious, etc)

Preconditions eCHIS Page 21

• None

Flow of activities

1) The HEW requests the Kebele administration about data related to resources in that particular Kebele.

2) The Kebele administration personnel will provide the necessary Kebele resources to

HEW.

3) The HEW captures and records kebele resource data obtained from kebele administration personnel or she may visit each kebele institution and collect the required data about the particular institute

4) The HEW records data obtained from the kebele administration and from each institution using eCHIS.

Variants

Exceptions

• At step 3, if all the required data could not be obtained from kebele administration, then the HEW will visit each kebele institutes (Schools, Religious institutes, ....) and captures the necessary data.

Links to other workflow

• None

Input

• None

Output

• Resources in the specified kebele are properly recorded in to eCHIS.

eCHIS Page 22

8.3 WF03 – Gote/Village/ Registration

Workflow Code WF03

Workflow Name Gote/Village/ Registration

This workflow shows the steps needed to identify and record possible Gotes/Villages/ using eCHIS.

Supported Transactions:

• Registration of Gote

Participants

• HEW

• Kebele Administration Personnel

Preconditions

Business Process Kebele Profile Registration WF Ke be le

P ro fi le

R eg is tr at io n

H

EW

Ke be le A dm in is tr at io n Pe rs on ne l

Ke be le In st it ut es

Start

Request Kebele Resource Data

Offer Kebele resrouce data

Check data completeness

Is data complete?

Record to eCHIS

Request adequate data

Offer institue related data eCHIS

End eCHIS Page 23

• Kebele Information should exist in eCHIS

1) The HEW in collaboration with Kebele Administration personnel collects necessary data about Gotes in the catchment Kebele.

2) The HEW records detail information of the Gote using eCHIS.

Variants

Exceptions

• None

Links to other workflow

• The output of Gote registration will be used as input data for the household registration workflow

Input

Output

• Gote information is recorded in to eCHIS.

Business Process Gote Registration WF

H

EW

Ke be le A dm in is tr at io n

O th er S ys te m

Start Collect Gote data

Data Complete?

Record Gote data eCHIS

End

Get Kebele Information

Send Gote Info

Yes

Request Additional Gote Info eCHIS Page 24

8.4 WF04 – Household Registration

Workflow Code WF04

Workflow Name Household Registration

Household information such as household characteristics, household package training and implementation are useful for the HEW to identity health service needs of the family. Hence this workflow describes the process by which the household information for a given household is processed using eCHIS.

Supported Transactions:

• Registration of Household Identification

• Registration of Household Member

• Registration of Household characteristics

• Registration of Household HEP package implementation status

Participants

• Household owner

• HEW

Preconditions

• Gote/Village/ information should be found in eCHIS.

Flow of activities

1) The HEW will visit the household to collect required household related data

2) The HEW asks the household head about detail information about each household related information

3) The household representative offers the required information to the HEW.

eCHIS Page 25

4) The HEW will check the completeness of the information.

5) If there are missing data, the household representative will fulfil the missing data about the household

6) If the information is obtained is up to the standard, the HEW will record such information to eCHIS.

Variants

Exceptions

• At step 4 if the data quality is not up to the standard (if not complete) it will not be recorded.

Links to other workflow

• The output of household registration will be used as input data for other workflows

Input

• None

Output

• Household related data in the specified household is properly recorded in to eCHIS.

Business Process Household Registration WF

H

EW

H ou se ho ld Re pr es en ta ti ve

Start

Get Household data

Data Complete?

Record Household data End eCHISReject

No

Offer Household dataRequest Household data eCHIS Page 26

8.5 WF05 – Registration of Household HEP package trainings

Workflow Code WF05

Workflow Name Registration of Household HEP package trainings

Different types of the community members take training on household HEP packages. .

Hence this workflow describes the process by which the household HEP package training is processed using eCHIS.

Supported Transactions:

• Registration of Household HEP package trainings

Participants

• HEW

• WDA

Preconditions

• WDA should be member of the registered household in the catchment area

• The WDA should be 1:5 network leader or 1:30 team leader

Flow of activities

1) The HEW fixes and announces the training start and end date.

2) The HEW selects candidate trainers (WDA Leaders or 1 to 30 leaders)

3) The HEW offers package training for WDA.

4) The HEW records necessary information in relation to the training to eCHIS.

Variants

Links to other workflow eCHIS Page 27

• The output of Household HEP package trainings registration will be used as input data for the Model Household Graduation Verification workflow

Input

• None

Output

• HEP Training is offered to WDA and/or 1 to 30 leaders and necessary information is recorded in to eCHIS.

8.6 WF06 – Graduation Verification of Model Household

Workflow Code WF06

Workflow Name Graduation Verification of Model Household

The Purpose of this process is to verify households practice of HEP packages and determines if the household fulfils the criteria for model household graduation based on an already set up criteria. Hence this workflow describes the process by which the graduation verification of Model Household can be processed using eCHIS.

Supported Transactions:

Business Process Household HEP package trainings WF

H ou se ho ld H

EP

p ac ka ge t ra in in gs

W F

H

EW

Start

Select Training Candidates

Offer Training

End eCHIS

Training Title Start Date Participant Detail Training Place Training Completion date eCHIS Page 28

• Graduation Verification of Model Household

Participants

• HEW

• WDA

• Candidate Household

Preconditions

• Should be reported by WDA as candidate for model household

Flow of activities

1) The WDA reports the candidate household for model household graduation

2) The HEW checks practices of each HEP package as per the standard using eCHIS.

3) Depending on the completeness, the HEW labels each HEP packages as Practicing or Not Practicing or Not Applicable using eCHIS.

4) Those households which scores Practicing and/or Not applicable for all HEP packages will be graduated as model household by the HEW.

5) The HEW notifies the model household head

Variants

Exceptions

Links to other workflow

• None

Input

• None

Output

• Model households which are proposed by WDA are verified as model household or not.

eCHIS Page 29

8.7 WF07 – Member Association registration

Workflow Code WF07

Workflow Name Member Association Registration

Each Household is expected to be member of WDA and each WDA will also be grouped into

1 to 30 network. Moreover, Households might have CBHI membership registration. Hence this workflow describes the process by which membership is processed using eCHIS.

Supported Transactions:

• Member association registration

Participants

• HEW

• Household head

Preconditions

• Should be registered as household member in eCHIS

Business Process Graduation Verification of Model Household WF

H

EW

W D

A

Candidate announced

Start assessing candidate model household Quarterly

Check HEP package statusStart assessing candidate model household Quarterly

Candiate Household data eCHIS

Practiced all HEP packages?

Graduated Model

Household End

Reject

Yes

Notify Model Household eCHIS Page 30

1) The HEW creates appropriate membership types using eCHIS

2) The HEW identifies the household member for each membership type using eCHIS

3) The HEW registers the identified household member with the corresponding membership type using eCHIS

Variants

Exceptions

Links to other workflow

• The output of Member Association Registration will be used as input data for the

Registration of Household HEP package trainings workflow

Output

• Appropriate Member Association Registration is registered

8.8 WF08 – ANC Service

Business Process Member Association Registration WF

H EW Start

Check Membership Type Existence eCHIS

Membership Type Exist?

Register Household Membership

End

Register Membership Type eCHIS Page 31

Workflow Code WF08

Workflow Name ANC Service

To identify and provide Pregnant mothers with in the kebele Focused longitudinal ANC care.

This workflow describes the necessary steps required to identify the pregnant mothers, decided whether she is eligible for FANC, Capture all necessary information during ANC service provision and any referral information with feedback and record using eCHIS.

Supported Transactions:

• Pre-follow up information registration

• Pregnancy ANC follow up information registration

• Birth preparedness

Participants

• Pregnant Women

• HEW

• WDA

• Partner of Pregnant Women

• Referral Facility

Preconditions

• Pregnant mother should be member of registered household.

• The women should be pregnant

Flow of activities

1) The pregnant women will go to the service site

2) The HEW verifies that the pregnant women is already a registered household member in the catchment area eCHIS Page 32

3) The HEW collects necessary information from the pregnant women and eCHIS

4) The HEW will provide necessary service for the pregnant women and possibly her partner and register important data using eCHIS

5) The pregnant will start pregnant follow up

6) The HEW will give the next follow up appointment using eCHIS

Variants

Exceptions

• At step 1, if the women is not in the intended catchment area, the HEW gives the service (counsel, attendant the delivery, treat and or refer) accordingly and necessary data will be recorded in eCHIS.

• Step 2: if the labouring mother has family folder but she is not member of that family folder, the HEW will register her as family member

• Step 2: if the labouring mother has no household information, the HEW creates the household information

• Step 4: In case of complication, the HEW refers the mother to referral facility

Links to other workflow

• The output of ANC Service will be used as input data for the Labour and delivery services workflow

Input

• None

Output

• The pregnant woman is identified, the necessary information is recorded into eCHIS and the FANC is started.

eCHIS Page 33

8.9 WF09 – Labour and Delivery Service

Workflow Code WF09

Workflow Name Labour and Delivery Service

The purpose of this service is to prevent maternal and neonatal deaths during labour and delivery. This workflow describes the necessary steps required for mothers undergoing labour and delivery and recording of necessary information using eCHIS.

Supported Transactions:

• General information about labouring mother

• Follow up of labour

• Delivery outcome

Business Process ANC Servie WF

A N

C Se rv ic e W

F H

EW

Re fe ra l F ac ili ty Pr eg na nt W om en

Pregnant Woment Arrived

Check if Household Member eCHIS collects necessary information provide necessary service

Record offered services

Household Memeber?

eCHIS End

Wait until membership registration

Perform refered activity eCHIS

Notify Next appointment time

Need Refereal?

No eCHIS Page 34

• Pregnant Women

• HEW

• Referral Facility

Preconditions

• The woman should be in labour

• The women should be found inside the registered Household as household member.

Flow of activities

1) The labouring women will go to the service site

2) The HEW verifies that the labouring women is already a registered household member in the catchment area using eCHIS

3) The HEW checks pregnancy related information from the pregnant women’s ANC service using eCHIS

4) The HEW assists the delivery of normal labour

5) The HEW links the mother and the new-born to PNC service ( basic care for the mother and the new-born)

6) The HEW records necessary information using eCHIS

7) The HEW will give the next follow up appointment using eCHIS

Variants

Exceptions

• At step 2, if the women is not in the intended catchment area, the HEW gives the service (counsel, attendant the delivery, treat and or refer) accordingly and record the information using eCHIS

• Step 2: if the labouring mother has no household information, the HEW creates the household information using eCHIS eCHIS Page 35

• Step 3: if the labouring mother did not have ANC service information, the HEW registers the labouring mother using eCHIS

• At step 4: In case of false labour, the HEWs counsels the mother to go to waiting home/area

• Step 4: In case of complication, the HEW refers the mother to referred Facility Links to other workflow

• The output of Labour and Delivery Service will be used as input data for the PNC workflow

Input

• None

Output

• The output of this workflow is to provide delivery service that can prevent maternal and neonatal morbidity and mortality.

eCHIS Page 36

8.10 WF10 – PNC Service

Workflow Code WF10

Workflow Name PNC Service

The purpose of PNC service is to prevent maternal and neonatal deaths during the postnatal period, and to provide counselling and necessary services for the mother and the new-born.

This workflow describes the information required for the mother and the new-born during the postnatal period and recording of important information using eCHIS.

Supported Transactions:

• PNC service registration

Participants

Business Process ANC Servie WF

La bo r an d D el iv er y

Se rv ic e

W F

H

EW

Re fe ra l F ac ili ty La bo ri ng W om en

Laboring Women Arrived

Check if in the catchment area eCHIS collects necessary information provide necessary service

Record offered services

In the catchment area?

eCHIS

End

Wait until membership registration

Perform refered activity eCHIS

Women's personal info

Check Household Memeber

Household Memeber?

eCHIS eCHIS

No

Yes

Yes No

Yes

Notify for PNC

Need Refereal?

eCHIS Page 37

• Postnatal Women

• HEW

• Referral Facility

Preconditions

• Women in the postnatal period

• The women should be found inside the registered Household as household member.

Flow of activities

1) The postnatal women will go to the service site or the HEW may visit the postnatal women at home.

2) The HEW verifies that the postnatal women is already a registered household member in the catchment area using eCHIS

3) The HEW checks delivery related information from the women’s pre-natal and postnatal services using eCHIS

4) The HEW assesses the postnatal women’s detail information and offers the PNC service for the mother and new born

5) The HEW records necessary information using eCHIS

6) The HEW will record the next PNC service appointment using eCHIS and notifies the postnatal woman

Variants

Exceptions

• At step 2, if the women is not in the intended catchment area, the HEW gives the service (counsel, attendant the delivery, treat and or refer) accordingly and record the information using eCHIS

• Step 2: if the mother has no household information, the HEW creates the household information and update her household membership information using eCHIS eCHIS Page 38

• Step 3: if the postnatal mother did not have prenatal and deliver service information, the HEW creates new PNC service registration for the mother using eCHIS

• Step 4: In case of complication, the HEW refers the mother to referred Facility Links to other workflow

• The output of PNC Service will be used as input data for the Expanded Programme on Immunization(EPI) workflow

Input

• None

Output

• Appropriate delivery service that can prevent maternal and neonatal morbidity and mortality is provided and also necessary information is captured and entered using eCHIS.

Business Process PNC Service WF

PN

C

Se rv ic e

W F H

EW

Re fe ra l F ac ili ty

Po st na ta l W om en

Postnatal Woment Arrived

Check if in the catchment area eCHIS collects necessary information provide necessary service

Record offered services

In the catchment area?

eCHIS

End

Wait until membership registration

Perform refered activity eCHIS

Women's personal info

Check Household Memeber

Household Memeber?

eCHIS eCHIS

Need Refereal?

No NoYes

Notify next appointment

Yes

Yes http://www.who.int/immunization/programmes_systems/supply_chain/benefits_of_immunization/en/ eCHIS Page 39

8.11 WF11 – Immunization Service Registration

Workflow Code WF11

Workflow Name Immunization Service Registration

This workflow describes the necessary steps required to identify eligible age groups for immunization, capture all necessary information during service provision or any referral information about EPI, TT, and HPV vaccination service and record using eCHIS.

• EPI service registration (including immunization and AEFI counselling)

• HPV service registration

• TT service registration

Participants

• Client for vaccination

• HEW

• Referral Facility

Preconditions

• The client should eligible for a particular vaccination

• The client should be found inside the registered Household as household member.

Flow of activities

1) The client will go to the service site or the HEW may visit the client at home, school, or outreach.

2) The HEW verifies that the client is already a registered household member in the catchment area using eCHIS eCHIS Page 40

3) The HEW checks the client’s previous health and immunization history using eCHIS

4) The HEW assesses and provide the required immunization service for the client

5) The HEW records necessary information using eCHIS

6) The HEW will record the next immunization service appointment using eCHIS and notifies the client (care giver)

Variants

• At step 4, if the client is new born the following procedures will be followed o The HEW will check the previous (BCG, OPV, Penta, PCV and Measles) immunization history from eCHIS o If there is remaining antigen which is not taken by the new born, the HEW will decide which vaccine dose is required o The HEW will provide the vaccine o If the new born completed all the antigens required before his/her first year, the eCHIS will mark the infant as fully immunized

• At step 4, if the client is new born and the mother already received TT2 and above, the eCHIS will mark the infant as Protected at Birth Against Tetanus(PAB)

• At step 4, if the client is eligible 9-14 aged girls, the following procedures will be followed o The HEW will check the previous Human papilloma virus (HPV) immunization history from eCHIS o If there is remaining antigen which is not taken by the girls, the HEW will decide which vaccine dose is required (HPV1, HPV2) o The HEW will provide the vaccine

• At step 4, if the client is in the reproductive age group(15-19 age) women, the following procedures will be followed o The HEW will check the previous Tetanus Toxoid (TT) immunization history from eCHIS o If there is remaining antigen which is not taken by the women, the HEW will decide which vaccine dose is required (TT1, TT2, TT3, TT4, TT5) o The HEW will provide the vaccine eCHIS Page 41

• At step 2, if the client is not in the intended catchment area, the HEW gives the service (counsel, attendant the delivery, treat and or refer) accordingly and record the information using eCHIS

• Step 2: if the client has no household information, the HEW creates the household information and the household membership information using eCHIS

• Step 4: In case of complication, the HEW refers the client to referred Facility

Links to other workflow

• None

Input

• None

Output

• Appropriate Immunization service is provided for the appropriate clients and the necessary information is captured and entered using eCHIS.

Business Process Immunization Service Registration WF

Im m un iz at io n Se rv ic e Re gi st ra ti on W

F

H

EW

Re fe ra l F ac ili ty Cl ie nt f or

V ac ci na ti n

Vaccinatin Request Arrived

Check if in the catchment area eCHIS check previous immunization history provide necessary service

Record offered services

In the catchment area?

eCHIS

End

Wait until membership registration

Perform refered activity eCHIS

Client's personal info

Check Household Memeber

Household Memeber?

eCHIS eCHIS

Yes

Notify next appointment

Yes

No No eCHIS Page 42

Sub Process of “provide necessary service”

8.12 WF12 – Immunization Defaulter Tracer Service

Workflow Code WF12

Workflow Name Immunization Defaulter Tracer Service

This workflow describes the necessary steps required to identify individuals who missed vaccines, provide all the missed vaccines, capture all necessary information during service provision or any referral information, and record the service using eCHIS.

• Immunization Defaulter Tracer Service

Participants

Business Process provide necessary service

Type of Client check previous (BCG, OPV, Penta, PCV and

Measles) remaining antigen? Provide appropriate vaccine (BCG, OPV, Penta, PCV and

Measles) completed all antigens on time?

mark the infant as fully immunized mother received

TT2 or greater?

mark the infant as

(PAB)

Start

End check previous HPV remaining antigen?

Provide appropriate vaccine (HPV1, HPV2)

End check previous TT remaining antigen? Provide appropriate vaccine (TT1, TT2, TT3, TT4, TT5)

End

End

No

Yes age group(15-19 age) women?

Yes client is 9-14 aged girls?

Yes

No

Yes

No

No

New born eCHIS Page 43

• Defaulter

• WDA

• HEW

• Referral Facility

Preconditions

• The Defaulter previous immunization history is already recorded in eCHIS

• The Defaulter should have previously started immunization and missed the next vaccination.

Flow of activities

1) The eCHIS will notify the HEW/Defaulter/WDA/ about Defaulter (who missed the vaccine).

2) The Defaulter will go to the service site (by himself or with the support of WDA, referred from other health service facility) or the HEW may visit the Defaulter

3) The HEW verifies that the Defaulter is already in the catchment area using eCHIS

4) The HEW checks the Defaulter’s previous health and immunization history using eCHIS

5) The HEW assesses the previous information and provide the required immunization service for the Defaulter

6) The HEW records necessary information using eCHIS

7) The HEW will record the next immunization service appointment using eCHIS and notifies the Defaulter (or care giver)

Variants

Exceptions

• At step 3, if the client is not in the intended catchment area, the HEW gives the information using eCHIS eCHIS Page 44

• Step 3: In case of complication, the HEW refers the client to referred Facility

Links to other workflow

• None

Input

• None

Output

• The Defaulter is identified, immunization service is given, the required information is entered using eCHIS.

8.13 WF13 – Family Planning Service

Workflow Code WF13

Workflow Name Family Planning Service

Business Process Immunization Default Tracer Service WF

Im m un iz at io n D ef au lt er

T ra ce r

Se rv ic e

W F

H

EW

Re fe ra l F ac ili ty D ef au lt er

Defaulter noticed

Check if defaulter is in the catchment area eCHIS collect previous health related information provide missed vaccine

Record offered services

In the catchment area?

eCHIS

End

Perform refered activity eCHIS

Defaulter personal info eCHIS

Notify next vaccine date

Yes

Need Referal?

eCHIS Page 45

To plan the timing, spacing and number of children that families should have, prevent unintended pregnancy and abortion and maternal deaths, provide counselling and necessary services for the woman and her partner. This workflow describes the steps required for the woman and her partner that are eligible for family planning services, capture all necessary information during service provision, and record the offered service using eCHIS.

• Family Planning Service Registration

• Family Planning method Switch

• Long Acting Family Planning (LAFP) Removal Participants

• Client (woman or man in reproductive age group)

• WDA

• HEW

• Referral Facility

Preconditions

• Should be found inside the registered Household as household member

• The women or man shall be in reproductive age group

• If client is women, then she should not be pregnant

Flow of activities

1) The client will go to the service site or the HEW may visit the client at home, school, or outreach.

2) The HEW verifies that the client is already a registered household member in the

3) The HEW checks the client’s previous family planning history using eCHIS eCHIS Page 46

4) The HEW assesses and provide the required family planning service for the client

5) The HEW records necessary information using eCHIS

Variants

Exceptions

• At step 2, if the client is not in the intended catchment area, the HEW gives the service (counsel, attendant the delivery, treat and or refer) accordingly and record the information using eCHIS

• At step 2, if the client is not registered as household member, he/she should be registered using eCHIS

• Step 3: In case of complication, the HEW refers the client to referred Facility

Links to other workflow

• None

Input

• None

Output

• Family Planning service is given; the required information is entered using eCHIS.

eCHIS Page 47

8.14 WF14 – Nutrition and Growth Monitoring Service

Workflow Code WF14

Workflow Name Nutrition and Growth Monitoring Service

The purpose of this workflow is to identify and monitor the nutritional status and promote healthy feeding behaviour of under two and under five children, pregnant and lactating woman in the catchment area and record necessary information using eCHIS.

Supported Transactions:

• Growth monitoring for under age of two children

• Nutrition screening for under age of five children

• Nutrition screening for pregnant woman and lactating woman

• Nutrition treatment

Participants

Business Process Family Planning Service WF

Fa m ily P la nn in g

Se rv ic e

W F

H

EW

Re fe ra l F ac ili ty Fa m ily

P la nn in g Cl ie nt

Check if in the catchment area eCHIS collect previous health related information provide required FP service

Record offered services

In the catchment area?

eCHIS

End

Wait until membership registration

Perform refered activity eCHIS

Client's personal info

Check Household Memeber

Household Memeber?

eCHIS eCHIS

Start

Yes

Yes

Yes

No

Notify next appointment eCHIS Page 48

• Client o Children under two ages group o Children under five ages group o Pregnant/Lactating Woman

• HEW

• Referred Facility

Preconditions

• The client should be eligible for nutrition and growth monitoring service

• The client should be found in eCHIS as registered household member.

Flow of activities

1) The client will go to the service site (himself/herself, or with the support of WDA, ...)

or the HEW may visit the client at home, or outreach.

2) The HEW verifies that the client is already a registered household member in the catchment area using eCHIS

3) The HEW checks the client’s previous health related history using eCHIS

4) The HEW assesses and provide the required service for the client

5) The HEW will provide appointments for the next treatment for the Client

6) The HEW records necessary information regarding the offered service using eCHIS

Variants

• At step 4, if the client’s age is under two, the following procedures will be followed o The HEW will measure the weight of the child o The child will be classified as per the WPA Classification o The HEW will give counselling service for the mother on complementary feeding o The HEW will give vitamin A and Deworming supplementation for children

• At step 4, if the client’s age is under five, the following procedures will be followed o The HEW will check the Visible wasting status(0-6 months) eCHIS Page 49 o The HEW will measure the Mid-Upper Arm Circumference (MUAC) (6-59 months) o The HEW will check Bilateral Pitting Edema o The child will be classified as N/MAM/SAM

• At step 4, if the client is pregnant or lactating women, the following procedures will be followed o The HEW will measure the weight of the mother o The HEW will measure the Mid-Upper Arm Circumference (MUAC) of the mother o The HEW will check if the mother is malnourished o The HEW will check if all nutrition counselling is provided for the woman

Exceptions

• At step 2, if the client is not in the intended catchment area, the HEW gives the service (counsel, attendant the delivery, treat and or refer) accordingly and record the information using eCHIS

• Step 2: if the client has no household information, the HEW creates the household information and the household membership information using eCHIS

• Step 4: In case of complication, the HEW refers the client to referred Facility

Links to other workflow

• None

Input

• None

Output

• Appropriate Nutrition and Growth Monitoring Service is provided for the appropriate clients and the necessary information is captured and entered using eCHIS eCHIS Page 50

Sub process “provide nutrition and growth monitoring service”

Business Process Nutrition and Growth Monitoring Service WF

N ut ri ti on a nd G ro w th M on it or in g Se rv ic e W

F

H

EW

Re fe ra l F ac ili ty Cl ie nt f or

N ut ri ti on an d G ro w th M on it or in g

Monitorying event raised

Check if in the catchment area eCHIS check previous health and monitoring history provide nutrition and growth monitoring service

Record offered services

In the catchment area?

eCHIS

End

Wait until membership registration

Perform refered activity eCHIS

Client's personal info

Check Household Memeber

Household Memeber?

eCHIS eCHIS

Yes

Notify next appointment

Need Refereal?

No No

Yes

Yes

Business Process provide nutrition and growth monitoring service

Type of Client measure weight Classify WPA give vitamin A and

Deworming

Start Check Visible wasting status measure Mid-Upper Arm Circumference

(MUAC) End measure weight check mother is malnourished

End counselling service for the mother End check Bilateral Pitting Edema classify as

N/MAM/SAM

measure MUAC all nutrition counselling is provided?

mark as nutrition counselling completed client is < 5 years of age?

No client is pregnant or lactating woman client is < 2 years of age eCHIS Page 51

8.15 WF15 – HIV/AIDS Service Provision

Workflow Code WF15

Workflow Name HIV/AIDS Service Provision

The purpose of this workflow is to describe the steps to identify, conduct HIV Testing, provide appropriate treatment, provide counselling service, care and support, follow up, and capture necessary information using eCHIS.

Supported Transactions:

• HIV Testing and Counselling

• ART follow up

• PLHIV Care and Support

• Orphan Care and Support

• Post Exposure Prophylaxis (PEP)

Participants

• Client

• HEW

• Referred Facility

Preconditions

• The client should be found in eCHIS as registered household member.

Flow of activities

1) The client will go to the service site (himself/herself, or with the support of WDA, ...)

or the HEW may visit the client at home, or outreach.

2) The HEW verifies that the client is already a registered household member in the

3) The HEW checks the client’s previous health related history using eCHIS eCHIS Page 52

4) The HEW provides appropriate counselling service for the client

5) The HEW conducts necessary tests based on the permitted testing mechanism

6) The HEW analyses the test result

7) The HEW notifies the test result to the client

8) The HEW conducts post-test counselling and advice to the client

9) THE HEW refers to referral facility for ART treatment

10) The HEW arranges necessary care, support and follow up for the client

11) The HEW records necessary information regarding the offered service using eCHIS

Variants

Exceptions

• At step 2, if the client is not in the intended catchment area, the HEW gives the service (counsel, attendant the delivery, treat and or refer) accordingly and record the information using eCHIS

• At step 2, if the client is not registered as household member, he/she should be registered using eCHIS

• At step 5, if the HEW is potentially exposed to HIV while offering service, she should use PEP

• Step 9: In case of complication, the HEW refers the client to referred Facility

Links to other workflow

• None

Input

Output eCHIS Page 53

Target groups are identified, HIV Testing conducted, appropriate treatment provided, counselling service offered, care and support given, follow up taken place, and capture necessary information using eCHIS

8.16 WF16 – Malaria Case Detection and Treatment Service

Workflow Code WF16

Workflow Name Malaria Case Detection and Treatment Service

The work flow describes the necessary steps required to identify the patient with malaria parasite, provide the necessary treatment, and capture necessary information using eCHIS.

Supported Transactions:

• Malaria Case Detection and Treatment

• Malaria Larva Control

Business Process HIV/AIDS Service Provision WF

H

IV

/A

ID

S Se rv ic e Pr ov is io n N o Re fe rr ed F ac ilt y

Cl ie nt

Start

Check client in the catchment area

Found in the catchment area eCHIS

Client personal info checks…