iRHIS rolling out to new countries

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Here we are with some updates on the Integrated Refugee Health Information System (IRHIS) project that aims at monitoring UNHCR’s public health activities in Refugee Camps worldwide. Fig.1 iRHIS Landing page

The mobile and web application designed to collect and report refugees medical records is up and running with a renovated look and it’s currently being used in 4 countries: Tanzania, Rwanda, Zambia and Ethiopia, involving over 1300 users and serving over 355.700 refugees. While Tanzania, Rwanda and Zambia have also participated to the pilot phase, the system has been introduced to Ethiopia only in the last month, where over 500 new users have started to collect data. While Data is collected daily and mostly offline on tablets by health staff, data synchronization and aggregation is performed weekly to update indicators on dashboard, reports and landing page. In some locations, such as in 2 Refugee camps in Zambia and one camp in Kenya, individual data collection has not been possible due to internal constraints. In order to overcome the challenge, the system provides the possibility to also enter already aggregated data directly into the application using a specific online form at health facility level. Once information has been entered into the system, dashboard, reports and landing page allow easily monitoring of mortality, morbidity, reproductive health, diseases surveillance, Epi and nutritional indicators. The landing page, that is publicly available,  displays indicator values at country and camp levels. The picture below shows pie charts (Fig.2) about the top five causes of morbidity in 6 Rwandese Refugee camps, grouped by disease type ( Acute Health Conditions, Chronic Diseases, Injuries, Mental Health Disease) Fig. 2: Total consultations, Rwanda-June 2018

The following image instead shows the breakdown of ‘Skilled Birth Attendance’ indicator in Rwandese camps (Fig.3) Fig. 3: Skilled Birth attendance breakdown, Rwanda-June 2018

The dashboard is also a key element of the iRHIS system. Displayed data is based on users’ permissions and Figure 4 shows some dashboard indicators (population, morbidity and mortality) related to Kiziba Refugee camp in Rwanda. Fig. 4: Dashboard for Kiziba camp- week 30 2018

A great advantage of the system is that not only camp, country or regional supervisors but also clinicians at health center level can view updated indicators directly on their dashboard on their tablets. This helps them to always have a clear picture of the current status of the Health Facility or Camp where they work in. Furthermore, they can see their data collection efforts being used to generate valuable information. Also reports are automatically generated weekly. They provide a comprehensive overview of public health and wash indicators at refugee camp level. Figure 5 and 6 show some examples of iRHIS reports. Fig. 5: Example of HIS Indicator Report for Nyarugusu Camp (Tanzania, June 2018)

Fig. 6: Example of Disease Surveillance Report for Mugombwa Camp (Rwanda, week 30)

In the coming months, the system will be constantly monitored to improve its performance and facilitate the roll out in other countries. In August, Sudan will be added to the list of implementing countries. Particularly, next week health staff from 7 camps in Easter Sudan will be trained on the use of the new system. We’ll continue keeping you posted on future updates of the project! Stay tuned!