Throughout 2021 the Digital Public Goods Alliance will be undertaking a series of pathfinding pilots. These pilots are meant to increase the number of countries implementing DPGs, promote and support the creation of DPGs in low- and middle-income countries, and increase national capacity for implementing projects utilizing DPGs. Learnings and insights gained from these pathfinding pilots will strengthen future DPG deployments by helping to inform how they can best be implemented. 

Pathfinding pilots must adhere to three criteria: 1) include local capacity building for creation of new DPGs, and/or adaptation and implementation of existing DPGs; 2) outcomes of the pilots must adhere to the DPG Standard; and, 3) pilots must be conducted either in direct cooperation with and/or with the endorsement of a relevant government entity.

Some of these pilots are already underway. Below, we showcase the work of digital public goods DHIS2 and DHIS2 for Education as they, with support from Norway, launch pathfinding pilots in The Gambia and Uganda.


DHIS2 – A Digital Public Goods Case Study 

Digital Public Goods Introduction 

Endorsed by the UN Secretary General’s Roadmap for Digital Cooperation, the Digital Public Goods Alliance defines digital public goods (DPGs) as: “open source software, open data, open AI models, open standards and open content that adhere to privacy and other applicable laws and best practices, do no harm, and help attain the SDGs.”

When operationalised, DPGs have proven to be much more. They have the ability to connect individuals and communities to vital services, improve data-based decision making capabilities, and build the infrastructure that societies rely on to respond to crises. 

The Digital Public Goods Alliance (DPGA)’s mission is to aid the discovery, development, use of, and investment in DPGs. Amplifying success stories of DPGs to show their value, and highlighting implementation strategies from around the world is key to accelerating our mission. Strengthening understanding and awareness of DPGs is critical to fostering trust and interest in open source projects, and can help propel adoption. 

One success story is the free and open source platform DHIS2, which is helping to attain the SDG’s in 73 low- and middle-income countries by supporting the management of education and health programs.

Background

From climate change to education, healthcare to transportation, digital public goods have the opportunity to solve some of society’s greatest challenges. This can be exemplified by District Health Information Software 2 (DHIS2), an open-source software project first created to identify and address gaps in health data collection. The software has recently expanded to show value not just in the health sector, but in the education sector as well. DHIS2 was developed by the Health Information Systems Programme (HISP) at the University of Oslo (UiO) in collaboration with partners in the Global South. It is shared for download at no cost and its open source software and source code is hosted on Github.

The first version of this software, DHIS, began in 1998-99 fueled by the belief that collecting and layering granular data can help facilitate governments to make informed decisions. Initially, DHIS was developed to track routine monthly data from Primary Health Centers in Cape Town, South Africa.(1) Today, DHIS2 is the world’s largest health management information system (HMIS) platform, used in 73 low- and middle-income countries.(2) An astonishing 2.4 billion people, or 30% of the world’s population, live in countries where DHIS2 is used. 

Over the last decade, DHIS2 has expanded beyond traditional HMIS reporting to include the collection of individual-level data feeding into shared health records including: lab results; disease surveillance; contact tracing and more. Seventy-seven countries and Indian states utilise the DHIS2 Tracker for case-based data entry, and 33 are using the DHIS2 Android app for data capture on mobile devices.(3)(4)

Proving its versatility beyond government ministries, DHIS2 is also used for data management by leading health organizations including Doctors Without Borders and the World Health Organization (WHO). As a Collaborating Center with WHO, the HISP team at the University of Oslo works with global and country experts to create downloadable standards-based configurations of the software for specific health domains, lowering the barrier to entry for many countries, and improving data quality within and across countries.(5)(6)

Building on the same theory of change developed for expansion in the health sector, DHIS2 is two years into piloting “DHIS2 for Education”. Crucially, DHIS2 for Education builds on the existing DHIS software platform in countries where it is already deployed in the health sector to support the collection, analysis, visualization, and use of individual and aggregate data from institutions of learning.(7) This includes not just health and education data, but socioeconomic indicators as well that can help contextualize the health and education data. 

Through these work streams, DHIS2 is directly addressing UN Sustainable Development Goals 3 (Good Health and Well-Being) and 4 (Quality Education) which call for the use of data to guide improvement in both health and learning outcomes as well as equitable access to education. It also touches on a number of other SDGs including reducing inequality and eliminating poverty. 

By the Numbers 
  • 73 countries use DHIS2 
  • 5 countries use DHIS2 for Education
  • 2.4 billion people live in places where DHIS2 is used
  • 38 countries are using the software to combat COVID-19 
 Innovations 

DHIS2 by the numbers alone is impressive, but that only tells part of the story. DHIS2 is a widely trusted platform that promotes holistic growth and impact by providing innovative solutions, including:

Accessibility

DHIS2 is both physically and financially accessible. It can capture data on computers, tablets and smartphones and most solutions work offline, enabling improved reach in locations with poor connectivity. The platform integrates easily with other software platforms bringing logistics, human resources, grading systems and payroll onto a single dashboard. DHIS2 is free to use aside from the cost of servers and internet connectivity and, because it is open source, it can be accessed and adapted to scenarios in any country. 

Capacity Building 

To ensure holistic, sustainable growth, and to combat brain drain, the Health Information Systems Programme (HISP) has built a community of users and experts in regions where DHIS2 is used through initiatives including the DHIS2 Academy and DHIS2 Community of Practice. As DHIS2 implementation varies based on local context, this also facilitates shared learnings and implementation strategies.

Versatility

“DHIS2 has a modular, layered architecture with a strong and open application programming interface (API).”(8) In practice, this means that native applications can run off of it. Currently, approximately 60 native applications do just that to perform different functions, and software developers can easily build their own external applications on top of DHIS2 making it more adaptable. DHIS2’s API also allows it to exchange data with other software, facilitating interoperability between systems. This agility means that DHIS2 teams can work closely with users or government representatives to explore different needs and scenarios that arise and adapt accordingly.

COVID-19 Response 

DHIS2 has led projects that assist countries and regions responding to COVID-19. It has been evaluated as a leading digital solution for COVID-19 response by Johns Hopkins University, the United State’s Center for Disease Control & Prevention (CDC), and Digital Square. Understanding their ability to quickly respond and adapt to growing health concerns, DHIS2 released a digital data package to accelerate case detection, reporting, surveillance and response. 

The package was inspired by the Sri Lankan Ministry of Health’s pioneering design of a DHIS2 tracker for COVID-19 which draws on years of DHIS2 collaboration with the WHO on designing standardized packages for key health programs. The tracker is operational in 38 countries and in development in 14 more.(9) In Uganda, for example, local health authorities are transmitting infection results digitally. In Rwanda, the health care system is fully digitalised, allowing data to arrive instantaneously.(10) 

This innovation extends to the education sector as well. DHIS2 for Education uses an educational management information system (EMIS) that layers in health data and will provide long-term and sustainable responses to COVID-19 and other health challenges. One example is school-level vaccination campaigns which can synergize health and education data.

DHIS2 and Digital Public Goods Alliance Pathfinding 

DHIS2 has been reviewed against the Digital Public Goods Standard, qualifying it as a digital public good which can be found on the DPG Registry

DHIS2 software is developed in line with the Principles for Digital Development, and it advances the SDGs in a number of ways. DHIS2 for Education is currently being deployed as an EMIS in several countries, facilitating effective communication between health and education programs (for example, vaccination campaigns targeting school-aged children), as well as supporting purely education-related goals like student enrollment and attendance, resource allocation, and infrastructure management. DHIS2 has identified opportunities to address and overcome similar challenges in both the health and education sectors such as data collection, where there is often no common approach to collecting valuable educational system data, such as human resource data for teachers or student’s tests results, that link with district or national systems. You can read more about this initiative here: https://www.dhis2.org/education.

Over the next three years the DHIS2 in Education pilot will be expanded. The pilot will focus on integration and scalable solutions in specific country contexts. It will draw from different regions with varying languages, norms, and traditions which will help shape its ability to respond to different countries with different needs.

Norway, a founding member of the DPGA, has been a funder of DHIS2 since 1994 and will partner with them to use this extended pilot as one of the key pathfinding cases for the DPGA. Pathfinding pilots help inform the development and roll out of DPGs for future use cases. Supporting this effort is of strategic importance to Norway’s efforts to highlight how DPGs developed for one sector can be relevant for other sectors, and hence help break down silos in international development cooperation.

Conclusion 

DHIS2 exemplifies the power and potential of digital public goods. Not only has it successfully scaled in market, it has done so in a way that brings us closer to the achievement of the Sustainable Development Goals. Additionally, its development has been holistic and localisable, allowing countries to leverage their existing capacity and expertise. And, DHIS2 has adapted to various sectors and challenges including scaling for COVID-19 response and addressing challenges in education.

From its beginnings in Cape Town, DHIS2 has grown to significantly cover health data and information, and now education. It is this opportunity to break the silos of development, and address challenges holistically, that is particularly interesting to us at the DPGA. Digital public goods like DHIS2 present an opportunity to innovatively address longstanding societal issues. 

Resources

(1) https://en.wikipedia.org/wiki/DHIS
(2) https://www.dhis2.org/
(3) https://dhis2.org/tracker/
(4) https://dhis2.org/android-in-action/
(5) https://www.who.int/healthinfo/tools_data_analysis_routine_facility/en/
(6) https://dhis2.org/who/
(7) https://www.dhis2.org/education
(8) https://www.dhis2.org/about
(9) https://www.dhis2.org/in-action
(10) https://www.aftenposten.no/norge/i/qARnOz/fra-husokkupasjon-til-smittejakt-naa-hjelper-et-norsk-verktoey-tre-av-t