Health Information Systems Program (HISP) is a new partner whose Cooperative Agreement is initiating at the end of Fiscal Year 2011, whose primary objectives are to provide technical assistance and build the capacity of the South African Department of Health (DOH) at national and provincial levels to strengthen the national health information system. The objectives of the HISP agreement align with the Partnership Framework by strengthening the health system, particularly by building capacity in the health information sector, and improving the information systems for use for management and decision making. The geographic coverage of the activities will be national, including directed activities within all nine provinces. Target populations to benefit are all patients receiving public healthcare in the country, as the project will impact all data collection and use of the routine health data information system, the District Health Information System (DHIS), which is utilized in all districts nationally. HISP is a local partner, who will hire staff to provide technical assistance to the health information division at each provincial DOH; the sustainability plan which will be developed in the first year of the agreement will outline the process to transition that technical expertise to the DOH staff before the agreements termination. The monitoring and evaluation plan for the five year project will be developed within the first year, with indicators targeted to health information capacity building in all provinces, the number of data capturers providing timely feedback reports to facilities, and the percentage of districts achieving data quality assessment scores of 80% or greater.

HISP is the developer of the national, primary HIS for routine health data, the District Health Information System (DHIS), and as such they are a natural leader in health information systems (HIS) and SI in South Africa. The SI barriers for the planned HISP SI activities are primarily that there are multiple different HIS which operate in parallel and are non-compatible, only one of which is the DHIS. Facilities are expected to report on required indicators using multiple different HIS, separate HIS for HIV/AIDS, TB, drug-resistant TB, HRH, pharmacy supply management, and primary healthcare routine indicators. There is a lack of interoperability between HIS, even those that seek to collect identical datasets. The new HISP agreement seeks to address these barriers by developing an enterprise architecture for the eHealth strategy which will account for the role and technical functionality of every HIS. The development of the architecture will enlist all stakeholders including NDOH and software developers who created the current HIS, as well as architecture experts and frameworks. HISP will also work towards developing standards for interoperability between HIS, and work to facilitate a national electronic data standards committee. These activities will be done enlisting the approval and cooperation of the NDOH. HISP will also pilot methods of leading the development of governance structures for HIS at the provincial level. They will also works closely with the USAID partner John Snow, Inc/Enhance SI and the CDC partner WAMTech. These linkages pertain to SI activities such as routinely monitoring and improving data quality within the DHIS, and working towards interoperability between the DHIS and the TB and drug-resistant TB electronic registry HIS by revising the database structure and function. The opportunities for future linkages include working towards interoperability in the newly selected ART monitoring HIS, and PEPFAR South Africa will work to ensure that cooperation.

HISP will strengthen the National Health Information System (NHIS) through facilitating an independent HIS capacity assessment to identify gaps in the overall NHIS. This assessment should at least assess and analyze 1) the Enterprise Architecture of the NHIS, 2) health data standards, 3) health data governing structures, 4) institutional capacity to support NHIS, 5) inter-sectoral collaboration, 6) country ownership and leadership. The results will be used to develop plans to bridge gaps in collaboration with NDOH and Provincial DOH. HISP will provide technical assistance, guidance and support to implement these plans as determined by NDOH. HISP will give implementation support to Districts and PEPFAR District Partners for Tiers 1 and 2 of the 3-tiered ART monitoring system. This system was selected by the National Health Council of South Africa to be the single ART monitoring system in the country; all ART statistics are to be reported via this system. OHSS activities pertaining to this roll-out are change management and tool-specific training for the district management teams and each facility. HISP will draft a comprehensive capacity building strategy and activity plan and start implementing the initiatives during FY2012. The plan will be drafted in collaboration with NDOH and PEPFAR/SA to ensure alignment with SAG priorities and coordination within the Partnership Framework. HISP will embark on activities aimed at strengthening the HMIS and institutional capacity in South Africa through: 1) providing targeted technical assistance to NDOH, Provinces and Districts. The TA will focus on strengthening data management, data quality, use of data, and reporting at all levels but mainly at facilities; 2) supporting existing or establishing new HIS Coordinating or Data Committees for NDOH, Provinces and Districts. The role of these committees will be to deal with data quality, feedback to data sources, integration of data from parallel sources, security/confidentiality policies, and general data management issues. The idea is to replicate the existing National Health Information Systems Committee structure at Provincial and District levels.