Identifier:
Revision:
Effective Date:
SOP-WBOT
0
1 April 2013
Feb 2013
STANDARD OPERATING PROCEDURES
District Health Information System
(DHIS) AGGREGATED Data Management
for
NON-FACILITY HEALTH PROGRAMS
Collection, Entry Validation and Dissemination:
1. Ward Based Outreach Teams (WBOT)
2. Integrated School Health Program (ISHP)
3. Environmental Health (EH)
4. Emergency Medical Services (EMS)
Draft: 6 Feb 2013
These materials have been developed in terms of Service Level Agreement between the National
Department of Health and HISP
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
LIST OF ABBREVIATIONS
DG
Director-General
DBE
Department of Basic Education
DHIS
District Health Information System
DHMIS
District Health Management Information System
DoH
Department of Health
DSD
Department of Social Development
DQ
Data Quality
EH
Environmental Health
EMIS
Education Management Information System
EMS
Emergency Medical Services
EMS PRF
EMS Patient Report Form
HIS
Health Information System
ISHP
Integrated School Health Program
HOD
Head of Department
ICT
Information and Communication Technology
IT
Information Technology
M&E
Monitoring and Evaluation
NDoH
National Department of Health
NHISSA
National Health Information Systems Committee of South Africa
NIDS
National Indicator Data Set
NDSA
National Service Delivery Agreement
PHC
Primary Health Care
PIDS
Provincial Indicator Data Set
PQRS
Provincial Quarterly Reporting System
QRS
Quarterly Reporting System
SOP
Standard Operating Procedure
WBOT
Ward Based Outreach Teams
Page 2 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
DEFINITIONS
TERMINOLOGY
Accuracy
OPERATIONAL DEFINITION
Also known as validity. Data is measured against a referenced source and
found to be correct. Accurate data minimize error (e.g. transcription error)
to a point of being negligible
Completeness
Data are present and usable and represent the complete list of eligible
sources and not just a fraction of it
Confidentiality
Assurance that data will not be disclosed inappropriately and treated with
appropriate levels of security
Data
Raw, unprocessed numbers
Data collation
Data input forms
The process where data for a data element from various service points are
added together. It is very important to ensure that during this process the
responsible person adds the data correctly to avoid arithmetic errors
This refers to the final form which will be used to enter the data into the
relevant database
Data sign off
Data sign off refers to the process where the person with the required
authority agree to the correctness and validity of the data and commits him
or herself to submit data in accordance with data flow guidelines
Indicator
A quantitative or qualitative variable that provides a simple and reliable
measurement of one aspect of performance, achievement or change in a
program or project
Information
Processed or analysed data that adds context through relationships
between data to allow for interpretation and use
Timeliness
Data and information is available on time for meeting budgeting,
monitoring, decision making and reporting requirements
Users of data
Stakeholders who are authorised to access and use data in DHIS for
monitoring, evaluation, research and reporting purposes
Classifying Schools -1 to 5.
Quintiles 1 to 5
Quintile 1 being the poorest school. The poorest schools in Quintile 1
receive a greater allocation per learner than those in Quintile 2. In 2007,
the Minister identified Quintile 1 and 2 schools as no-fee schools. In order
to rank schools into Quintiles, each school has to be given a school
poverty score. The score should be based on the relative poverty of the
community around the school, looking at (1) Income (2) dependency ratio
(or unemployment rate), (3) level of education of the community (or literacy
rate)
The national data source used to determine the poverty score for schools
is not able to analyse spatial areas smaller than wards. As such it is not
sensitive enough to recognise neighbourhoods of poverty within a larger
community. Poor schools in close proximity to better off suburbs will be
prejudiced by the wealth of their neighbours and may be ranked in a higher
quintile than is justified by their learner demographics
Page 3 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
LIST OF ABBREVIATIONS .............................................................................................2
DEFINITIONS ..................................................................................................................3
1.
Introduction .............................................................................................................6
1.1
Purpose ......................................................................................................................... 6
1.2
Scope............................................................................................................................. 6
1.3
Training .......................................................................................................................... 6
1.4
Background .................................................................................................................... 6
1.5
Principles ....................................................................................................................... 7
1.6
Data Tools for AGGREGATED monthly DHIS data management .................................. 9
1.7
Reference Documents ................................................................................................... 9
1.7.1
General documents applicable to all health programs and services ......................... 9
1.7.2
WBOT-specific documents .................................................................................... 10
1.7.3
ISHP-specific documents and software.................................................................. 10
1.7.4
EH-specific documents .......................................................................................... 10
1.7.5
EMS-specific documents ....................................................................................... 10
2.
DATA/INFORMATION MANAGEMENT and FLOW ............................................. 11
2.1
DHMIS Responsibilities and Procedures ...................................................................... 12
2.1.1
Health Care Provider = Data Collector ................................................................... 12
2.1.2
Deputy Manager’s DHMIS Responsibilities and Procedures .................................. 13
2.1.3
Facility / Program Manager’s DHMIS Responsibilities and Procedures.................. 14
2.1.4
Data Capturer’s Responsibilities and Procedures .................................................. 16
3.
Entering monthly aggregated data for NON-FACILITY health programs .............. 18
3.1
Data Entry and Entry Validation ................................................................................... 18
3.2
Post Entry Data Validation (Data Quality Checks) ........................................................ 21
3.3
Export of data............................................................................................................... 24
3.3.1
Export to next level ................................................................................................ 24
3.3.2
Export to Data Mart................................................................................................ 25
3.4
Generating Reports ...................................................................................................... 26
3.5
Pivot Tables ................................................................................................................. 28
4.
NON-FACILITY Health Program- Specific Annexures .......................................... 29
4.1
WBOT .......................................................................................................................... 29
4.1.1
WBOT Data Elements (extracted from DHIS Jan 2013) ......................................... 29
4.1.2
WBOT Indicators (extracted from DHIS Jan 2013)................................................. 31
4.1.3
WBOT Validation Rules (extracted from DHIS Jan 2013) ...................................... 33
Page 4 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
4.1.4
WBOT Tools for routine aggregated monthly DHIS data management .................. 34
4.1.5
PHC WBOT Monthly DHIS Data Input Form (DHIS auto-generated) ..................... 37
4.2
Integrated School Health Program (ISHP) .................................................................... 38
4.2.1
ISHP Data Elements (extracted from DHIS Jan 2012) ........................................... 38
4.2.2
ISHP NIDS Indicators (extracted from DHIS Jan 2012).......................................... 42
4.2.3
ISHP Data Tools .................................................................................................... 44
4.3
Environmental Health Program (EH) ............................................................................ 48
4.3.1
EH Data Elements (extracted from DHIS Jan 2012) .............................................. 48
4.3.2
EH Indicators ......................................................................................................... 50
4.3.3
EH Validation Rules (extracted from DHIS Jan 2012) ............................................ 52
4.3.4
EH Data Tools (examples) ..................................................................................... 53
4.4
Emergency Medical Services Program (EMS) .............................................................. 59
4.4.1
EMS Data Elements (extracted from DHIS Jan 2012) ............................................ 59
4.4.2
EMS Indicators (extracted from DHIS Jan 2012) ................................................... 61
4.4.3
EMS Data Tools .................................................................................................... 62
4.5
Maintain the Organisational Hierarchy of NON-FACILITY DHIS data files .................... 65
4.5.1
Organisational Hierarchy Integrated School Health Program (ISHP) data file ........ 65
4.5.2
Organisational Hierarchy Environmental Health (EH) data file ............................... 65
4.5.3
Organisational Hierarchy Emergency Medical Services (EMS) data file/set ........... 65
4.5.4
Organisational Hierarchy – Ward Based Outreach Team (WBOT) data file ........... 65
4.5.5
The PHC WBOT Household Profile Data File ........................................................ 68
4.5.6
Adding Local Data Elements and Indicators .......................................................... 69
Page 5 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
1. Introduction
1.1
Purpose
This document provides Standard Operating Procedures (SOPs) to ensure appropriate, standardised and
effective data and information management for monthly aggregated NON-FACILITY Health Programs. It
also provides guidelines for:


Standard DHIS data capturing, validation and data flow procedures
Maintaining and expanding the Organisational Hierarchy in the DHIS Data File in a standardised
manner
NON-FACILITY Health Programs include the following:
1)
2)
3)
4)
PHC Ward Based Outreach Teams (WBOT)
Integrated School Health Programs (ISHP) services
Environmental Health (EH)
Emergency Medical Services (EMS)
These SOPS focus on general principles applicable to management of all the NON-FACILITY Health
Programs and specifics in terms of each program will be indicated throughout the manual.
1.2
Scope
These National Department of Health (NDoH) SOPS are mandatory and shall be implemented by all
employees and contractors when engaging in health information related activities in the Department of
Health (DoH) facilities. The SOPs must be used in conjunction with the following:

DHMIS Policy 2011

National Indicator Dataset (NIDS)

Reference Documents listed in Section 3
Please note that these SOPs do not cover pilot projects
1.3
Training
The Health Program Managers and Facility Managers must ensure that where relevant team members
who follow these procedures understand these SOPS understand the objectives and other inter-related
activities.
Each team member involved in data collection, validation capturing, dissemination and use must sign
that (s)he has studied and understand these SOPs.
1.4
Background
In terms of the National Health Act (Act 61 of 2003) the National Department of Health (NDoH) is
required to facilitate and coordinate the establishment, implementation and maintenance of health
information systems at all levels. The District Health Management Information System (DHMIS) Policy
2011 defines the requirements and expectations to provide comprehensive, timely, reliable and good
quality routine evidence for tracking and improving health service delivery. The strategic objectives of the
policy are to strengthen monitoring and evaluation (M&E) through standardization of data
management activities and to clarify the main roles and responsibilities at each level for each
category of staff to optimize completeness, quality, use, ownership, security and integrity of data.
Page 6 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health




PHC Ward Based Outreach Team services - Central to the PHC Re-engineering Strategy is a
cadre of Community Health Workers (CHW) organised into approximately 5,500 WBOTs. Each of
these teams, consisting of 6 community health workers (CHWs), provides outreach services to
around 1500 households with a ratio of 250 households per CHW and each team is linked to one
PHC facility, called the team’s parent facility.
Integrated School Health Program (ISHP) – As reflected in the National Service Delivery
Agreement (NSDA) strengthening of ISHP services a national Primary Health Care (PHC) Reengineering priority. It is also an important component of the Department of Basic Education
(DBE) Care and Support for Teaching and Learning framework.
Environmental Health Services – EH services include water quality monitoring, health
surveillance of premises, port health, and control of hazardous substances, waste management
and chemical safety.
Emergency Medical Services - EMS is recognised as a key component within the health care
delivery system. They are often an entry point into health system services when people are under
life-threatening circumstances. EMS comprises of various elements such as Emergency Care
practitioners, Emergency Physicians, specialised vehicles and equipment, computerised call
centres with computerised communication centres and training.
In 2000 the District Health Information System (DHIS) was adopted as the official South African routine
health information system for managing aggregated routine health service based information. Modules
NON-FACILITY Health Programs were implemented in some provinces but a standardised National
Database will be implemented for each in April 2013.
The national aim is to have computers and competent data capturers at each facility in an incremental
manner but, until all facilities are computerised, well managed and monitored paper-based data
collection, collation and dissemination systems must be maintained in the most effective and efficient
way.
1.5
Principles
The following principles should be kept in mind when these SOPS are implemented:
1. These SOPS are meant for managing routine aggregated DHIS data and NOT for individual
records for which SOPS will be published at a later stage
2. The DHIS contains population-based data (for example population estimates from Statistics
South Africa) and school data (for example schools and number of learners imported from the
Education Management Information System (EMIS) of the DBE) which serves as denominators
for some of the NIDS indicators
3. Data and information must be used at all levels for planning and monitoring against data quality
and health program targets
4. Data collection: Routine aggregated NON-FACILITY Health Program data to be captured into
the DHIS are collected by means of Standardised Tick Registers. The cover page of each Tick
Register should have space for the following:
 Team / practitioner name and where applicable parent health facility name (as in DHIS), year
and register number (Tick Register number starts on 1 April and ends on 31 March of the
following year )
 Start date of register
 End date of register
 Register pages must be numbered
Page 7 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
5. Data tools and processes for NON-FACILITY services must be managed in the same manner
as those for fixed facilities.
6. Data capturing, -validation and -feedback: NON-FACILITY data will be captured by the same
designated data capturer capturing aggregated health facility data at:
 Facility level where resources are available
 Sub-district level where facility level capturing is not available
7. Information Management in terms of data flow, monitoring, mentoring, training and DQ feedback
is the responsibility of Information Officers/Managers at sub-district, district, provincial and
national levels. The following are crucial for monitoring and optimising data quality:
 Standardised management of Organisational Unit levels, types and ‘owners’
 Standardised activation of relevant data elements at capturing level
 Standardised use of 0 (zero) reporting at data collection and capturing levels
 Audit readiness similar to health facilities
8. All records, data collection and collation tools must be stored in a secure facility on a daily basis
9. Non-health information staff responsibilities for each NON-FACILITY Health program and the
OrgUnit level for which the program’s data is captured are tabled below
10. Materials, equipment and staff – Facility and District Managers are responsible to ensure that
sufficient stationary, equipment and staff are available to meet responsibilities at each level.
Table 1: Responsibilities – aggregated data management
NON-FACILITY
Health Program
WBOT
ISHP
EH
EMS
Page 8 of 69
Health
service
providers =
data
collectors
Collection
level
validation &
summary
CHWs
CHWs &
WBOT Team
Leader
Parent Facility
Manager
School Health
Professional
Nurses
School Health
Nurses
Parent Facility
Manager
Environmental
Health
Practitioners
EH
Practitioners
EH Program
Manager
Shift Manager
EMS Program
Manager
EMS
Practitioners
Control
Centres
Pre-capturing
validation
Monthly
feedback on
data quality
and program
progress
WBOT
Program
Manager
OrgUnit Level
for Data Entry
OrgUnit 7
(all levels)
ISHP Program
Manager
OrgUnit 5
(all levels)
EH Program
Manager
OrgUnit 5
(all levels
EMS Program
Manager
(all Levels)
OrgUnit 5
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
1.6
Data Tools for AGGREGATED monthly DHIS data management
As stated before, individual patient / client records are excluded from these SOPS
Table 2: Tools – aggregated data management
Program
Data collection
Collation: Sub-totals
Collation: Monthly DHIS Data Input
forms
(DHIS auto-generated)
PHC
WBOT
ISHP
EH
CHW Household visit
Tick Sheet
ISHP Tick Sheet (all
phases)
CHW Household Visit Monthly
Summary form (CHW)
PHC WBOT Monthly DHIS Data Input
Form
Outreach Team Monthly
Summary form (Team Leader)
(Per WBOT)
ISHP Summary Report Form
ISHP Monthly DHIS Data Input Form
(Per School)
1.Monthly Data Input form Municipal Health
Daily Register
MUNICIPAL EHO
Daily Register
PROVINCIAL EHO
2.Quarterly Data Input form Municipal Health
No sub-total forms are used
3.Monthly Data Input form Provincial Health
4.Quarterly Data Input form Provincial Health
Daily Register PORT
HEALTH EHO
5.Monthly Data Input form Port Health
6.Quarterly Data Input form Port Health
EMS
Call Centre
No sub-total forms are used
EMS Monthly DHIS Data Input Form
(Per EMS station)
1.7
Reference Documents
Individuals using these procedures should become familiar with the following general and health program
specific documents:
1.7.1 General documents applicable to all health programs and services
1) DHMIS Policy, National Department of Health, 2011.
2) National Health Act (Act 61 of 2003): Commencement Section 53 of the National Health Act,
2003.
3) PHC Supervisory Manual, National Department of Health, October 2009
4) Promotion of Access to Information Act (Act 2 of 2000): GN 585, Government Gazette 26332, 14
May 2004.
5) Public Audit Act of 2004 (Act 25 of 2004): Government Gazette Vol 474, Cape Town, 20
December 2004 No. 27121.
6) Public Finance Management Act (Act 1 of 1999): Public Finance Management Amendment Act
(Act No. 29 of 1999).
7) Statistics Act (Act 6 of 1999): Government Gazette Vol. 406, Cape Town 21 April 1999. No.
19957.
8) Treasury Regulations: Government Gazette, Vol. 500, Pretoria, 20 February 2008, No 29644.
9) Health National Service Delivery Agreement (NSDA) 2011
Page 9 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
1.7.2 WBOT-specific documents
1) Provincial Guidelines Implementation PHC 3 Streams Overview
2) PHC Re-engineering Narrative
3) Community Health Worker Training Implementation Plan
1.7.3 ISHP-specific documents and software
1) Education Management Information System (EMIS)
2) Integrated School Health Policy
3) ISHP Monitoring and Evaluation
1.7.4 EH-specific documents
1) International Health Regulations
2) (Updated) SUPPLEMENTARY REGULATIONS MADE UNDER THE
INTERNATIONAL HEALTH REGULATIONS ACT, 1974 (ACT NO. 28 OF 1974)
1.7.5 EMS-specific documents
Page 10 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
2. DATA/INFORMATION MANAGEMENT and FLOW
This data flow diagram provides the timelines to ensure that the 45 day deadlines for routine data
submission (for all health programs) to NDoH is met.
DAILY
1. Collect data during
service provision (Tick
Sheets / Registers)
2. Validate data
3. Calculate sub-totals
4. Capture data (selected
facilities)
WEEKLY
MONTHLY (data from 1st to last day of reporting month)
FACILITY
LEVEL
• Interim
• 1st Validated data collection level (sub-total) summaries
aggregation &
complete
validation
• 2nd Validated Monthly Input Summary to manager
• 5th :Validated Monthly Input Summary data capturer
• 10th Facility level capturing , validation and export to subdistrict level completed
• Feedback in 5 days to data collectors = health care
providers
SUB-DISTRICT LEVEL
MONTHLY
20th : Sub-district level capturing,
import, validation & export
completed
Feedback in 5 days down to
facility level
DISTRICT LEVEL
MONTHLY
30th : District level import,
validation & export completed
Feedback in 5 days down to subdistrict level
PROVINCIAL LEVEL
MONTHLY
45 days after reporting
period
Provincial import,
validation & export
completed
Feedback in 5 days to
district level
NATIONAL LEVEL
MONTHLY
Page 11 of 69
50 days after reporting
period
National import,
validation & saving on
server completed
Feedback 60 days after
reporting period to
provinces
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
2.1 DHMIS Responsibilities and Procedures
2.1.1 Health Care Provider = Data Collector
Health care providers (nurses, doctors, EMS and EH practitioners) are responsible and accountable for
ensuring high quality data in household and individual patient records and on their own routine data
collection and collation tools.
It is essential that all people write clearly and legibly on all data collection tools
Action
Step
1
RECORDING OF DATA ON DATA COLLECTION TOOLS:
On a daily basis the health service provider is responsible and accountable for the
following:
1.1
Record data in individual patient/client records (for local use and therefore not included in
these routine health information management SOPS). See table 2 for list of individual
records used for each NON-FACILITY program
1.2
Record required data in line with the national definitions in the standardised Tick Sheets /
Registers during or directly after each visit / service provided. See table 1 and 2 for list of
data collectors and tools for each NON-FACILITY program (Annexure 4)
1.3
Indicate the file number / patient number (where relevant) clearly on the standardised Tick
Sheets / Registers for follow-up and auditing purposes
1.4
Double check that all the correct data elements in the correct columns were ticked for each
visit / service provided
1.5
Maintain confidentiality of all data / information
1.6
File and store individual client records, Tick Sheets / Registers and Summary forms in the
dedicated locked facility
2
COLLATION OF DATA ON TICK SHEET / REGISTER
On a weekly and/or monthly basis the health service provider is responsible and
accountable for the following:
2.3
Complete and sign Interim (weekly, monthly, ‘when page is full’, for each school) summary
forms and submit to the delegated manager on the 1st day of each month. See table 2 for list
of individual Sub-total summary tools used for each NON-FACILITY program (Annexure 4)
Page 12 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
Action
Step
NO BLANKS should be left on the monthly summary form
2.1.2
Deputy Manager’s DHMIS Responsibilities and Procedures
Some programs have Deputy Managers called Team Leaders (WBOT), Shift Supervisors (EMS) and
various other terms.
‘Deputy Managers’ are responsible for managing respective teams and to collaborate with the linked
parent health care Facility Manager and/or Health Program Manager to ensure effective NON-FACILITY
services and good quality data in the DHIS.
Step
Action
3
COLLATION OF DATA ON THE MONTHLY DHIS (auto-generated) INPUT FORMS
3.1
Capture the total for each health care provider / team member a Sub-total Monthly Summary
Form (Table 1 and Annexure 4)
3.2
Count the number of referrals and other management related data (which doesn’t appear on Tick
Sheets/Registers) and capture total on the Sub-total Monthly Summary Form
3.3
Calculate and sign clearly
3.4
Validate and transcribe the monthly totals for each team onto the Monthly DHIS Data Input Form
(one auto-generated form per team) and sign (Table 1 and Annexure 4)
3.5
Submit the Monthly DHIS Data Input Form to the parent facility (or other dedicated) manager for
verification and signature on 2nd of each month and file a copy in the Monthly DHIS Data Input
Form file
Ensure training of team members on data elements, data quality assessment and data use
3.6
Ensure that all new team members are orientated on the health information management system
Oversee, lead and support effective and efficient data collection, management and use on:
3.7



Visits and care / health services provided
Work days and supervision visits
Stock and equipment
Provide monthly feedback to team members with regard to:
3.7
Page 13 of 69


Data quality – timeliness, completeness and accuracy of data
Program-related indicators highlighting good performance and service delivery
shortcomings
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
Analyse, interpret and use information for remedial interventions to optimise patient care and
health care system performance
3.8
Develop action plans in collaboration with team members for indicators that reflect poor
performance
2.1.3 Facility / Program Manager’s DHMIS Responsibilities and Procedures
If data submitted for capturing into the DHIS is of poor quality, evidence-based management decisions
are compromised at all levels.


Where NON-FACILITY health care services are provided as outreach services, the Facility
Manager is responsible and accountable for the quality of the outreach service data (for example
WBOT and ISHP)
Where NON-FACILITY health care services are provided by teams not directly linked to health
facilities, the lowest level Program Manager/Coordinator is responsible and accountable for the
quality of health program data (for example EH and EMS)
These responsibilities focus on the management of high quality information that must be used to:
 optimise patient care and/or community services
 optimise public health and the health status of the population
 optimise performance of health programs and the healthcare system
 improve data quality
 monitor, evaluate and report on performance against all legislated plans in the health sector
The health information management responsibilities of Facility Managers / Program
Managers/Coordinators are similar for all health programs.
Step
Action
Provide sufficient resources for routine health information management:
1






Stationery such as pens, rulers, carbon paper, calculators and staplers
Filing cabinets, files and an effective filing system
Telephones and fax machines
Up-to-date pivot tables, graphs and reports on data quality and program
performance
Definitions of data elements and indicators
Data collection tools (Tick Register, standardised registers, summary forms and
Data Input forms
Mobilise for further resources (staff, hardware and software, email and internet connections)
2
3
Include data management, monitoring and reporting in performance contracts and job
descriptions of all managers, team leaders and health care providers
Ensure training on data elements, data quality assessment and data use for all staff responsible
for data collection and collation and who manage service points
Ensure that all new staff are orientated on the health information management system
Page 14 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
Step
Action
Oversee, lead and support effective and efficient data collection, management and use on:



4
Health visits and care/interventions provided
Work days and supervision visits
Stock and equipment
Optimise DHIS data quality and use by means of:








5




Weekly Spot checks on:
o
Individual records by means of record reviews (10 records per month)
o
Verification that data in Tick Sheets / Registers and on summary forms correlate
o
Filing practices for records and data collection tools as required for data verification
and audits
Keep dated and signed records on spot checks done
Keep hard copies of data collection tools for a minimum of three (3) years
Establish an information committee/team for the facility / program to discuss data before
it is sent to the next level, assess data quality and promote an information culture in the
facility
Validate data on monthly DHIS Monthly Data Input Forms
Submit DHIS Monthly Data Input Forms for capturing on the 7th of each month
Ensure that data quality report and pivot table of raw data is received from data capturer
Follow up on feedback from the data capturer and make corrections. If changes to the
data are required it should be made on all the sheets to indicate that the totals have
changed. Draw a line through the incorrect value, write in the new value. These changes
are to be initialled and dated. No correction fluid is to be used. Ensure the entire data trail
back to the initial collection point is corrected
Ensure that the validation rules that were violated are corrected or commented on and
that feedback on violations are given to the sub-district/sub-structure/district office
Ensure that outliers are commented on
Ensure that updated data quality reports and pivot table of raw data is received from the
data capturer after corrections were made in the DHIS
Submit corrected signed-off Data Input form to the data capturer and ensure that a
duplicate is filed in the DHIS Monthly Input Form folder
Provide monthly feedback to Team Leaders and health care providers with regard to:


7
8
10
Data quality – timeliness, completeness and accuracy of data
Program-related indicators highlighting good performance and service delivery
shortcomings
Analyse, interpret and use information for remedial interventions to optimise patient care and
facility / program performance
Develop action plans in collaboration with Team Leaders and health care providers for indicators
that reflect poor performance
Ensure that facilities and programs are ready for an audit at all times
Page 15 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
A facility is ready for an audit when:












All internal policies and procedure documents are available and are implemented
Each patient has only one patient folder/clinical record and file is available in the facility at all times
(proper filing system)
Information recorded on data collection tool (Tick Register, standard register or patient based
software application) are consistent with patient folder and supporting documentation
Where applicable all patient records are captured on electronic databases, e.g.ETR.net, TIER.net,
Information recorded in DHIS is consistent with data input forms
All data input forms applicable to the facility have data collected for and are captured in the DHIS
All data collection tools used for collection of data by institution have been reviewed for quality and
have been signed off by the health care provider who collected the data
All registers are reviewed for quality and have been signed off by the facility manager
All validation errors are corrected or explained
All outliers are explained
Processing of data updates is done correctly
All sign off forms are properly completed and signed off by the facility manager
2.1.4 Data Capturer’s Responsibilities and Procedures
Data capturers are responsible for capturing data and then forwarding the data to the next level. These
responsibilities are similar for all health programs and all levels at which data is captured.
Data capturers must spend 100% of their work time on the data-related responsibilities stipulated
below (integrated for all health programs)
Step
Action
THE DATA CAPTURER IS ACCOUNTABLE FOR THE FOLLOWING IN TERMS OF AGGREGATED
MONTHLY DHIS DATA FOR ALL HEALTH PROGRAMS:
1
CAPTURING OF AGGREGATED MONTHLY DATA INTO DHIS (for all facility and NONFACILITY) Health Programs
Obtain validated Data Input forms from the facility manager on all data sets on the 7th of
each month

2.1





Page 16 of 69
Conduct a rapid data quality assessment of data on DHIS Monthly Data Input forms –
must be 100% complete and should contain no gaps or outliers without comments
Capture monthly data into the DHIS
Indicate date of capturing on each monthly data input form and sign
Run Min/Max range violations, Absolute validation and Statistical Validation reports on
data
Run Standard Reports on data for outstanding input forms, routine raw data reports and
ad hoc reports
Follow up any discrepancies found in data with facility manager and keep record of
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
Step
Action








Page 17 of 69
follow up date and person
Verify that facility manager made the appropriate corrections on the data input form. A
line should be drawn through the incorrect value and the new value should be written.
Changes are to be initialled and dated. No correction fluid is to be used. The entire data
trail back to the initial service point must be corrected
On receiving feedback from the facility manager, correct the values in DHIS and send
updated reports and pivot tables to the facility manager to sign off the data
Export data to Data Mart and refresh pivot tables – compare data in pivot tables with that
on summary forms. The following is crucial in this process:
o Save existing standard pivot tables with a different name (for example add date)
before exporting to Data Mart
o Empty the Data Mart, do a full export to Data Mart and then refresh the standard
pivot tables
Obtain sign-off from the Facility Manager of the data
Attach following DHIS reports to sign-off form as proof of data quality:
o Data entry validation report
o Min/Max violations
o Outstanding input forms
o Pivot table of raw data
Export data on all NIDS data elements and send export file to sub-district or district level
(as relevant) before the 10th of each month
Ensure that back-ups are made every time data is changed
File records needed to meet monitoring and audit requirements and store safely in a
locked facility
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
3. Entering monthly aggregated data for NON-FACILITY health programs
Data capturers must provide comprehensive and integrated data capturing services and are expected to
capture data for all health programs. NON-FACILITY Health Program data is captured by the same data
capturers entering health facility data. This data can be captured into the DHIS at facility, at sub-district or
district level, depending on resources and processes in place for capturing (ALL) health program data.
The process for capturing monthly aggregated DHIS data is the same for all NON-FACILITY health
programs in their respective data files displayed below.
Health
Program
WBOT
ISHP
EH
EMS
DHIS Data
Base /
Data File
DHIS_#ZA_NDOH_WBOT.
MDB
DHIS_#ZA_NDOH_ISHP.
MDB
DHIS_#ZA_NDOH_EHP.
MDB
Provincial data file e.g.
DHIS_#ZA_ECAPE
The WBOT data file will be used to illustrate the data capturing process and program-specific aspects will
be specified where relevant.
.
3.1
Data Entry and Entry Validation
Data cannot be entered or edited unless logged in with a user name
Desktop – Use DHIS14 Start Up icon to open
the DHIS database
Control Centre – Click on Switch data file
Page 18 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
For entering PHC Ward Based Outreach Team
data, select
DHIS_#ZA_NDOH_WBOT and click OK
For capturing School Health data, select
DHIS_#ZA_NDOH_ISHP and click OK
For capturing Environmental Health data select
DHIS_ZA_NDOH_EHS and click OK
For entering EMS data select your provincial
data file and click OK.
Control Centre – Click on Data – Entry/Edit
Select the Data Set you want to enter data for –
we will use PHC WBOT Data (PHC Ward
(1) Select the Data set for which you want to
capture data
(2) Select period /month for which you want to
enter data for example Nov-12
(3) Select the OrgUnit for which you want to
enter data for example:
 Province = nw North West Province
 District = nw Dr Ruth Segomotsi
Mompati
 Sub-district = nw Naledi LM
 Ward = nw Naledi Ward 4
 Facility = nw Huhudi CHC
 Team = Huhudi CHC Outreach Team 1
– W004
If the WBOT for which you want to enter
data does not display in the OrgUnit
Hierarchy, ask your information officer to
assist. See annexure 1 for explanation.
To show or hide OrgUnits, click the ‘+’ and ‘–‘.
Page 19 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
The following Data Entry screen will appear
Enter the data from the Monthly Input form into the Entry box for each of the elements. The sequence of the data
elements on the Monthly Input form and those on the computer screen are the same, but it is good data capturing
practice to make sure that each Entry is for the correct data element
Validation of data during the data capturing process
The DHIS software has several functions to assist data capturers to optimise data quality:
1. Min/max values / entry out of range – the
Min and Max values displaying the values for
each element (values with which the
database was developed), will be autocalculated after 3 months of data entry using
the values captured for each individual
facility
2. It is good practice to reset Min/max values
for each WBOT team with the Team Leader
when entering data for the first time
Page 20 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
When a value outside the min/max range is
captured a graph indicating the trend lines
appears to flag a potential data quality
problem.
After verifying the data by means of
checking the value on the Input form or
phoning the Parent Facility Manager, select
the most suitable alternative from the action
list next to the graph.
3. Colour coding of entry cells – when a
potentially incorrect value is captured, the
cell colour indicates that the data in that
Entry cell may be incorrect and should be
verified
See colour code explanation in the lower left
corner of the Data Entry screens.
4.
5.
Click in the Check box if you want to
check or investigate a value at a later
stage. This will indicate that the value may
not be correct
A comment should be added to indicate
that a value might not be correct. You can
choose a Comment from the drop-down list
or type a comment free text.
Comments are useful as they can inform
the next person that needs to interpret the
data long after the data has been entered.
3.2 Post Entry Data Validation (Data Quality Checks)
After data entry has been completed, the system prompts the user to run
validation rules. Good data management dictates that these should be run routinely
after the data for each reporting unit has been entered. Any violations found must be
addressed immediately.
Data validation while in the data entry screen (after completing data entry)
Page 21 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
After entering and saving the data in the
data entry screen you need to press the
Validate button at the top of the screen
The programme runs a quick validation
check of the data entered and produces
a report that describes any errors in the
data.
Close, follow up and correct input errors
for which corrections can be obtained
immediately.
If you need to share these results you
can copy the report to clipboard and
save.
When finished click on Control Centre
button in right top corner of screen
Data Validation from Control Centre
Further validation of the data is found in the Control
Centre – clicking on Data Quality .
1. Routine ‘Check it’ data allows you to view all the
data entries that have been marked for follow up
 Select OrgUnit
 Select Data Set
 Select Data Element Group
Entries for which check boxes were clicked displays –
follow up and verify
Page 22 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
2. Data Validation:
National absolute and/or statistical validation rules
have been designed in order to identify data errors for
correction

Run Absolute Validation – select OrgUnits,
Source Level, Data Set, Data Period and click
Run Analysis

Run Statistical Validation
Example of Absolute Validation rule violations
To view the data elements where the violations occurred, click on Show Data Record Detail button
To edit data (after verification with facility) click Open Data Entry Form button
Examples statistical validation rule violations (no statistical validation rules set up in current WBOT data file)
Page 23 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
Advanced Quality Checks are for advanced users to :
-
Identify gaps and outlier values. You can either
identify missing records or outliers.
Run integrity checks
3.3 Export of data
3.3.1 Export to next level
After entering and validation of data, the data capturer must export the data to the next level
Export to next level
After capturing and validation of data for all the reporting units that submitted data, OR on the d-date for
sending data to the next level irrespective whether all units submitted, data must be exported to the next
level.
Click on Export / Import button
Select Export to XML/Text
Select the data set you want to export
Browse for OrgUnits to include in the export
and select
Select the period
Select months for which records were
modified after validation
Click Export Specification button
Page 24 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
Select data sets you want to export by
moving them from the Available (right
column) to left column. Use selection
arrows to move items
Data element groups
Data elements
OrgUnit groups
Click on back to Export Criteria button
Click on Export button (bottom right corner)
The export file will by default be stored in the C:\DHIS 14\Transfer folder in a 7Zip format
(R) click on the file you want to export. Click on Send to and select Mail recipient and email to dedicated
person at the next level
3.3.2 Export to Data Mart
After data was forwarded to next level data must be exported to the Data Mart from where pivot tables
are refreshed (see section 3.5)
Export to Data Mart
After capturing and saving new data, export it to
Data Mart.
In the Control Menu choose Export To Data Mart.
Then click on Export Data to Data Mart button
again and choose Full if it’s the 1st time and Partial
export thereafter and set the dates for ideally the
Page 25 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
previous month in case there were adjustments
made.
3.4 Generating Reports
Short reports on the data can be generated by clicking
on the Control Centre.
The two common reports we will examine will be the
1. Routine Raw Data Report and the
2. Ad Hoc Raw Data Report.
The Routine Raw Data Report:
a) choose the Data Set (eg CHW Outreach Teams)
b) Select the Org Unit - district, sub-district or facility you
wish to create a report for (nw Naledi Local
Municipality)
If you tick Use Default OrgUnit from Data Entry Form your drop-down options for select Org Unit described
above will have the same OrgUnit tree as in your Data
Entry screens
c) The Source level is the reporting Unit
d) Set the data period
e) You can filter the Org unit group to show just the
reporting Unit.
Page 26 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
Select if you want to Include the Min/Max Values or if you
want to Include Totals in the report.
Under Outputs you have a variety of choices for the
format you want the report in:
MS Word Report
If you select
this MS Word Setup screen will open
You can edit the title, margins and layout of the report in
Word on this screen.
Click OK
Your Word report will look similar to this.
The Ad-Hoc Raw Data report allows you to extract any
raw data and display it in a pivot table. The report is
useful if you only want data for a selected few data
elements.
Similar steps are followed as above but the ‘Root’ Org
Unit is usually at District or Province so that you can pivot
at different levels in the data.
Select the data elements you want in your report by
highlighting the elements in the Available List and clicking
on the Right arrow.
An example of the resulting report.
Page 27 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
3.5 Pivot Tables
Pivot tables are generated when data is exported to the Data Mart. The pivot tables are located in the
DHIS root folder or you can access them from the DHIS Control Centre. The following looks very briefly
at accessing the PHC Outreach Pivot table.
Pivot tables are saved in Excel files with
naming DHIS_$ followed by the province.
Another way of opening the Pivot Table is to
click this shortcut on the Control Centre in the
DHIS.
A table appears for you to select what Pivots
are available.
Click on the table name and the excel pivot
table opens.
At the bottom of the screen there are different
tabs for different sheets.
The Overview explains the Org unit setup. So
you can see all the Outreach teams per clinic
Routine data allows you to examine the data
elements and the Indicator Sheet allows you to
examine the indicators.
The ‘DE Des’ and ‘Ind Des’ is where you will
find the definitions of either Data Elements or
Indicators in this Outreach Data File.
Page 28 of 69
4. NON-FACILITY Health Program- Specific Annexures
4.1 WBOT
4.1.1 WBOT Data Elements (extracted from DHIS Jan 2013)
Number
Data Element
Name
Definition
Use and context
IndGr
oup
Frequen
cy
Collecte
d By
Collection
Points
Tools
1
OHH
Households in
population
Total number of households in the population
that should be visited and registered by Ward
Based Outreach Teams
Monitors implementation of PHC re-engineering in
terms of Ward Based Outreach Teams. Will be autocalculated when stats SA releases break-downs of
2011 Census data (the Small Area Layer)
PHC
WBOT
Yearly
StatsSA
N/A
N/A
2
OHH CHW
supervised by
team leader
The number of CHWs who are supervised by
the Ward Based Outreach Team leader
Team leader should enter this monthly
PHC
WBOT
Monthly
Manager
WBOT
N/A
3
OHH allocated
to team
Number of households allocated to Ward
Based Outreach Teams
Each Ward Based Outreach Team is allocated a
specific number of households to support
PHC
WBOT
Monthly
WBOT
Household
Tick
Register
WBOT
4
OHH registration
visit
Number of initial visits to households by Ward
Based Outreach Teams that included
completing a household registration form
Each household allocated to Ward Based Outreach
Team must be registered during the first household
visit by a team member, using the standardised
Household Registration form
PHC
WBOT
Monthly
WBOT
Household
Tick
Register
WBOT
5
OHH follow-up
visit
Number of households visited by a Ward
Based Outreach Team to provide follow-up
health care support
Members of the Ward Based Outreach Teams are
expected to visit each household for follow-up support
each month. At risk households might need to be
visited more frequently
PHC
WBOT
Monthly
WBOT
Household
Tick
Register
WBOT
6
OHH visits total
Total number of households visited by Ward
Based Outreach Teams
This is the sum of registration visits and follow-up visits
PHC
WBOT
Monthly
N/A
N/A
DHIS
calculate
7
OHH supervised
visit
Number of Ward Based Outreach Team visits
accompanied by a supervisor
Monitors supervision of Ward Based Outreach Team
member (Community Health Workers - CHW)
PHC
WBOT
Monthly
WBOT
Household
Tick
Register
WBOT
8
OHH with
pregnancy care
PHC outreach household (OHH) visit where
care was provided to pregnant women
Do not count individual pregnant women
PHC
WBOT
Monthly
WBOT
Household
Tick
Register
WBOT
9
OHH with
postnatal care
PHC outreach household (OHH) visit where
care was provided to woman and/or newborn
baby within 6 days after delivery
Do not count individual postnatal woman
PHC
WBOT
Monthly
WBOT
Household
Tick
Register
WBOT
10
OHH with child
under 5 years
care
Outreach household (OHH) visit where care
was provided to child(ren) under 5 years of
age
Do not count individual children
PHC
WBOT
Monthly
WBOT
Household
Tick
Register
WBOT
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
Data Element
Name
Number
Definition
Use and context
IndGr
oup
Frequen
cy
Collecte
d By
Collection
Points
Tools
11
OHH with
adherence
support
Outreach household (OHH) visit where
adherence support was provided
Do not count individual clients
PHC
WBOT
Monthly
WBOT
Household
Tick
Register
WBOT
12
OHH with home
based care
Outreach household (OHH) visit where home
based care was provided
Do not count individual clients
PHC
WBOT
Monthly
WBOT
Household
Tick
Register
WBOT
13
OHH client refer
to facility
Number of clients of all ages referred to health
facilities by Ward Based Outreach Teams
Include referrals to all health facilities, including
referrals for care provided by special teams like Oral
Health or Mental Health
PHC
WBOT
Monthly
WBOT
Household
Tick
Register
WBOT
14
OHH client refer
to social
services
A client who was referred to social services by
a Ward Based Outreach Team (CHW) during a
household visit
Monitors referral to social services. Count individual
clients
PHC
WBOT
Monthly
WBOT
Household
Tick
Register
WBOT
15
OHH client refer
to home based
care
A client who was referred to home based care
by a Ward Based Outreach Team (CHW)
during a household visit
Monitors referral to home based care. Count individual
clients
PHC
WBOT
Monthly
WBOT
Household
Tick
Register
WBOT
16
OHH headcount
under 5 years
Number of children under 5 years to whom
care was provided by Ward Based Outreach
Teams
The community health worker (CHW) must enter the
total number of children under 5 years of age to whom
support was provided in each household visited, on
the CHW Household visit form
PHC
WBOT
Monthly
WBOT
Household
Tick
Register
WBOT
17
OHH headcount
5 years and
older
Number of clients 5 years and older to whom
care was provided by Ward Based Outreach
Teams
The community health worker (CHW) must enter the
total number of clients 5 years and older to whom
support was provided in each household visited, on
the CHW Household visit form
PHC
WBOT
Monthly
WBOT
Household
Tick
Register
WBOT
18
OHH headcount
total
Total number of outreach clients care for (sum
of outreach headcount under 5 years and
outreach headcount 5 years and older)
Add the total of the outreach headcount under 5 years
and the total of the outreach headcount 5 years and
older
PHC
WBOT
Monthly
N/A
N/A
DHIS
calculate
19
OHH support
group
The number of community support groups
facilitated by Ward Based Outreach Teams
Count the number of support group meetings
facilitated
PHC
WBOT
Monthly
Manager
WBOT
N/A
20
OHH campaign
The number of community campaigns
supported by Ward Based Outreach Teams
Count each campaign once irrespective of number of
team members involved
PHC
WBOT
Monthly
Manager
WBOT
N/A
21
OHH backreferral form
Outreach household (OHH) client with health
facility back referral form
Count individual forms
PHC
WBOT
Monthly
Manager
WBOT
N/A
Page 30 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
4.1.2 WBOT Indicators (extracted from DHIS Jan 2013)
Nr
Indicator Name
Type
Annu
alised
1
OHH registration
visit coverage
(annualised)
%
1
2
OHH follow-up
visit rate
%
0
Numerator
OHH registration
visit
OHH follow-up
visit
OHH in
population
OHH visits total
3
OHH supervised
visit rate
4
OHH with
pregnancy care
rate
5
OHH with
postnatal care
rate
6
OHH with child
under 5 years
care rate
7
OHH with
adherence
support rate
%
0
OHH with
adherence support
OHH visits total
8
OHH with home
based care rate
%
0
OHH with home
based care
OHH visits total
Page 31 of 69
%
%
%
%
0
OHH supervised
visit
Denominator
0
OHH with
pregnancy care
0
OHH with
postnatal care
0
OHH with child
under 5 care
OHH visits total
OHH visits total
OHH visits total
OHH visits total
Definition
Use and context
Proportion of households in
the target wards covered by
Ward Based Outreach Teams
Monitors implementation of the
PHC re-engineering strategy
Outreach household follow-up
visits as proportion of all
households visits by Ward
Based Outreach Teams
Outreach household (OHH)
visits accompanied by a
supervisor as proportion of all
household visits by Ward
Based Outreach Teams
Outreach households (OHH)
visits during which antenatal
care was provided to pregnant
women as proportion of
households visited by the
Ward Based Outreach Team
Outreach households (OHH)
with postnatal care provided to
a mother and/or neonate
within 6 days after delivery as
proportion of households
visited by the Ward Based
Outreach Team
Outreach households (OHH)
with basic health care
provided to children under 5
years as proportion of
households visited by the
Ward Based Outreach Team
Outreach households (OHH)
with adherence support
provided as proportion of
households visited by the
Ward Based Outreach Team
Outreach households (OHH)
with home based support
provided as proportion of
households visited by the
Ward Based Outreach Team
Freq
Level
PHC
WBOT
Monthly
Output
Monitors follow-up visits to
registered households.
Community health workers are
expected to visit each
household for follow up
support monthly. At risk
households need to be visited
more frequently
PHC
WBOT
Monthly
Proce
ss/Acti
vity
Monitors supervision of ward
based community Health
workers
PHC
WBOT
Monthly
Proce
ss/Acti
vity
Monitors households where
care was provided to pregnant
women, irrespective of the
number of pregnant women
cared for
PHC
WBOT
Monthly
Output
Monitors households where
care was provided to postnatal
women, irrespective of the
number of postnatal women
cared for
PHC
WBOT
Monthly
Output
Monitors households where
care was provided to children
under 5, irrespective of the
number of children under 5
cared for
PHC
WBOT
Monthly
Output
PHC
WBOT
Monthly
Output
PHC
WBOT
Monthly
Output
Monitors households where
adherance support was
provided, irrespective of the
number of clients who
received support
Monitors households where
homebased care was
provided, irrespective of the
number of clients who
received homebased care
IndGroup
Key
reports
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
Nr
Indicator Name
9
OHH backreferral forms
rate
10
OHH client
referred to facility
rate
11
OHH client
referred to social
services rate
12
OHH client
referred to home
based care rate
13
OHH registration
visit rate
14
OHH headcount
under 5 years
coverage
(annualised)
15
OHH headcount
5 years and older
coverage
(annualised)
Page 32 of 69
Type
%
%
%
%
%
%
%
Annu
alised
Numerator
Denominator
Definition
0
OHH client with
back-referral form
OHH client
referred to
facility
Outreach households (OHH)
back referral forms received
from PHC facilities as
proportion of all households
with referrals to PHC facility
done by the Ward Based
Outreach Team
0
OHH client refer
facility
OHH headcount
total
Proportion of outreach
household clients referred to
health facilities
0
OHH client
referred to social
services
OHH headcount
total
0
OHH client
referred to home
based care
OHH headcount
total
Outreach households (OHH)
clients referred to social
services as proportion of the
total number of clients
supported (total headcount)
during outreach team visits
Outreach households (OHH)
clients referred to home based
care as proportion of the total
number of clients supported
(total headcount) during
outreach team visits
Use and context
IndGroup
Freq
Level
Key
reports
Monitors back-referrals fron
PHC facilities. Each backreferral form is counted
PHC
WBOT
Monthly
Proce
ss/Acti
vity
Monitors referral by
Community Health Workers
(CHW) to health facilities.
Individual clients referred are
counted
PHC
WBOT
Monthly
Proce
ss/Acti
vity
NSDA;
NSP;
WHO
Monitors referral by
Community Health Workers
(CHW) to social services.
Individual clients referred are
counted
PHC
WBOT
Monthly
Proce
ss/Acti
vity
NSDA;
NSP;
WHO
Monitors referral by
Community Health Workers
(CHW) to home nased care.
Individual clients referred are
counted
PHC
WBOT
Monthly
Proce
ss/Acti
vity
NSDA;
NSP;
WHO
PHC
WBOT
Monthly
Output
0
OHH registration
visit
OHH allocated
to team
Outreach household (OHH)
registration visits as proportion
households allocated to Ward
Based Outreach Teams
Monitors household
registration. Each household
allocated to a community
health worker must be
registered during the first
outreach household visit,
using the standardised
Household Registration form
1
OHH headcount
under 5 years
Population
under 5 years
Proportion of children under 5
years in population who
received care during Ward
Based Outreach Team visits
Monitors proportion of
population under 5 years
attended to during household
visits
PHC
WBOT
Monthly
Output
1
OHH headcount 5
years and older
Population 5
years and older
Proportion of people 5 years
and older in the population
who received care during
Ward Based Outreach Team
visits
Monitors proportion of
population 5 years and older
attended to during household
visits
PHC
WBOT
Monthly
Output
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
4.1.3 WBOT Validation Rules (extracted from DHIS Jan 2013)
1
OHH registration visit must be less than or equal to OHH total visits
2
OHH supervised visit must be less than or equal to OHH total visits
3
OHH with pregnant care must be less than or equal to OHH total visits
4
OHH with postnatal care must be less than or equal to OHH total visits
5
OHH with child under 5 years care must be less than or equal to OHH total visits
6
OHH with adherence support must be less than or equal to OHH total visits
7
OHH with home based care must be less than or equal to OHH total visits
8
OHH client refer to clinic must be less than or equal to OHH headcount total
9
OHH client refer to social services must be less than or equal to OHH headcount total
10 OHH client refer to home based care must be less than or equal to OHH headcount total
Page 33 of 69
4.1.4 WBOT Tools for routine aggregated monthly DHIS data management
4.1.4.1 WBOT Tick Register / Sheet
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
4.1.4.2 WBOT sub-total Summary Form
Page 35 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Department of Health
4.1.4.3 WBOT Monthly Summary Form (Team Leader)
Page 36 of 69
4.1.5 PHC WBOT Monthly DHIS Data Input Form (DHIS auto-generated)
District: ______________________________
Sub-district: ________________________
Health Facility: __________________________
Ward: _______________________________
WBOT Team: ______________________________ Reporting Month: _____________________
Sort
Order
DataElement
1
OHH follow-up visit
2
OHH supervised visit
3
OHH with pregnancy care
4
OHH with child under 5 years care
5
OHH with adherence support
6
OHH with home based care
7
OHH headcount under 5 years
8
OHH headcount 5 years and older
9
OHH support group
10
OHH campaign
11
OHH back-referral form
12
OHH registration visit
13
OHH visits total
14
OHH allocated to team
15
OHH CHW supervised by team leader
16
OHH with postnatal care
17
OHH headcount total
18
OHH client refer facility
19
OHH client refer social services
20
OHH client refer home based care
Designation
PHC WBOT Team Leader
Parent Facility Manager
Data Capturer (after entry)
Value
Name & Surname (Print clearly)
Comment
Data Verification
Signature
Date
4.2 Integrated School Health Program (ISHP)
4.2.1 ISHP Data Elements (extracted from DHIS Jan 2012)
Nr
Data Element
Name
Type
Definition
Use and context
Number
All schools are
classified into
quintiles by the DBE,
with for instance Q1
and Q2 schools being
the poorest/no fee
schools
Planning and monitoring. Schools including their quintile
classification are imported from the Department of Basic Education
(DBE) database into the DHIS, or if not available from the
provincial/local DBE
IndGroup
Frequency
Collected
By
Collection
Points
School
Health
OnChange
DoE
EMIS
N/A
School
Health
OnChange
DoE
EMIS
N/A
School
Health
OnChange
DoE
EMIS
N/A
School
Health
OnChange
DoE
EMIS
N/A
School
Health
OnChange
DoE
EMIS
N/A
School
Health
OnChange
DoE
EMIS
N/A
Monthly
N/A
N/A
DHIS
calculate
Monthly
School
Health
School
Tick
Register
School
Health
1
School Quintile
classification
2
School Grade
All - learners
total
Number
The total number of
learners in the school
3
School Grade 1
- learners total
Number
Total number of
Grade 1 learners in
the school
4
School Grade 4
- learners total
Number
The total number of
Grade 4 learners in
the school
5
School Grade 8
- learners total
Number
The total number of
Grade 8 learners in
the school
6
School Grade
10 - learners
total
Number
The total number of
Grade 10 learners in
the school
Number
The total number of
all grade learners in
the school screened
by a nurse in line with
the ISHP service
package
This data element is also used to calculate indicators for proportion
of schools covered by the School Health Teams
School
Health
Number of Grade 1
learners in the school
screened by a nurse
in line with the ISHP
service package
Health Screening include oral health, vision, hearing, speech,
height and weight, physical assessment, mental health,
tuberculosis, chronic illnesses, psychosocial support. On-site
services include deworming, immunization, oral health, minor
ailments. Health education include hand washing, personal and
environmental hygiene, nutrition, tuberculosis, road safety,
poisoning, know your body, abuse (sexual, physical, emotional).
Quintile 1 (Q1) and Quintile 2 (Q2) schools are the poorest / no
fees schools. Integrated School Health Package (ISHP) includes
health screening, on site services, health education)
School
Health
7
8
School learners
screened - total
School Grade 1
- learners
screened
Number
Planning and monitoring. Schools including their quintile
classification are imported from the Department of Basic Education
(DBE) database into the DHIS, or if not available from the
provincial/local DBE
Planning and monitoring. Schools including their quintile
classification are imported from the Department of Basic Education
(DBE) database into the DHIS, or if not available from the
provincial/local DBE
Planning and monitoring. Schools including their quintile
classification are imported from the Department of Basic Education
(DBE) database into the DHIS, or if not available from the
provincial/local DBE
Planning and monitoring. Schools including their quintile
classification are imported from the Department of Basic Education
(DBE) database into the DHIS, or if not available from the
provincial/local DBE
Planning and monitoring. Schools including their quintile
classification are imported from the Department of Basic Education
(DBE) database into the DHIS, or if not available from the
provincial/local DBE
Tools
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Department of Health
Nr
9
10
11
12
Data Element
Name
School Grade 4
- learners
screened
School Grade 8
- learners
screened
School Grade
10 - learners
screened
School Grade
Other - learners
screened
Page 39 of 69
Type
Number
Number
Number
Number
Definition
Use and context
IndGroup
Number of Grade 4
learners in the school
screened by a nurse
in line with the ISHP
service package
Health Screening include oral health, vision, hearing, speech,
height and weight, physical assessment, mental health,
tuberculosis, chronic illnesses, psychosocial support. On-site
services include deworming, immunization, oral health, minor
ailments. Health education include hand washing, personal and
environmental hygiene, nutrition, tuberculosis, road safety,
poisoning, know your body, abuse (sexual, physical, emotional).
Integrated School Health Package (ISHP) includes health
screening, on site services, health education)
School
Health
Number of Grade 8
learners in the school
screened by a nurse
in line with the ISHP
service package
Health Screening include oral health, vision, hearing, speech,
height and weight, physical assessment, mental health,
tuberculosis, chronic illnesses, psychosocial support. On-site
services include deworming, immunization, oral health, minor
ailments. Health education include hand washing, personal and
environmental hygiene, nutrition, tuberculosis, road safety,
poisoning, know your body, abuse (sexual, physical, emotional).
Quintile 1 (Q1) and Quintile 2 (Q2) schools are the poorest / no
fees schools. Integrated School Health Package (ISHP) includes
health screening, on site services, health education)
School
Health
Number of Grade 10
learners in the school
screened by a nurse
in line with the ISHP
service package
Health Screening include oral health, vision, hearing, speech,
height and weight, physical assessment, mental health,
tuberculosis, chronic illnesses, psychosocial support. On-site
services include deworming, immunization, oral health, minor
ailments. Health education include hand washing, personal and
environmental hygiene, nutrition, tuberculosis, road safety,
poisoning, know your body, abuse (sexual, physical, emotional).
Integrated School Health Package (ISHP) includes health
screening, on site services, health education)
School
Health
Number of Other
Grade learners in the
school screened by a
nurse in line with the
ISHP service package
(not in grade 1/4/8/10)
Health Screening include oral health, vision, hearing, speech,
height and weight, physical assessment, mental health,
tuberculosis, chronic illnesses, psychosocial support. On-site
services include deworming, immunization, oral health, minor
ailments. Health education include hand washing, personal and
environmental hygiene, nutrition, tuberculosis, road safety,
poisoning, know your body, abuse (sexual, physical, emotional).
Integrated School Health Package (ISHP) includes health
screening, on site services, health education)
School
Health
Frequency
Collected
By
Monthly
School
Health
Monthly
School
Health
Collection
Points
Tools
School
Tick
Register
School
Health
School
Tick
Register
School
Health
Monthly
School
Health
School
Tick
Register
School
Health
Monthly
School
Health
School
Tick
Register
School
Health
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Department of Health
Nr
13
14
15
16
Data Element
Name
School learner
underweight
School learner
overweight
School learner
referred for Oral
Health
School learner
referred for Eye
Care
Page 40 of 69
Type
Number
Number
Number
Number
Definition
Use and context
IndGroup
Frequency
Collected
By
Collection
Points
School
Tick
Register
School
Health
School
Tick
Register
School
Health
Tools
A learner with weight
diagnosed below the 2 SD line but above
the -3 SD line for the
first time
Health Screening include oral health, vision, hearing, speech,
height and weight, physical assessment, mental health,
tuberculosis, chronic illnesses, psychosocial support. On-site
services include deworming, immunization, oral health, minor
ailments. Health education include hand washing, personal and
environmental hygiene, nutrition, tuberculosis, road safety,
poisoning, know your body, abuse (sexual, physical, emotional).
Integrated School Health Package (ISHP) includes health
screening, on site services, health education)
School
Health
Monthly
School
Health
A learner with weight
diagnosed above the
-2 SD line for the first
time
Health Screening include oral health, vision, hearing, speech,
height and weight, physical assessment, mental health,
tuberculosis, chronic illnesses, psychosocial support. On-site
services include deworming, immunization, oral health, minor
ailments. Health education include hand washing, personal and
environmental hygiene, nutrition, tuberculosis, road safety,
poisoning, know your body, abuse (sexual, physical, emotional).
Integrated School Health Package (ISHP) includes health
screening, on site services, health education)
School
Health
Monthly
School
Health
A learner referred for
Oral Health issues
Health Screening include oral health, vision, hearing, speech,
height and weight, physical assessment, mental health,
tuberculosis, chronic illnesses, psychosocial support. On-site
services include deworming, immunization, oral health, minor
ailments. Health education include hand washing, personal and
environmental hygiene, nutrition, tuberculosis, road safety,
poisoning, know your body, abuse (sexual, physical, emotional).
Integrated School Health Package (ISHP) includes health
screening, on site services, health education)
School
Health
Monthly
School
Health
School
Tick
Register
School
Health
A learner referred for
Eye Care
Health Screening include oral health, vision, hearing, speech,
height and weight, physical assessment, mental health,
tuberculosis, chronic illnesses, psychosocial support. On-site
services include deworming, immunization, oral health, minor
ailments. Health education include hand washing, personal and
environmental hygiene, nutrition, tuberculosis, road safety,
poisoning, know your body, abuse (sexual, physical, emotional).
Integrated School Health Package (ISHP) includes health
screening, on site services, health education)
School
Health
Monthly
School
Health
School
Tick
Register
School
Health
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Department of Health
Nr
17
18
19
20
Data Element
Name
School learner
referred for
Hearing
problems
School learner
referred for
Speech
problems
School learner
referred for
Suspected TB
School learner
immunised
Page 41 of 69
Type
Number
Number
Number
Number
Definition
Use and context
IndGroup
Frequency
Collected
By
Collection
Points
School
Tick
Register
School
Health
School
Tick
Register
School
Health
Tools
A learner referred for
Hearing problems
Health Screening includes oral health, vision, hearing, speech,
height and weight, physical assessment, mental health,
tuberculosis, chronic illnesses, psychosocial support. On-site
services include deworming, immunization, oral health, minor
ailments. Health education includes hand washing, personal and
environmental hygiene, nutrition, tuberculosis, road safety,
poisoning, know your body, abuse (sexual, physical, emotional).
Integrated School Health Package (ISHP) includes health
screening, on site services, health education)
School
Health
Monthly
School
Health
A learner referred for
Speech problems
Health Screening includes oral health, vision, hearing, speech,
height and weight, physical assessment, mental health,
tuberculosis, chronic illnesses, psychosocial support. On-site
services include deworming, immunization, oral health, minor
ailments. Health education includes hand washing, personal and
environmental hygiene, nutrition, tuberculosis, road safety,
poisoning, know your body, abuse (sexual, physical, emotional).
Integrated School Health Package (ISHP) includes health
screening, on site services, health education)
School
Health
Monthly
School
Health
A learner referred for
Suspected TB
Health Screening includes oral health, vision, hearing, speech,
height and weight, physical assessment, mental health,
tuberculosis, chronic illnesses, psychosocial support. On-site
services include deworming, immunisation, oral health, minor
ailments. Health education includes hand washing, personal and
environmental hygiene, nutrition, tuberculosis, road safety,
poisoning, know your body, abuse (sexual, physical, emotional).
Integrated School Health Package (ISHP) includes health
screening, on site services, health education)
School
Health
Monthly
School
Health
School
Tick
Register
School
Health
A learner given
immunisation
Health Screening includes oral health, vision, hearing, speech,
height and weight, physical assessment, mental health,
tuberculosis, chronic illnesses, psychosocial support. On-site
services include deworming, immunisation, oral health, minor
ailments. Health education includes hand washing, personal and
environmental hygiene, nutrition, tuberculosis, road safety,
poisoning, know your body, abuse (sexual, physical, emotional).
Integrated School Health Package (ISHP) includes health
screening, on site services, health education)
School
Health
Monthly
School
Health
School
Tick
Register
School
Health
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Department of Health
Nr
21
Data Element
Name
School learner
dewormed
Type
Number
Definition
A learner given
deworming tablets
Use and context
IndGroup
Health Screening includes oral health, vision, hearing, speech,
height and weight, physical assessment, mental health,
tuberculosis, chronic illnesses, psychosocial support. On-site
services include deworming, immunisation, oral health, minor
ailments. Health education includes hand washing, personal and
environmental hygiene, nutrition, tuberculosis, road safety,
poisoning, know your body, abuse (sexual, physical, emotional).
Integrated School Health Package (ISHP) includes health
screening, on site services, health education)
School
Health
Frequency
Collected
By
Monthly
School
Health
Collection
Points
School
Tools
Tick
Register
School
Health
4.2.2 ISHP NIDS Indicators (extracted from DHIS Jan 2012)
Nr
Indicator Name
Type
Ann
ualis
ed
Numerator
Denominator
Definition
Use and context
IndGr
oup
Freq
Level
Key
reports
1
School ISHP
coverage
(annualised)
%
1
Schools with any
learner screened
Schools - total
Proportion of schools in which
the ISHP service package was
provided
Monitors implementation of
the Integrated School Health
Program (ISHP)
School
Health
Monthl
y
Proce
ss/Acti
vity
APP;
NSDA
2
School learner
screening coverage
(annualised)
%
1
School learners
screened
School learners total
Proportion of all learners
screened by a nurse in line with
the ISHP service package
Monitors implementation of
the Integrated School Health
Program (ISHP)
School
Health
Monthl
y
Proce
ss/Acti
vity
APP
3
School Grade 1
screening coverage
(annualised)
%
1
School Grade 1
learners screened
School Grade 1
learners - total
Proportion of Grade 1 learners
screened by a nurse in line with
the ISHP service package
Monitors implementation of
the Integrated School Health
Program (ISHP)
School
Health
Monthl
y
Proce
ss/Acti
vity
APP
4
School Grade 4
screening coverage
(annualised)
%
1
School Grade 4
learners screened
School Grade 4
learners - total
Proportion of Grade 4 learners
screened by a nurse in line with
the ISHP service package
Monitors implementation of
the Integrated School Health
Program (ISHP)
School
Health
Monthl
y
Proce
ss/Acti
vity
5
School Grade 8
screening coverage
(annualised)
%
1
School Grade 8
learners screened
School Grade 8
learners - total
Proportion of Grade 8 learners
screened by a nurse in line with
the ISHP service package
Monitors implementation of
the Integrated School Health
Program (ISHP)
School
Health
Monthl
y
Proce
ss/Acti
vity
6
School Grade 10
screening coverage
(annualised)
%
1
School Grade 10
learners screened
School Grade 10
learners - total
Proportion of Grade 10 learners
screened by a nurse in line with
the ISHP service package
Monitors implementation of
the Integrated School Health
Program (ISHP)
School
Health
Monthl
y
Proce
ss/Acti
vity
School learners
screened - total
Proportion of learners screened
by a nurse in line with the ISHP
service package diagnosed as
underweight (below -2SD but
above -3SD)
Monitors implementation of
the Integrated School Health
Program (ISHP)
School
Health
Monthl
y
Proce
ss/Acti
vity
7
School learner
underweight rate
Page 42 of 69
%
1
School learners
underweight
APP
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Department of Health
8
School learner
overweight rate
%
9
School learner
referred for Oral
Health rate
10
School learner
referred for Eye Care
rate
11
School learner
referred for Hearing
problems rate
12
School
Health
Monthl
y
Proce
ss/Acti
vity
Monitors implementation of
the Integrated School Health
Program (ISHP)
School
Health
Monthl
y
Proce
ss/Acti
vity
Monitors implementation of
the Integrated School Health
Program (ISHP)
School
Health
Monthl
y
Proce
ss/Acti
vity
Proportion of learners screened
by a nurse in line with the ISHP
service package and referred
for Hearing problems
Monitors implementation of
the Integrated School Health
Program (ISHP)
School
Health
Monthl
y
Proce
ss/Acti
vity
School learners
screened - total
Proportion of learners screened
by a nurse in line with the ISHP
service package and referred
for Speech problems
Monitors implementation of
the Integrated School Health
Program (ISHP)
School
Health
Monthl
y
Proce
ss/Acti
vity
School learner
referred for
Suspected TB
School learners
screened - total
Proportion of learners screened
by a nurse in line with the ISHP
service package and referred
for Suspected TB
Monitors implementation of
the Integrated School Health
Program (ISHP)
School
Health
Monthl
y
Proce
ss/Acti
vity
1
School learner
immunised
School learners
screened - total
Monitors implementation of
the Integrated School Health
Program (ISHP)
School
Health
Monthl
y
Proce
ss/Acti
vity
1
School learner
dewormed
School learners
screened - total
Monitors implementation of
the Integrated School Health
Program (ISHP)
School
Health
Monthl
y
Proce
ss/Acti
vity
School learners
screened - total
%
1
School learner
referred for Oral
Health
School learners
screened - total
%
1
School learner
referred for Eye
Care
School learners
screened - total
%
1
School learner
referred for
Hearing problems
School learners
screened - total
School learner
referred for Speech
problems rate
%
1
School learner
referred for
Speech problems
13
School learner
referred for
Suspected TB rate
%
1
14
School learner
immunised rate
%
15
School learner
deworming rate
%
Page 43 of 69
Proportion of learners screened
by a nurse in line with the ISHP
service package diagnosed as
overweight (above +2SD)
Monitors implementation of
the Integrated School Health
Program (ISHP)
1
School learners
overweight
Proportion of learners screened
by a nurse in line with the ISHP
service package and referred
for Oral Health
Proportion of learners screened
by a nurse in line with the ISHP
service package and referred
for Eye Care
Proportion of learners screened
by a nurse in line with the ISHP
service package and given
immunisation
Proportion of learners screened
by a nurse in line with the ISHP
service package and given
deworming tablets
4.2.3 ISHP Data Tools
Department of Health
Page 45 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Serial number
Learner’s Name and Surname
Follow up
Deworming
Psycho-social
Minor ailinment
12 yr Td given
6 yr Td given
Immunization status
Quintile:
Other referrals
Suspected TB
Speech
Hearing
Vision or Eye
EMIS number:
Oral Health
Over Weight
Under Weight
Other Grades
Grade 10
Grade 8
Grade 4
Grade 1
School:
Gender: M or F
SHS 7
4.2.3.1 ISHP Tick Sheet / Register (all phases)
Each new school visited should be captured on a new page
Sub-district:
Date:
Referred
Comment and/or Treatment given
4.2.3.2 ISHP Sub-total Summary form
SHS 9
ISHP SUMMARY REPORT FORM: DATA ITEMS
Period:
TOTAL
Unit:
1.
2.
3.
4.
5.
Number of Q1 and Q2 schools in which the ISHP service package was provided.
Number of Grade 1 learners in Q1 and Q2 schools screened by a nurse in line with the
ISHP service package
Number of Grade 4 learners in Q1 and Q2 schools screened by a nurse in line with the
ISHP service package
Number of Grade 8 learners in Q1 and Q2 schools screened by a nurse in line with the
ISHP service package
Number of Grade 10 learners in Q1 and Q2 schools screened by a nurse in line with
the ISHP service package
6.
Number of Grade 1 learners screened by a nurse in line with the ISHP service package
7.
Number of Grade 4 learners screened by a nurse in line with the ISHP service package
8.
Number of Grade 8 learners screened by a nurse in line with the ISHP service package
9.
Number of Grade 10 learners screened by a nurse in line with the ISHP service
package
10.
Number of learners screened by a nurse in line with the ISHP service package
11.
Grades 1 learners referred for visual problems after screening.
12.
Grade 1 learners referred for hearing problems after screening.
13.
Learners given 6 year Td immunisation on site
14.
Learners given 12 year Td immunisation on site
Completed by:
Name:
Signature:
Date:
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Department of Health
4.3 Environmental Health Program (EH)
4.3.1 EH Data Elements (extracted from DHIS Jan 2012)
Data Element Name
Definition
Use and context
IndGroup
Frequency
Collected
By
Collection
Points
Tools
EH Domestic water
samples collected
Total number of domestic drinking water samples
collected and analysed from a Water Services
Authority and Non Water Services Authority
(Vessels, Aircrafts, etc) in terms of the standards
set out in SANS 241
This should exclude samples
collected in outbreaks and for
other specific purposes
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
2
EH Domestic water
samples compliant
Number of domestic drinking water samples
collected and analysed from a Water Services
Authority and Non Water Services Authority
(Vessels, Aircrafts, etc) in terms of the standards
set out in SANS 241
This should exclude samples
collected in outbreaks and for
other specific purposes
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
3
EH Food poisoning
reported new
Number of new food poisoning cases reported to
EHP officers
Monitors food safety
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
4
EH Food sample
bacteriological analysis
Total number of food samples taken for
bacteriological analysis according to regulations
promulgated in terms of the Foodstuffs, Cosmetics
and Disinfectants Act, Act 54 0f 1972
This includes milk samples
taken for bacteriological analysis
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
5
EH Food sample
bacteriologically
compliant
Number of food samples bacteriologically analysed
that complied to the Foodstuffs, Cosmetics and
Disinfectants Act, Act 54 0f 1972
This includes milk samples
taken for bacteriological analysis
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
6
EH Food samples
chemical analysis
Total number of food samples taken for chemical
analysis according to the regulations promulgated
in terms of the Foodstuffs, Cosmetics and
Disinfectants Act, Act 54 0f 1972
This includes imported food
stuffs
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
7
EH Food samples
chemically compliant
Number of food samples chemically tested that
complied to the Foodstuffs, Cosmetics and
Disinfectants Act, Act 54 0f 1972
This includes imported food
stuffs
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
8
EH Hazardous
substance dealer
compliant
Number of the Hazardous Substances dealers
inspected that comply with the regulations for
hazardous substances
All hazardous substances
dealers must be inspected and
compliant with Hazardous
Substances Act and Regulations
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
9
EH Hazardous
substance dealer
inspected
The total number of Hazardous Substance dealers
inspected
All hazardous substances
dealers must be inspected and
compliant with Hazardous
Substances Act and Regulations
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
Nr
1
Page 48 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Department of Health
Nr
Data Element Name
Definition
Use and context
IndGroup
Frequency
Collected
By
Collection
Points
Tools
10
EH Health care waste
generator compliant
Number of registered health care waste generators
inspected that complied with minimum standards
according to SANS 10248
All waste generators should be
inspected at least once a year.
Inspection should be done
according to SANS 10248 and
any other applicable legislation
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
11
EH Health care waste
generator inspected
Total number of registered health care waste
generators inspected according to SANS 10248
All waste generators should be
inspected at least once a year.
Inspection should be done
according to SANS 10248 and
any other applicable legislation
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
12
EH International
conveyance arrival at
first point of entry
Total number of international conveyances arrivals
at each international point of entry
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
13
EH International
conveyance inspected
at first point of entry
Number of international conveyances arrivals at
each international point of entry inspected in terms
of the National Port Health Standard Operating
Procedures (revised SOPs)
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
14
EH International
imported consignment
arrival at point of entry
Total number of international imported
consignments arrivals at each international point of
entry
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
15
EH International
imported consignment
inspected
Total number of international imported
consignments inspected at each international point
of entry in terms of the National Port Health
Standard Operating Procedures (revised SOPs)
and International Health Regulations (IHR, 2005)
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
16
EH Lead poisoning
reported new
Number of new cases of lead poisoning reported
to EHP officers
Registered under Act 36 of 1947
Environmental
Health
Monthly
EHP
EH sites
17
EH Mercury poisoning
reported new
Number of new cases of mercury poisoning
reported to EHP officers
Registered under Act 36 of 1947
Environmental
Health
Monthly
EHP
EH sites
18
EH Milling
establishment
compliant
Number of maize meal/bread flour mill
establishments that were inspected and found to
comply with the fortification regulation
Regulation promulgated in terms
of the Foodstuffs, Cosmetics
and Disinfections Act (Act 54 of
1972) and regulations
promulgated in terms of the Act
Environmental
Health
Monthly
EHP
EH sites
Page 49 of 69
Tick
Register
EH
Tick
Register
EH
Tick
Register
EH
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Department of Health
Definition
Use and context
IndGroup
Frequency
Collected
By
Collection
Points
Tools
19
EH Milling
establishment
inspected
Total number of maize meal / bread flour mill
establishment that were inspected
Inspected according to
regulation promulgated in terms
of the Foodstuffs, Cosmetics
and Disinfections Act (Act 54 of
1972) and regulations
promulgated in terms of the Act
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
20
EH Notifiable medical
conditions investigated
new
Number of Notifiable medical conditions reported
to the District Health Office that were investigated
by EHP officers
Only count the first inspection
during the financial year. Don't
include follow-up inspections
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
21
EH Notifiable medical
conditions reported to
District Health Office
Total number of Notifiable medical conditions
reported to the District Health Office
Only count the first inspection
during the financial year. Don't
include follow-up inspections
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
22
EH Pesticide poisoning
reported new
Number of new cases of pesticide poisoning
reported to EHP officers
Registered under Act 36 of 1947
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
23
EH Premises tobacco
legislation compliant
Number of premises (as defined in the National
Health Act) inspected that comply with Tobacco
legislation
Standards set out in the
Tobacco Products Control Act,
Act 83 of 1993
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
24
EH Premises tobacco
legislation inspected
Total number of premises (as defined in the
National Health Act) inspected for Tobacco
Legislation
Standards set out in the
Tobacco Products Control Act,
Act 83 of 1993
Environmental
Health
Monthly
EHP
EH sites
Tick
Register
EH
Nr
Data Element Name
4.3.2 EH Indicators
Typ
e
Nr
Indicator Name
1
EH Domestic
water sample
compliance rate
%
2
EH Flour mills
compliance rate
%
3
EH Food sample
bacteriological
compliance rate
Page 50 of 69
%
Ann
uali
sed
Numerator
Denominator
Definition
Use and
context
IndGroup
Freq
Level
0
EH Domestic
water samples
compliant
EH Domestic
water samples
collected
Proportion of routine domestic water
samples taken for a Water Services
Authority and Non Water Services
Authority that conforms to the
standards set out in SANS 241
Monitors
domestic water
safety
Environmental
Health
Monthly
Process/A
ctivity
0
EH Milling
establishment
compliant
EH Milling
establishments
inspected
Proportion of operational flour milling
establishments that were compliant
with regulations
Monitors flour
milling
establishment
compliance
Environmental
Health
Monthly
Process/A
ctivity
0
EH Food sample
bacteriologically
compliant
EH Food sample
bacteriological
analysis
Proportion food samples
bacteriologically tested that complied
to the Foodstuffs, Cosmetics and
Disinfectants Act, Act 54 0f 1972
Monitors food
safety. Includes
imported food
stuffs
Environmental
Health
Monthly
Process/A
ctivity
Key
reports
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Department of Health
Nr
Indicator Name
Typ
e
Ann
uali
sed
Numerator
Denominator
Definition
Use and
context
IndGroup
4
EH Food sample
chemical
compliance rate
%
0
EH Food samples
chemically
compliant
EH Food samples
chemical analysis
Proportion food samples chemically
tested that complied to the
Foodstuffs, Cosmetics and
Disinfectants Act, Act 54 0f 1972
Monitors food
safety. Includes
imported food
stuffs
Environmental
Health
Monthly
Process/A
ctivity
5
EH Hazardous
substance
dealers
compliance rate
%
0
EH Hazardous
substance dealer
compliant
EH Hazardous
substance dealer
inspected
Proportion Hazardous Substances
dealers that complied with the
regulations for hazardous
substances
Environmental
Health
Monthly
Process/A
ctivity
6
EH Health care
waste generator
compliance rate
%
0
EH Health care
waste generator
compliant
EH Health care
waste generators
inspected
Proportion inspected health care
waste generators that complied with
minimum standards according to
SANS 10248
Environmental
Health
Monthly
Process/A
ctivity
7
EH International
conveyance
inspection rate
%
0
EH International
conveyance
inspected at first
point of entry
EH International
conveyance
arrivals at first
point of entry
Proportion international conveyance
at arrival inspected for compliance to
International Health standards
Monitors
international
conveyance
inspection
Environmental
Health
Monthly
Process/A
ctivity
EH International
imported
consignment
inspected
EH International
imported
consignment
arrivals at first
point of entry
Proportion international imported
consignments that complied to
International Health standards,
compliant in terms of the National
Port Health Standard Operating
Procedures (revised SOPs) and
International Health Regulations
(IHR, 2005)
Monitors
international
imported
consignment
inspection
Environmental
Health
Monthly
Process/A
ctivity
0
EH Notifiable
medical conditions
investigated new
EH Notifiable
medical conditions
reported to District
Health Office
Proportion Notifiable medical
conditions reported to the District
Health Office that were investigated
by EHP officers
Monitors
Notifiable
medical
condition
inspections by
EHP officers
Environmental
Health
Monthly
Process/A
ctivity
%
0
EH Premises
tobacco legislation
compliant
EH Premises
tobacco legislation
inspected
Proportion inspected premises that
were compliant with Tobacco Act
Monitors
premises
compliant with
Tobacco Act
Environmental
Health
Monthly
Process/A
ctivity
per1
00K
1
EH Food
poisoning reported
new
Population total
New cases of food poisoning
reported to EHS per 100 000
population
Monitors food
poisoning trends
Environmental
Health
Monthly
Outcome
per1
00K
1
EH Lead
poisoning reported
new
Population total
New cases of lead poisoning
reported per 100 000 population
Monitors
chemical
poisoning trends
Environmental
Health
Monthly
Outcome
8
EH International
imported
consignment
compliance rate
9
EH Notifiable
disease
investigation
rate
10
EH Premises
tobacco
compliance rate
11
12
EH Reported
Food poisoning
incidence
(annualised)
EH Reported
lead poisoning
incidence
(annualised)
Page 51 of 69
%
%
0
Monitors
hazardous
substance
dealer
compliance
Monitors health
care waste
generator
compliance
Freq
Level
Key
reports
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Department of Health
Nr
13
14
Indicator Name
EH Reported
mercury
poisoning
incidence
(annualised)
EH Reported
pesticide
poisoning
incidence
(annualised)
Typ
e
Ann
uali
sed
Numerator
per1
00K
1
EH Mercury
poisoning reported
new
Population total
per1
00K
1
EH Pesticide
poisoning reported
new
Population total
Denominator
Use and
context
IndGroup
New cases of mercury poisoning
reported per 100 000 population
Monitors
chemical
poisoning trends
Environmental
Health
Monthly
Outcome
New cases of pesticide poisoning
reported per 100 000 population
Monitors
chemical
poisoning trends
Environmental
Health
Monthly
Outcome
Definition
Freq
Level
Key
reports
4.3.3 EH Validation Rules (extracted from DHIS Jan 2012)
No
ValidationRule
1 Domestic water samples collected VS Domestic water samples compliant
2
Food samples bacteriological analysis VS Food sample bacteriologically
compliant
3 Food samples chemical analysis VS Food sample chemical compliant
RoutineDataValidationRuleDescription
Domestic water samples collected MUST be greater than or equal to Domestic water samples compliant
Food samples bacteriologically analysed MUST be greater than or equal to Food sample bacteriologically
compliant
Food samples chemically analysed MUST be greater than or equal to Food sample chemically compliant
Hazardous substance dealer inspected MUST be greater than or equal to Hazardous substance dealer
compliant
Health care waste generator inspected MUST be greater than or equal to Health care waste generator
5 Health care waste generator inspected VS Health care waste generator compliant
compliant
International conveyance arrival at first point of entry MUST be greater than or equal to International
6 International conveyance arrival VS International conveyance inspected
conveyance inspected
International imported consignment arrival VS International imported consignment International imported consignment arrival at point of entry MUST be greater than or equal to
7
inspected
International imported consignment inspected at point of entry
4
Hazardous substance dealer inspected VS Hazardous substance dealer
compliant
8 Milling establishment inspected VS Milling establishment compliant
9
Notifiable medical conditions reported VS Notifiable medical conditions
investigated
10
Premises tobacco legislation inspected VS Premises tobacco legislation
compliant
Page 52 of 69
Milling establishment inspected MUST be greater than or equal to Milling establishment compliant
Notifiable medical conditions reported MUST be greater than or equal to Notifiable medical conditions
investigated
Premises tobacco legislation inspected MUST be greater than or equal to Premises tobacco legislation
compliant
Reference
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
TOTAL
EH Notifiable medical conditions investigated new
Surveillance
of Premises
EH Notifiable medical conditions reported to District Health Office
EHP Name: ______________________________________
EH Premises tobacco legislation compliant
Food Control
EH Premises tobacco legislation inspected
EH Milling establishment compliant
EH Milling establishments inspected
EH Food samples chemically compliant
EH Food samples chemical analysis
Chemical Safety
EH Food sample bacteriologically compliant
EH Food sample bacteriological analysis
EH Food poisoning reported new
EH Pesticide poisoning reported new
EH Mercury poisoning reported new
Waste
Management
EH Lead poisoning reported new
EH Health care waste generator compliant
Water
Quality
EH Health care waste generators inspected
EH Domestic water samples compliant
EH Domestic water samples collected
4.3.4 EH Data Tools (examples)
1) DAILY REGISTER: MUNICIPAL ENVIRONMENTAL HEALTH PRACTITIONER
Month: __________________
DAILY REGISTER: MUNICIPAL ENVIRONMENTAL HEALTH PRACTITIONER
EHP Name: ______________________________________________
Date __________________________________________________
Communicable
Diseases
Comment
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Department of Health
2) DAILY REGISTER: PROVINCIAL ENVIRONMENTAL HEALTH PRACTITIONER
EHP Name: ___________________________________
Date: _____________________________
DAILY REGISTER: PROVINCIAL ENVIRONMENTAL HEALTH PRACTITIONER
EHP Name: ______________________________________
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
TOTAL
Page 54 of 69
EH Health care waste generators inspected
Waste
Management
EH Health care waste generators inspected
Reference
EH Hazardous substance dealer compliant
EH Hazardous substance dealer inspected
Hazardous
Substances
Date:________________________
Comment
Reference
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
TOTAL
Page 55 of 69
Conveyance Control
EH Premises tobacco legislation compliant
EHP Name ______________________________________
EH Premises tobacco legislation inspected
EH International imported consignment inspected
EH International imported consignment arrivals at point of entry
Food Control
EH International conveyance inspected at first point of entry
EH International conveyance arrivals at first point of entry
EH Food poisoning reported new
EH Food samples chemically compliant
Waste
Management
EH Food samples chemical analysis
EH Food sample bacteriologically compliant
EH Food sample bacteriological analysis
EH Health care waste generator compliant
Water Quality
EH Health care waste generators inspected
EH Domestic water samples compliant
EH Domestic water samples collected
Department of Health
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
3) DAILY REGISTER PORT HEALTH ENVIRONMENTAL HEALTH PRACTITIONER
Date: ___________________
DAILY REGISTER: PORT HEALTH ENVIRONMENTAL HEALTH PRACTITIONER
EHP Name: ______________________________________________Date __________________________________________________
Surveillance of
Premises
Comment
Department of Health
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
4.3.4.1 EH DHIS Monthly Data Input form
1) Monthly Data Input Form Municipal Health Services
Municipal EHS Area : ____________________________________
Month: _______________________________________________
Completed by:_____________________________
No
Verified by: ______________________________
Data Element
Water Quality Monitoring
1
EH Domestic water samples collected
2
EH Domestic water samples compliant
Chemical Safety
3
EH Lead poisoning reported new
4
EH Mercury poisoning reported new
5
EH Pesticide poisoning reported new
Food Control
6
EH Food poisoning reported new
7
EH Food sample bacteriological analysis
8
EH Food sample bacteriologically compliant
9
EH Food samples chemical analysis
10
EH Food samples chemically compliant
11
EH Milling establishments inspected
12
EH Milling establishment compliant
Surveillance of Premises
13
EH Premises tobacco legislation inspected
14
EH Premises tobacco legislation compliant
Communicable Diseases
15
EH Notifiable medical conditions reported to District Health
Office
16
EH Notifiable medical conditions investigated new
Waste Management
17
EH Health care waste generators inspected
18
EH Health care waste generator compliant
Page 56 of 69
Value
Comment
Department of Health
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
2) Monthly Data Input Form Provincial Environmental Health Services
Provincial EHS Area___________________________________________
Month:________________________________________________
Completed by:_________________________________
No
Data Element
Control of Hazardous Substances
1
EH Hazardous substance dealer inspected
2
EH Hazardous substance dealer compliant
Waste Management
3
EH Health care waste generators inspected
4
EH Health care waster generator complaint
Page 57 of 69
Verified by: __________________________
Value
Comment
Department of Health
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
1) Monthly Data Input Form Port Health Services
Port Name____________________________________
Month: ___________________________
Completed by:_________________________________
Verified by: _________________________
No
Data Element
Water Quality Monitoring
1
EH Domestic water samples collected
2
EH Domestic water samples compliant
Food Control
3
EH Food sample bacteriological analysis
4
EH Food sample bacteriologically compliant
5
EH Food samples chemical analysis
6
EH Food samples chemically compliant
7
EH Food poisoning reported new
Port Health
8
EH International conveyance arrivals at first point of entry
9
EH International conveyance inspected at first point of entry
10
EH International imported consignment arrivals at point of entry
11
EH International imported consignment inspected
Surveillance of Premises
12
EH Premises tobacco legislation inspected
13
EH Premises tobacco legislation compliant
Waste Management
3
EH Health care waste generators inspected
4
EH Health care waster generator complaint
Page 58 of 69
Value
Comment
4.4 Emergency Medical Services Program (EMS)
4.4.1 EMS Data Elements (extracted from DHIS Jan 2012)
Nr
Data Element Name
Definition
Use and context
IndGroup
Frequency
Collected
By
Collection
Points
Tools
1
EMS call client
transported
Number of calls which resulted in any
number of clients being transported
Monitors calls which resulted in clients being
transported in relation to total calls for which
ambulances were dispatched
EMS
Monthly
EMS Call
Centre
EMS Call
Centre
Tick
Register
EMS
2
EMS calls total
Number of calls received by the
communications centre
Only count calls for which an ambulance was
requested
EMS
Monthly
EMS Call
Centre
EMS Call
Centre
Tick
Register
EMS
3
EMS inter-facility
transfer
Number of clients transferred between
health facilities by an ambulance (from
one inpatient facility to another inpatient
facility)
Monitors use of ambulances for inter-facility
transfers
EMS
Monthly
EMS Call
Centre
EMS Call
Centre
Tick
Register
EMS
4
EMS obstetric client
Number of maternity/obstetric clients
transported to a health facility
Monitors use of ambulances for transporting
maternity/obstetric clients. Include clients
transported in Obstetric Emergency Units and
those transported in other operational
ambulances
EMS
Monthly
EMS Call
Centre
EMS Call
Centre
Tick
Register
EMS
5
EMS operational
ambulances
Actual number of operational
ambulances at an ambulance station
during the shift
Monitors compliance with norm for operational
ambulances. Exclude Obstetric Emergency
Units
EMS
Monthly
EMS Call
Centre
EMS Call
Centre
Tick
Register
EMS
6
EMS operational
Obstetric Emergency
Units
Number of operational Obstetric
Emergency Units at an ambulance
station
Monitors compliance with norm for Obstetric
Emergency Units
EMS
Monthly
EMS Call
Centre
EMS Call
Centre
Tick
Register
EMS
7
EMS P1 calls total
Total number of P1 calls received by the
communication centre
EMS
Monthly
N/A
N/A
DHIS
calculate
8
EMS P1 response
under 60 minutes total
Number of P1 calls where the response
time was within 60 minutes in both urban
and rural areas
EMS
Monthly
EMS Call
Centre
EMS Call
Centre
Tick
Register
EMS
9
EMS P1 rural calls
Total number of P1 calls received from
rural areas by the communication centre
Monitors P1 EMS needs in rural areas
EMS
Monthly
EMS Call
Centre
EMS Call
Centre
Tick
Register
EMS
10
EMS P1 rural
response under 40
minutes
The number of P1 calls in a rural area
where the response time was under 40
minutes
Monitors effectiveness of EMS services in rural
areas. Response time is the time it takes an
ambulance to reach an emergency medical
scene, calculated from the time of the first call
to the control room up to the time of arrival on
the scene
EMS
Monthly
EMS Call
Centre
EMS Call
Centre
Tick
Register
EMS
Sum of EMS P1 urban calls and EMS P1 rural
calls
Monitors effectiveness of EMS services.
Response time is the time it takes an
ambulance to reach an emergency medical
scene, calculated from the time of the first call
to the control room up to the time of arrival on
the scene
Department of Health
Nr
Data Element Name
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Definition
Use and context
IndGroup
Frequency
Collected
By
Collection
Points
Tools
11
EMS P1 urban calls
Total number of P1 calls received from
urban areas by the communication
centre
Monitors P1 EMS needs in urban areas
EMS
Monthly
EMS Call
Centre
EMS Call
Centre
Tick
Register
EMS
12
EMS P1 urban
response under 15
minutes
The number of P1 calls in an urban area
where the response time was under 15
minutes
Monitors effectiveness of EMS services in
urban areas. Response time is the time it
takes an ambulance to reach an emergency
medical scene, calculated from the time of the
first call to the control room up to the time of
arrival on the scene
EMS
Monthly
EMS Call
Centre
EMS Call
Centre
Tick
Register
EMS
13
EMS clients total
Total number of clients transported by an
ambulance during reporting period
Total number of emergency clients (all
priorities) transported by ambulance,
irrespective of the number of calls or trips
EMS
Monthly
EMS Call
Centre
EMS Call
Centre
Tick
Register
EMS
Page 60 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Department of Health
4.4.2 EMS Indicators (extracted from DHIS Jan 2012)
Nr
Indicator
Name
1
EMS call
transport rate
2
EMS interfacility transfer
rate
3
EMS obstetric
client transport
rate
4
5
EMS
operational
ambulance
coverage
(annualised)
EMS
operational
Obstetric
Emergency
Unit coverage
Type
%
%
%
per10
K
%
Annu
alised
Numerator
0
EMS call client
transported
0
EMS inter-facility
transfer
0
EMS obstetric
client
1
EMS operational
ambulances
0
EMS operational
Obstetric
Emergency
Units
Denominator
Definition
IndGr
oup
Freq
Level
EMS calls total
Proportion EMS calls
which resulted in clients
being transported
Monitors the proportion of calls which
resulted in clients actually being
transported to health facilities in
relation to the total number of calls
dispatched by the Communications
Centre
EMS
Monthly
Output
EMS clients total
Inter-facility (from one
inpatient facility to another
inpatient facility) transfers
as proportion of total EMS
clients transported
Monitors use of ambulances for interfacility transfers as opposed to
emergency responses
EMS
Monthly
Output
EMS clients total
Obstetric clients as
proportion of total EMS
clients transported
Monitors need for and use of
ambulances for obstetric clients.
Includes obstetric clients transported
in obstetric and other operational
ambulances
EMS
Monthly
Output
Population total
Number of operational
ambulances per 10 000
population
Monitors compliance with the norm
for operational ambulances to meet
population needs. This includes
obstetric ambulances
EMS
Monthly
Input
Population total
The number of operational
obstetric units available for
transporting obstetric
cases per 10,000
population
Count only operational obstetric units.
Exclude normal operational
ambulances
EMS
Monthly
Input
EMS
Monthly
Output
EMS
Monthly
Output
EMS
Monthly
Output
6
EMS P1 call
response under
60 minutes rate
%
0
EMS P1
response under
60 minutes
EMS P1 calls
total
Proportion of all P1 calls
with response times under
60 minutes
7
EMS P1 rural
response under
40 minutes rate
%
0
EMS P1 rural
response under
40 minutes
EMS P1 rural
calls
Proportion P1 calls in rural
locations with response
times under 40 minutes
8
EMS P1 urban
response under
15 minutes rate
%
0
EMS P1 urban
response under
15 minutes
EMS P1 urban
calls
Proportion P1 calls in
urban locations with
response times under 15
minutes
Page 61 of 69
Use and context
Monitors compliance with the norm
for all critically ill or injured clients to
receive EMS within 60 minutes. This
includes P1 urban responses under
15 minutes and P1 rural calls under
40 minutes. Low rates indicate
inadequate resources
Monitors compliance with the norm
for critically ill or injured clients to
receive EMS within 40 minutes in
rural areas
Monitors compliance with the norm
for critically ill or injured clients to
receive EMS within 15 minutes in
urban areas
Key
reports
4.4.3 EMS Data Tools
4.4.3.1 EMS Individual patient record / data collection tool
Date
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Name / number
RUNNING TOTAL
TOTAL
Sex
Age
EMS clients total
EMS P1 urban response under 15 minutes
EMS P1 urban calls
EMS P1 rural response under 40 minutes
EMS P1 rural calls
Station Name
EMS P1 response under 60 minutes total
EMS P1 calls total
EMS operational Obstetric Emergency Units
EMS operational ambulances
EMS obstetric client
EMS inter-facility transfer
EMS calls total
EMS call client transported
Department of Health
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
4.4.3.2 EMS Tick Sheet / Register
Month
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Department of Health
4.4.3.3 EMS DHIS Monthly Data Input form (DHIS auto-generated)
EMS Station
Month
Completer by
Date
Verified by
Date
Checked by (Station Manager)
Date
Captured by
Date
SortOrder
DataElement
1 EMS call client transported
2 EMS calls total
3 EMS inter-facility transfer
4 EMS obstetric client
5 EMS operational ambulances
6 EMS operational Obstetric Emergency Units
7 EMS P1 calls total
8 EMS P1 response under 60 minutes total
9 EMS P1 rural calls
10 EMS P1 rural response under 40 minutes
11 EMS P1 urban calls
12 EMS P1 urban response under 15 minutes
13 EMS clients total
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Value
Comment
Department of Health
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
4.5 Maintain the Organisational Hierarchy of NON-FACILITY DHIS data files
The provincial and district Information officers are responsible for managing the Organisational Hierarchy
in the DHIS data files.
4.5.1 Organisational Hierarchy Integrated School Health Program (ISHP) data file
ISHP data is captured by School at OrgUnit 5 level
If a School is captured where the name is not on the DHIS list, the Information Officer must contact the
Department of Education.
4.5.2 Organisational Hierarchy Environmental Health (EH) data file
EH data is captured at OrgUnit 5 level.
4.5.3 Organisational Hierarchy Emergency Medical Services (EMS) data file/set
EMS data is captured at OrgUnit 5 level
4.5.4 Organisational Hierarchy – Ward Based Outreach Team (WBOT) data file
PHC Outreach Teams have to use a more complex Organisational Hierarchy for reporting than normal
health facilities for at least two reasons:
1. The routinely collected data must relate to the community, which in this case means each of the
current political wards in the country.
2. The same data and the teams must also relate to the “parent facility” of each team, both because
the outreach teams are managed via these facilities and because the households and individuals
covered receive health services from these facilities.
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Department of Health
OrgUnit
Level
OrgUnit
1-5
OrgUnit 6
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Description
These Organisational Unit levels are the standard ones used for normal monthly and quarterly
reporting from health facilities: National (OU 1), Province (OU 2), Health District (OU 3), Health Subdistrict (OU 4), and Health Facility (OU 5). The naming convention for these OU1-OU5 OrgUnits is the
same as for all other DHIS data files containing facility data.
The currently (2012) 4,277 political wards in the country form the Organisational Units at level 6. Each
ward must be linked to a “parent” PHC health facility within the same health sub-district, preferablye
the health facility that provide the bulk of health services to the population in the ward. The closest or
largest fixed PHC health facility in the within or in the vicinity of each ward has initially been allocated
as the parent facility for each ward in the DHIS. Local managers must review this initial allocation and
move the ward to a more suitable “parent” PHC facility where required.
The naming convention for political wards follows the format
<Prov Prefix> <Health sub-District Name> <Ward><Ward Number “0xx”>
Examples: Ward 7 in the City of Johannesburg is “gp City of Johannesburg Ward 007” and ward 112
is “gp City of Johannesburg Ward 112” (always use 3 characters for the ward number).
The activities of each outreach team active in a ward forms the reporting unit at level 7. Note that one
reporting unit is only directly equivalent to one outreach team if that outreach team work only in one
ward. It is important to understand that



OrgUnit
7
There might be several outreach teams working in the larger wards (i.e. several reporting
units)
One outreach team might work in several (usually smaller) wards (i.e. several reporting units)
While not recommended, there might be cases where an Outreach Team linked to a health
facility in health sub-district A assist with the work in a ward in the neighbouring sub-district B.
Such reporting units must reside under that ward in sub-district B. In the highly unlikely event
that one team is operating in two wards from different sub-districts with the same ward
number, then name those reporting units by adding an “a” or “b” at the end of the name.
The primary analysis of Ward Based Outreach Team activities and health data will be per ward and
then geographically aggregated to sub-district, district, province, and national. The DHIS has
nevertheless also been configured to enable aggregation of data via the “parent” facility of each
outreach team, since that often will be relevant for monitoring the Ward Based Outreach Team rollout across the country.
The naming convention for Ward Based Outreach Team reporting units follows the format
<Prov Prefix> <Parent Health Facility> <- W><Ward Number “0xx”>
Example: The first Outreach Team at the Stanza Bopape II Clinic in the City of Tshwane are working
in Ward 20, 27, and 97, whereas the second team is working in Ward 98. Four reporting units are
created:
gp Stanza Bopape II Clinic Outreach Team 1 - W020, child OU under Tshwane Ward 020
gp Stanza Bopape II Clinic Outreach Team 1 - W097, child OU under Tshwane Ward 097
gp Stanza Bopape II Clinic Outreach Team 1 - W099, child OU under Tshwane Ward 099
gp Stanza Bopape II Clinic Outreach Team 2 - W098, child OU under Tshwane Ward 098
It is important that all reporting units under a specific facility have identical names except for the team
and ward numbers, since that part of the name will be used to group reporting units in accordance
with the PHC facility that the teams are operating from.
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Department of Health
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
4.5.4.1 Managing and Expanding the WBOT Organisational Hierarchy
When establishing Ward Based Outreach Teams, district and sub-district management teams should
consider several aspects that will make long term data management easier:




Each ward should have as many Outreach Teams as required by the current number of
households, and preferably not more – avoid dividing up a ward among many teams if possible,
and even if such fragmentation might have a few logistical/transport benefits.
Avoid cross-sub-district-border Outreach Teams if possible.
Temporary allocations of Outreach Teams to wards might be particularly tempting during the
initial build-up of the Ward Based Outreach Team structure, but should be avoided if possible.
Significant shifts over time in which teams work where, will either result in a significant number of
closed reporting units with data for only a few months or years, or calls for moving data between
teams (mergers etc).
Ensure that all new Outreach Teams being established are clearly defined in terms of (a) the ward
or wards they will work in and how many households allocated to each team; (b) the “parent” PHC
facility they are attached to; and (c) any other semi-permanent data about the team required for
processing indicators or monitoring the roll-out.
4.5.4.2 Updating the Primary Health Facility “Parent” for each Political Ward
All districts and sub-districts must as soon as possible review the preliminary allocation of political wards
to their “primary PHC service provider” facility done by the National Department of Health. This
preliminary allocation was based on the following (except for a few cases where Outreach Teams had
been established already):


If one or more fixed PHC facilities were located within the borders of the ward, the largest such
facility was selected as the “parent” health facility for that ward.
If there were no fixed PHC facility within the ward, then select the largest and/or “dominant” fixed
PHC facility located in any of the surrounding wards.
In order to correct this child-parent relationship between the ward and its primary service provider in the
DHIS, go to Maintenance and then Organisational Hierarchy. Select the relevant ward, and use the
MOVE function to place it under the correct health facility within the geographically correct health subdistrict.
Note again that allocating wards to health facilities in other sub-districts are prohibited. Even if one or
more wards end up being serviced by Outreach Teams from neighbouring sub-districts, and even if the
population in that/those wards predominantly used health facilities from neighbouring sub-districts – such
wards must use a health facility located in the correct sub-district as a “parent”.
Political wards are in general demarcated by the Municipal Demarcation Board, with revisions before
every local election. Modifications to the WBOT data file related to such national revisions from the
Municipal Demarcation Board will be co-ordinated by the National Department of Health.
In the exceptional event that wards are created or modified in between these election cycles, the District
Manager is responsible for ensuring that the WBOT reporting and the DHIS OrgHierarchy is updated
accordingly and that the province and national are informed.
The primary PHC health facility “parent” for a ward might change over time, for instance due to the subdistrict re-organising its services or due to a new health facility opening. If that is the case, simply MOVE
the relevant ward to its new facility “parent”, and all existing data will be moved along with it.
Page 67 of 69
Department of Health
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
4.5.4.3 Adding or Modifying Ward Based Outreach Team Reporting Units
The DHIS WBOT data file will be disseminated with a few hundred Outreach Team reporting units
included, and some of these might be incorrect in terms of the ward or in terms of which facility the team
is related to. Verify the level 7 reporting units for your area before you start capturing data.
The number of teams is expected to expand rapidly over the next 2-3 years, with an expected total of
around 6,500 teams active when the re-engineered PHC system is fully operational. This means on
average around 1.5 teams for each political ward.
When a new team has been established or started in a ward, then create a new reporting unit at level 7
under that ward, naming it as described above (fixed PHC facility name + team number under that facility
+ ward number):





Add the new Reporting Unit to the DHIS under Maintenance -> Organisational Hierarchy, set the
correct start data (note: always use the first day of the start-up month), and tick the “Submit data”
tick-box. Follow the established naming convention also for the short version of the name. If
“standard” short names end up being over 25 characters when the “Outreach Team X” and
“W0xx” are added, then use common sense to shorten the first “facility” part of the name and
make sure all reporting units linked to that facility have short names constructed in an identical
manner.
Add the Reporting Unit’s Organisational Code if available from the district management team
Use “Ward Based Outreach Team” for OrgUnitType
Use “Province Outreach Team” or “Municipality Outreach Team” or “NGO Outreach Team” for
OrgUnitOwnerShip
Use “Rural” or “Urban” or “Peri-Urban” for OrgUnitRuralUrban
A Ward Based Outreach Team reporting unit and its data are primarily linked to the ward, so the normal
response to a specific team ceasing activity in a ward would be to CLOSE that reporting unit. Remember
then that the closing date should be the last day of the last reporting month, and that the “Submits data”
tick-box should be un-ticked.
When a specific team changes the PHC facility it is affiliated with, but otherwise continue its activities in
the same ward as before, then each of the relevant WBOT reporting units should be RENAMED so the
reporting unit names reflect its affiliated PHC facility name.
4.5.5 The PHC WBOT Household Profile Data File
A separate DHIS data file has been created to capture and store the data from the Household
Profile/Registration forms collected during the initial visit to each household, and possibly later updated.
As the Organisational Hierarchy is the main WBOT data file is updated and maintained as outlined
above, the same changes should be done to the Household Profile data file (which runs under the DHIS
Patient Module).
The PHC WBOT Household Profile Data File will be rolled out for implementation at a later stage
Page 68 of 69
Department of Health
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
4.5.6 Adding Local Data Elements and Indicators
For the large majority of Ward Based Outreach Teams that work according to the national guidelines for
such teams, adding local data elements or indicators are strongly discouraged during the initial roll-out of
the WBOT system.
In districts or areas that have opted for an expanded mandate that includes additional services during
household visits, it might be necessary to add local data elements and indicators. This should be done as
follows:



Add the additional data elements and indicators as required (see other sections of the SOP and
the DHIS user manual for how to do this)
Create a new local data set that contain all national data elements plus the local ones – do not
modify the national WBOT data set.
Clarify with the district and with the province if they want such local data elements / data
submitted. If yes, use the extended “WBOT Local” data set for export. If no, use the standard
WBOT data set for export to higher levels.
________________________________________________________________________
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