Project Component 5:

Strengthening VL surveillance through scaling up web based surveillance system of MIS, DGHS, GoB.

The National disease management and information system under the Directorate General of Health Services, Government of Bangladesh has established and launched a web based surveillance system which has recently been adapted to include visceral leishmaniasis. This surveillance tool is available only in Bangladesh among other four member states of WHO South East-Asia Region (Bhutan, India, Nepal and Thailand) signing an MoU to eliminate VL from their countries. The system is a powerful tool for following issues:

  • Generate information of VL and PKDL cases including their symptoms
  • Duration of symptoms and treatment outcome of cases which is required for programme personnel, policy makers and development partners
  • Generated follow-up cards which are very useful for national programme and patients
  • Different analysis options is available including GIS mapping that helps to identify hot spots of the disease which is very crucial for national programme. Using this platform to support interventions (i.e. IRS) increases cost-effectiveness.

The system has some excellent build in reporting tools, which includes data virtualization (bar diagram, pie chart, line chart etc), several pivot tables, etc. The system has also the scope of customizing reporting which can be used to generate report as per user need. Customize analyses also include some basic reporting

including summary statistics such as mean, percentage, rates etc. The system will be exceptionally useful to ensure follow up of treated VL and PKDL patients. So the system has facility to use for responding to cases, reporting case loads in close-to real time, and validating the data. If the GPS location of the cases is available then, the system can also be used to map the cases to see the spatio-temporal distribution of cases. This map can be used to identify the hot spot of the disease and plan effective interventions to control disease.

This web based VL surveillance system has been tested successfully on a pilot basis in some endemic UHCs. Due to HR and funding constraints the NKEP could not scale it up in all UHCs, which is extremely important for strengthening the surveillance system. The NKEP wishes to scale it up as strengthening of VL surveillance is one of the strategic pillars of the VL elimination programme. The KalaCORE programme will provide support to NKEP to strengthen its disease surveillance system using the VL web based surveillance system of MIS, DGHS, GoB through this component of the project.

The system is integrated into the DHIS2 platform for disease surveillance. DHIS 2 is a free and open source software released under the liberal BSD license. It is highly scalable as with DHIS 2 the client can have thousands of concurrent users and hundreds of millions of data records using only a single, standard web-server. DHIS 2 comes with great capabilities for system interoperability and features its own format for meta-data and data exchange called DXF 2 as well as the SDMX-HD standard. Most parts of the system can be accessed through the extensive REST-based Web API, making interoperability with third-party clients like Android apps, Web portals and other information systems easy. It was initially developed by University of Oslo, Norway, and later on developed by the Health Information Systems Program (HISP). To know more about DHIS 2, please visit the website, www.dhis2.org.

Currently, most of the programmes of DGHS are using DHIS 2 platform for the surveillance purpose; they are:- EPI, IMCI, EmOC, HIV-AIDS, MNCH, Disease surveillance (by IEDCR), TB and Leprosy control programme, school health programme, Filariasis elimination programme, other infectious diseases, etc. In the list Kala-azar surveillance is the newly added component. There are many development partners of GoB like GIZ, USAID, DFID, European Union, UNICIEF, WHO, UNFPA, GAVI, Global Fund, CIDA, JICA, Care, Save the Children, PLAN International are supporting MIS, DGHS to accommodate the web based surveillance system in Bangladesh. Different development partners are supporting separate components of the surveillance system according to their field of interest. KalaCORE has the opportunity to support GoB in enhancing the web based surveillance system on Kala-azar through MIS, DGHS.