Informed consent form

Introduction
Good day. This consent form is prepared by researchers, from the MOH and HABTech
Solutions, whose main aim is to assess current DHIS2’s usability level for development of
DHIS2 capacity building roadmap.
Purpose of the research
Specifically, this study is trying to assess DHIS2’s implementation status, identify issues that
hinder the functionality of DHIS2, explore potential measures to overcome hindrances and
challenges, assess gender inclusiveness in DHIS2 implementation, and to develop a DHIS2
capacity building roadmap that guides the localization and sustainability of DHIS2
implementation in Ethiopia. Thus, we believe that your previous experience and thoughts on
DHIS2 will help us to achieve the main aim of the study.
If you agree to take part, we will have a discussion that will last up to 1 hour. Throughout the
interview period, we will take handwritten notes and also tape record the session.

Risk and discomfort: There is no or minimal risk in this study. There is a small risk your opinions
might not be kept private if someone shares the discussion, but we will discuss the importance of
confidentiality at the beginning of the session and try to maintain it.
Confidentiality: We will not record participants’ names during the interview. Instead, we will
assign numbers to individuals that will be matched against the responses. The notes will be
translated into English if needed. Where we use quotes from the discussions they will be
designated by number. No quotes will be traceable to a specific person. All study materials will
be kept in a locked cabinet or password protected computer. Your name and identity will not be
shown in any reports about this study.
Voluntary participation and right to refuse (withdraw): Participation in this study is
voluntary. If you decide not to participate in this study, your decision will not affect your future
relations. If you decide to participate, you are free to withdraw your consent and to discontinue
participation at any time
Are you willing to participate in this study? [ ] Yes [ ] No
Having been well explained and informed of the intentions and benefits of the study, I decided voluntarily
to participate in the study.
Name of participant/Witness …………………………………………………
Signature ………………Date……………… Time…………………………
 1. Name of interviewer ______________________________

2. Date of interview ___________________________________

3. Region _____________________________________________

4. Sex of interviewee (circle it) 1. Male 2. Female

5. Specific position/occupation of _______________________________________________

interviewee (program personnel)

In-depth Interview Guideline for program Personnel

Introductory question
1. How is your overall experience with DHIS2 since 2018?
Probe on:
o How frequent do you use it?
o Is the system easy to use
o Was the system able to do what you expect
o Do you find each component useful like the additional analytics and visualization
tools

Capacity Building
1. How do you explain the adequacy and participatory nature of DHIS2 training given
since 2018?
Probe on:
o Have you participated in DHIS2 training?
o How adequate was the content of the training?
o In what areas did the training were given?
o What training strategies are used? (availability of standard module or PPT,
duration of training, practical/theoretical, trainers)

2. What training strategies did trainers usually use when providing capacity building
training on DHIS2?
Probe on:
 Are the training strategies and materials be documented?
 Was the effectiveness of the training given be evaluated?
 Do consecutive training opportunities were designed and provided for health
workers?
 Have you initiated DHIS2 training by your institute budget?

3. How do you evaluate the gender inclusiveness of DHIS2 trainings given?

Probe:
 Explain this considering the female to male ratio of trainees of DHIS2
  Also explain this considering the female to male ratio of trainers of DHIS2

4. What challenges or hindrances have you experienced or observed regarding DHIS

training?

Probe on:
 What possible remedies do you suggest to overcome those challenges?
 What can be done to improve the DHIS2 trainings in general?

Governance
1. How do you explain the governance established to administer and lead the development,
customization, and support of DHIS2 across the health system?

Probe:
o Is there a technical committee or anything equivalent? Its mix?
o Role and responsibilities of the committee
o How functional/effective were the committees?
o Governance and coordination mechanisms across programs or organizational
hierarchy?

2. What governance and coordination mechanisms of DHIS2 implementation available

across programs or organizational hierarchy?
Probe:
 If available, what does its coherence look like?
 If not available, what were the challenges to establish governance and
coordination mechanisms?

3. What coordinated strategies and investments that can address different instances of
DHIS2 were implemented in Ethiopia?
Probe:
 If no, how significant is to have a coordinated strategy and investment to
manage DHIS2 instances?
 What should be considered in this strategy?

4. If there was any DHIS2 related governance problem (in establishing a technical
committee, coordination mechanisms, and presence of coordinated strategy and
investments), what do you suggest to overcome it?
Equipment and Internet
1. How do you judge the sufficiency of desktop computers distributed to all health centers,
hospitals How do you judge the availability and quality of infrastructure to support the
implementation of DHIS2?
Probe:
o How many facilities are online and offline in your setting?
 o Whether all distributed computers are currently working
o Presence of desktop computer constraints to implement DHIS2
o The internet connectivity of all health facilities
o DHIS2 system maintenance and its sufficiency
o Policy of hardware and software maintenance and its implementation

2. How do you evaluate the internet connectivity of all health facilities?

Probe:
o Do all health facilities connected
o Do you use the online and/or the offline instances of DHIS2?

3. Which instances do you like to use? What are the main reasons for using the instances?
How frequent did you give computer and DHIS maintenance for the lower level HIS?
Probe
o Do you feel that all computers needing maintenance got the services?
o How frequent did you give DHIS2 system failure maintenance?

4. What do you say about the policy for hardware and software maintenance in your
institution?
Probe: its availability, appropriateness, and implementation

5. What challenges or hindrances have you experienced or observed in providing

equipment and internet in implementing DHSI2, availability of internet, and
maintenance related policies?
o What could have been improved? Recommendations for future intervention?

Sustainability Plan and Budget

1. How do you feel about the culture of preparing and using high level planning and budget
guidance to sustainably respond to DHIS2 user needs?
Probe on:
o Strategies to maintain DHIS2’s sustainability?
o Discuss on the quality of the plan and guidance
o If there was no such a culture, what were the main reasons for not preparing it?

5. How do you cover the cost of training and technical assistance during DHIS2
implementation?
Probe on:
o Who is involved in providing technical assistance?
o How expensive is it?
o Do you have other budget sources to finance training and technical assistant?
o What are the main sources of budget?
 o What can be done to improve the culture of preparing and using high level plan
and guidance for DHIS2 implementation?

Security
1. What local legislations and guidelines are available to protect breaches and data loss in
DHIS2 at the MOH and RHBs level?
Probe:
o Who should be responsible to enforce security in DHIS2?
o How do you evaluate that the MOH and RHBs have the following attributes to
manage DHIS2 routinely:
 The right skills to enforce security
 Well-defined policies
 Auditing procedures and key security tools and documents?

2. To what extent does MOH and RHB manage security at server, instance and data level?
Probe:
o Do the MOH has conducted an audit to specifically test the server and the DHIS2
instances for security issues.
o Who is responsible to do the audits?
o Effective uses of tools and documents (e.g. risk registers, threat model, privacy
impact assessment, non-disclosure agreements, and incident response)

3. To what extent does MOH manage DHIS2 server administration and maintenance?
Probe on:
o Do they run server administration tools? Performance monitoring tools?
o What is your server usage in terms of CPU, RAM, and HDD?
o Do you think that these resources are effectively used?

4. What could have been improved regarding security? Recommendations for future
intervention?

Issues/Bugs in DHIS2
1. What are the common usability challenges of DHIS2 that you faced?
Probe on:
o Data importing/ exporting, performance time, data entry and editing, data
aggregation and compilation, reporting, data analysis, understandability, and
feedback mechanism?
o Comprehensiveness challenges experienced in incorporating all report types, data
transfer and data analysis features (pivot table, visualization score card, and
maps/GIS)
o How common are these usability challenges?
 2. What do you recommend for future intervention to overcome usability challenges?

DHIS2 data use for informed Decision making

3. How do you explain the utilization of DHIS2 data for decision making?
Probe:
o What major decisions were made using DHIS2 data?
o How frequently is it used?
o For what purpose? For planning? Quality of service improvement? Performance
improvement?
o Use of indicator-driven data analysis and reporting
o Disaggregation of health data in DHIS2 to facilitate informed decisions
o If not, what were the challenges or hindrances to use DHIS2 data for informed
decision making?

4. At what level did you disaggregate health data in DHIS2 to facilitate informed
decisions?
Probe on: Gender? Age? Residence? ,

5. What analytical and reporting capabilities you have?

Probe on: Indicator-driven data analysis and reporting

6. If there is any limitation of informed decision making that you know, what do you
suggest to improve it?

Data Analytics and Visualization

1. How do you see the culture of using data analytics and visualization apps of DHIS2?
Probe:
o For what purpose do people use data analytics and visualization apps?
o What are the most commonly used DHSI2 data analytics and visualization apps or
data analysis features (pivot table, visualization score card, and maps/GIS)?
o What were the challenges that hinder the use of DHIS2 data analytics and
visualization
2. If there is any limitation in using DHIS2 data analytics and visualization, what remedies
do you suggest to improve it?

3. Any overall reflection that was not asked and you want to share with us about DHIS2
from your experience?
Thank you!