Extending and Strengthening Routine DHIS2 Surveillance Systems for COVID-19 Responses in Sierra Leone, Sri Lanka, and Uganda

Abstract

The COVID-19 pandemic challenged countries to protect their populations from this emerging disease. One aspect of that challenge was to rapidly modify national surveillance systems or create new systems that would effectively detect new cases of COVID-19. Fifty-five countries leveraged past investments in District Health Information Software version 2 (DHIS2) to quickly adapt their national public health surveillance systems for COVID-19 case reporting and response activities. We provide background on DHIS2 and describe case studies from Sierra Leone, Sri Lanka, and Uganda to illustrate how the DHIS2 platform, its community of practice, long-term capacity building, and local autonomy enabled countries to establish an effective COVID-19 response. With these case studies, we provide valuable insights and recommendations for strategies that can be used for national electronic disease surveillance platforms to detect new and emerging pathogens and respond to public health emergencies.

Keywords: COVID-19; DHIS2; District Health Information Software; SARS; SARS-CoV-2; Sierra Leone; Sri Lanka; Uganda; coronavirus; coronavirus disease; respiratory infections; severe acute respiratory syndrome coronavirus 2; surveillance; surveillance systems; viruses; zoonoses.

Figure 1

Countries using the District Health Information Software version 2 (DHIS2, https://dhis2.org) platform for COVID-19 surveillance, as described in review of extending and strengthening routine DHIS2 surveillance systems for COVID-19 responses in Sierra Leone, Sri Lanka, and Uganda. The online map (https://dhis2.org/in-action, cited 2022 Sep 8) is interactive and indicates which countries have DHIS2 operational or in development for COVID-19 surveillance in the country’s health management information system. Surveillance can include case-based surveillance, contact tracing, port of entry screening, hospital stay monitoring, call center data, and exposure risk assessment.

Figure 2

Countries using the District Health Information Software version 2 (DHIS2, https://dhis2.org) platform to monitor COVID-19 vaccination status, as described in review of extending and strengthening routine DHIS2 surveillance systems for COVID-19 responses in Sierra Leone, Sri Lanka, and Uganda. The online map (https://dhis2.org/in-action, cited 2022 Sep 8) is interactive and indicates which countries have DHIS2 operational or in development to monitor COVID-19 vaccination status in the country’s health management information system. Monitoring can include tracking electronic immunization registries, vaccine stock management, the Android Capture application, and electronic certifications.