Table 4 Recommendations on system sustainability
Axis | Domain | Recommendations |
|---|---|---|
Groundwork, | Domains 1-7 | • Understand the existing context, including the technical capacity, for implementing an EIR prior to introduction of the system • Strong government interest in electronic data is key to continued program support • Piloting and software updates should be included in planning for scale; a phased roll-out approach can help accommodate changes |
Partnerships, and | ||
Financial Health | ||
Technology and contingency planning | Domains 8, 9, and 14 | • EIR data should be easily accessed and used to monitor errors occurring at the facilities • Create mechanisms to ensure EIR security • Plan for the number of servers needed to host data locally |
Operations-training | Domain 12 | • Training strategies should accommodate a variety of skill levels, be standardized across facilities, include multiple cadres of staff, and incorporate multiple on-site visits • Ensure there are enough staff to perform high-quality training and leverage the use of mentors and champions at the facility-level • Create training plans to accommodate staff turnover |
Operations- supervision and technical support | Domain 12 | • Integrate supervision within existing structures and adequately budget for visits and incorporate capacity building • Use standardized supervision checklists • Develop technical support team to respond assist with troubleshooting and triage issues |
Operations- personnel and outreach | Domains 11 and 13 | • Incorporate all levels of EIR-users into program decision-making • Use community mobilization/sensitization to increase buy-in for the system • Consistently engage with partners at every step of the roll-out • Understand existing user capacity and incorporate this into training strategies • Plan for sustained use of the system from the beginning, including handover of activities from partner organizations to the government |
Monitoring and evaluation | Domains 15 and 16 | • Provide access to EIR data so supervisors can monitor the system remotely • Use standard indicators, tools, and reporting mechanisms to monitor the system • Develop plan for scale-up and indicators to track system maturity |
Sustainability—other | NA | • Create a data use culture among users and supervisors • Identify partners that can support scale-up in other regions • Plan for equipment and data bundle costs as well as system maintenance, monitoring, and supervision activity costs • Encourage a high-level of government involvement and leadership • Plan for scale-up alongside other health programs |