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Towards the Construction of Adaptable Software to Support
 the Evaluation of Routine Data in District Health Systems:
An Experience from Western Uganda

U. Wahser, E. Nyesigye, T. Rubaale, G. Kabagambe

Managers of public health systems in developing countries have to face many constraints in their efforts to provide broad based health services to their client population. One of the main constraints reported by WHO is the lack of adequate information for the managerial process. In a decentralized district health system, which today is promoted as an adequate organizational structure for public health services in developing countries, managers are still more or less left alone with their information needs. In the discussions about adequate health information systems for district health systems, the facilitation of personal computers is considered to be a cost-effective support for the evaluation of routine service data. These service data are already massively collected. However, specialized application software which is adaptable to the needs of a district is not available, although its construction is considered to be feasible.

Based on a two months' systems analysis of the health information system in Kabarole District, Uganda, a software for the processing of routine data has been developed for the district. The software provides functions for data entry and for simple calculations and presentations of the results. From a digitized district map, the health facilities can be selected for which the functions are to be applied. Essential part of the software is a data base which allows an adaptation to changes of the district settings - e.g. a new version of a reporting form - without a disruption of the routine data flow. The actual code is not accessible for staff. Therefore changes are only possible within the wanted scope.

Since it was installed in October 1994, the software has been used for the routine processing of service data. It is maintained solely by local staff without programmers' skills. An improved version of the software was installed by the same staff without problems from diskettes which were sent to the district. Failures of the software have not yet been reported.

The high degree of adaptability to changes in the settings of the district forwarded the construction of a product, which could easily be adapted to similar districts as well. It can be assumed that the gap between the construction of software for one district and the construction of software for an adaptation to several districts is very narrow.

The production of such adaptable software should therefore be encouraged to provide a data processing tool to districts, which want to benefit from computer technology, but do not have the manpower for software production.

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This page was build and published by Uwe Wahser (uwe@wahser.de)
in August 2001. Last Revision: August 2001
The original document was released in September 1996.
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