 Okay, okay, everyone. Let's get started with the next session still waiting on a couple people But I think it's a good idea to get started anyway. So what we're going to do We're just changing the session up a little bit Still the same topic for disease surveillance But just to give the countries a little more time If we're able to talk about the surveillance toolkit that we will do so at the end But I'm going to allow the countries to go first just so they can you know Not have to rush through their presentations and there's time for questions and everything like that if there is time at the end, of course We can talk about the toolkit. I've uploaded that presentation and you can have a look at it as well So I'm going to invite our colleague from Lebanon to come speak in him Right now, and then we're also going to hear from Pakistan as well as loud Session as well. So please sir Yes, thank you, everybody. I'm Samhshah Ma from the Deir Chouli Manon Thank you for allowing me to participate in the presentation I'm going to present the Deir Chouli Manon implementation in Lebanon By the way, I have prepared this presentation co-ordination with the Ministry of Health For the surveillance unit team We are working as a close cooperation with the Ministry of Health on this project I'll just give you a briefing about Lebanon Thanks, thank you Okay, let's talk a little bit about Lebanon We are in the Mediterranean Sea We are the smallest country compared to your area, we're just 10,000 km2 We are 4 million population And we have the big challenge that we have 2 million refugees and we are 4 million population So half of the people here there are refugees coming from Syria and Palestinian And just giving us a big challenge to keep the health system working well So we started in 2014 and close cooperation with the Ministry of Health We're supporting them financially and technically Since then we're focusing on the disease mostly We are using the HIS for disease monitoring We have many systems in Lebanon But especially the diseases is controlled by the HIS since 2014 So we started with the aggregate data in 2014 Then later we moved to tracker bases And with the support of HISP India We're just trying to activate our GIS module in the HIS because we have many layers already As we were using usually as we platform And now we are moving the GIS platform to the HIS So we are getting our Kaza, our Mohafaza, our peripherals So we are importing them on the HIS with the support of HISP India We migrated many times on the server since 2014 But in the meantime we are now on 2.345 We have three servers We prefer to distribute the load So we get three servers running at the same time, the same version And from time to time we just aggregate them With the support of HISP India And we made some custom reporting on the HIS Different from the standard one So we have our own reporting system at the same time Just I will brief you about what we had to implement I will not go through them all of them But I have selected some of them Maybe we can go in details Mostly this is our forms that we have used We have datasets We have for the hospital weekly And for the medical center reporting We have for laboratory We have school based We have for the COVID We have for cholera lately We get some cholera cases And we have stuff for filming reporting I will select some of them later on We will go through And concerning tracking For the trackers We have influenza We have disease reporting We have cholera We have samples We have COVID We have other forms too Next piece Okay Finally So I am going to talk about COVID We made some Trackers in various cases But this is not just the COVID one It was a project by WHO To analyze the COVID patient From A to Z When he admitted to the hospital And then he left the hospital And we got some forms Also on COVID So We have the full patient file from day one Till he is either dead Or he is out from the hospital Full power readers So it was Case based reporting We made it at Hariri hospitals Governmental hospitals Where we analyzed the form We developed the form And we implemented it in 2021 Okay So we have the full patient Full file And later on this data has been sent To our medical committee in Lebanon To analyze the stages That the COVID patient is passing So to know exactly How to enhance the treatment And what medication should be given For them So it was really helpful for us To manage the COVID patient So it has full file patient file Next piece For the TB We did not use the TB Already existing one But based on the actual form We developed our own TB programs And based on national TB program By the means of health requests Accordingly We have developed for them the form of tracker base And It has some workflow Where the patient first Captures by the By exhale on the hospital And then we send later on to For treatment For sanatorium For the TB treatment For if it is a confirmed case Because we have two different systems One is not confirmed case Only this We are capturing here Not only the confirmed case The latent patient is not captured So it's composed of nine stages As you can see These are the stages now The patient will pass it through Okay But each type of user has access on them Let's see the nurse can access some stages The lab can access another stages The sanatorium will access another stages So this is not open for everybody And We are trying to see how we can Transfer one patient from one center To another center And then we have to To another center And then we have to To see how we can transfer one patient From one center to another center I'm just discussing with this now So how to enhance the Transfer of patient So when he leaves the sanatorium Then he has to go to the TB center So we have to transfer the file So this is the challenge for us How to manage the workflow In the HIS So as we can see We started this program And right now we work on the How to analyze the data Next please Okay concerning COVID The HIS2 was not used as As a system for giving certificate We have another system Adopted by the government called impact Was manipulating all the COVID Cases in Lebanon Where people can register and take the vaccination So the impact system was for vaccination And while the HIS was For tracing the COVID cases So the So very soon the They developed this form Capturing all COVID cases So covering the patient identification The case investigation And even trust capturing the contact cases And by the way we reached That time about 1 million That we are 4 million plus 2 million refugees We have 6 million people We get around 1 million cases Confirmed cases It started January 2020 And Even was used by municipalities Because when they have contact Cases and confirmed cases The municipality was tracing the Citizen To be sure that staying home And who is contacting them Who has seen So the municipality Played a big role To monitor the confirmed cases So we give them access for municipalities And we drain them On the HIS2 They have a username password To monitor their area So each municipality is controlling The territory And for this Second case Has an organization unit We capture the cases We give some credentials For the municipality For the labs Because the labs were entering The lab paper It was online So we give users For the certified laboratory for COVID They have a username and password They were entering directly The result of the test And we made some dashboards And we get some import From Excel For the big hospital They have the lab They refuse to use the HIS Accordingly We made some importing system We are using the SCRILE And PIR And QGIS Lately This is the first time Lebanon Get some cholera cases Due to refugees And other Sometimes we get a new disease in Lebanon So sometimes we're getting some Cholera cases coming from Syria So we found out that we have to capture this Cholera cases And we decided to develop Again, it's developed by The Surveys of Health So it's the same case Approximately the same routine as COVID And we have trained The hospital labs To feed up the data As you can notice, not so fast We're entering the data Each time we have a case We are trying to let the user enter the data Give them a user access and we train them And only the municipality's role Is to monitor the data So mostly we prefer to be done directly in the lab Not by myself To reduce the error And as you can see, the stages That's been defined for this cholera Stage one, two, three, four Next please Okay, concerning the organization unit Okay, we have five level labs in the country Eight Provence 26 district And we have 115 localities And five around 6000 facilities And the facilities are composed of labs, hospitals, medical centers And the houses and schools In the way the school are evolving The system They took a lot of effort for us To involve them in the system But they are committed And we usually monitor cases If a student happens And a special case with them They feed up in DHS The student case And as you can see the chart We have around 8000 users using the system So as you can see the data So when you so far doesn't enter any data We don't have any forms Let me keep you think electronic Facility directly enter the data Or we can have an Excel And put it into the system It's feed up in the DHS Later on, the role of we so far Is to investigate to update the data To clean the data and to analyze it At the end We develop some reports and dashboards With other decision makers So as you can see this is the work Of the data Who is doing the validation Of each part of this process These are some of the reports We have about 113 dashboards For all tracker and aggregate data And we have some visualizer Next is Okay And we have about 900 surveillance reports So I think 2020 And we share the data With the Facebook, WhatsApp, Twitter By Ministry of Health This data will be posted And this is the site of Ministry of Health So everything has been published From DHS directly to the public sites Next This is more reporting in Arabic As you can see This is Lebanon And this is about the cholera The distribution of the cases Around now we have around 600 cases of cholera in Lebanon Next please For sonic support We have 20 Ministry of Health To perform the report And creating the tracker And the aggregate data At the same time we as WRT Provide them with the financial For sonic the hardware The servers, the setup And server support And sometimes we develop We help them developing some forms And assisting them in some Sometimes happening And also the support is They are concerning the aggregate data migration And concerning the GIS layers They help us to update our server So mostly we have three levels Of support on the GIS Future plans Okay As I said we have three servers About two years ago We have 2.345.4 And now we are planning in March To upgrade to the latest version 2.3 now Then some advantages of workflow And other existing app We have tested the mobile As you know in Lebanon Usually We have a lot of iOS Mobile not only Android This is a challenge for us As the HHS is only using Android I don't know how come to solve it We tested some form On our mobile But still we did not go deeply This technology We are planning in 2023 To go a little more on mobile Use the mobile app And see how the user will be The reaction Would be interesting for us While doing some survey With the HHS on the floor At the same time The input and export We find it a little bit Not easy But fine So we will try to migrate To APIs And has the input and export facilities For our system So to have more open system For other system to talk to the HHS On the HHS server So we are going to invest More in the input and export features The main challenge is We have a financial crisis Two years now Our banks has big issues And this financial crisis Is affecting the whole countries In many areas Most of all The electricity is Mostly down And when the electricity is down The internet is down So working without internet Is very difficult for us these Data collection Is not stable anymore And concerning infrastructures Actually it's helping Building the main center But what about the peripherals Who will invest in performing The peripherals They don't have any more budget To cover the infrastructure And update the setup So again the infrastructures Of the whole country Since two years We have problems upgrading And the new surface Is missing hardware And for the staff Due to the crisis Many qualified staff Are leaving Lebanon for other countries So when you invest in training For the staff Then later on you lose the staff Again you start from zero Again to training other stuff So the stability of the staff Is affecting the stability Of the capture of the data on the floor Especially this financial crisis Mostly the infrastructure Is very bad And the environment Is very hard So getting remote data Is getting harder now After the crisis In addition As I told you we are getting New viruses in Lebanon So it's new for us And each time We recover from a virus We get another virus Now we are in Kulawah So we keep up Creating new tracker cases For us From one disease to another disease We finish from one case To moving to another case And the Ministry of Health Has some limitations Especially after the crisis So we are running out of time Capturing the data Due to the crisis itself Next piece This is thank you No languages I think So everybody should be able to Thank you If you have any questions I'll give them a microphone Thank you so much for Sharing about PDHS I have a question On one of these sites You mentioned And I just wanted to ask Like how How do you go about that To start through GIS And kind of costly That you said Or something else Now just As I told you We are just investing in GIS And DHS GIS module As the first level We are just capturing the Now we reach the level of localities But since we have advanced As the modules and advanced servers We are just exporting them And we project them on the maps So in the meantime We just take them as an excel format Okay thank you Welcome Till now the HHS people Did not help me to solve this iOS Still pending And they don't want to invest in iOS I don't know But we are facing Especially with the high management Usually they have an iOS system And till now Can't find a solution to it So to buy them another phone And the world Is difficult for us And it's not practical So till now Just iOS giving to the users But for top management Will buy till now The other phone number Thank you for your presentation Thank you Okay thank you After today We have Meeting and many countries That have presented And today I'm from Laos My name is Subhan And I work for PSI Laos Half of Laos team We have a son And I'm very happy to be here And present about the surveillance in Laos Since we have the ESI true system Come to Laos and we have implemented So many years already Next slide And today I would like to present about the system Outline Breakout Consistent between the own system From the own system to the new system DSI true And the The first one is the system design configuration And deployment process And the next is the data entry where Where we are capturing the data entry In the DSI true And then Where is the data source that We are picking up from that To enter into the DSI true And then the next outline is Training and deployment And for data to action I will be talking about the data That we have entered into the DSI true And then for further use Like for the in Inventigation And for the list point Any updates in Laos And the last one is the next step So next slide please Okay These are before Before the DSI true will Implemented in Laos, Peter Especially for the surveillance Department We already have discussed about Like many things to To enable the government to Monitor in terms of Infection disease surveillance in Laos During 2020 To 2021 The Ministry of Health developed Notifiable disease in the DSI true To deploy to the To replacement of the old programs We call it E1 But E1 is The database that have Developed in Microsoft Access Maybe you Maybe most of the country here Maybe use the access To create a database Or for some disease Something about Laos Before we using the DSI true We have developed the Database It is called Microsoft Access To capture the data Disease runs for further detection And for the computer data To Inventigation and list points Yeah Next slide please Okay for this slide I'm talking about the transition We call it E1 To the DSI true Once again, surveillance Especially for the department We call it the National National Center for Laboratory Epimologies Is the new department Allow We are starting using the DSI true So it's For the people For the health worker To implement it in the DSI true And Since 2003 2018 Can you Yeah, stop there In 23 2018 We have below The Excel database Is called Access To correct the surveillance Allow And For data analysis And for further detection And list points for any Outbreak We have many Implemented We have many conducted During that year We have been using that Microsoft Access That we have From the approach to develop This database for the surveillance Allow And we have been using this For a couple of years And since that time Because it's a It's an online program So this program Is just applied to the Only the PSO level To do the time free So it's a These are very limited Databases And in 2018 To 2021 DSI true Have occurred In that time In 2018 We have pilot In the capital For the pilot in data and free For the DSI true and parallel Which the Allow you want Because we cannot like throw out The own program Which is like While we are using the new program So the own program We are still using In that time We are using the tool To system at the same time So it's very hard For people to working on But we have to To do like this Because we cannot Throw away one program Which they are already Using at first And then And then we have implemented And we have Imported the data Because we have the historical data From the own program Because in the DSI true We just allow We just started in 2018 And for the For the own data From the Excel spreadsheet We have to store that data Into the DSI true We have a lot of data to clean To import And then For this process We have the And we took a long time To clean the data From the Excel to the DSI true And the Is more than like From For more than Two or three years So we And then together We have the The TOT training Because the DSI true Just started And we have to To make a plan To develop Plan for it to absorb the using And at first We have the data to store And the next step We have to train For the For the For the For the For the For the health workers To do the For the health workers To do the For the health workers To do the For the health workers But in the end So many Level can do it And we have so many training And PSO training DSO training as well That is occurring in In 2018-21 Later in 2022 This year Because So we started using the DSI-2 as an informal system. And then since that time, up to now, in April 2022, the government have announced, as a formal, later to stop using their own system for Kola Iwan to integrate it fully into the DSI-2 in April 2022. And it means that all of the country we are stopping one, the own program, initiated using new system is called DSI-2. And also, clearly, in this year, in Sri Lanka now, we are conducting the DQA, Data Quality Assessment, because we just started. Since we implemented the DSI-2 for several months, right now, we just go into the face of the DQA. But this face DQA, we don't have exactly the report or the tool to detection the DQA yet. But we are working on that with our personnel. Yes. Next slide, please. Yeah, this is the system design and configuration. Before that, I'm talking about the key components before we start using the new system. The key component is the information system, the specific code, and the design, and the training, and the technical design. So for this one, the technical design because, at first, we don't have too many personnel to support. And we just like to absorb the capacity of the user as well. So we have to find out the personnel to help on that to below everything. So it's hard at start as well. And then I'm talking about the data flow. And for this one, for the data flow, maybe for the workflow, actually, obviously, the picture one and picture two, the picture one is the own program, like Cora Ewan. The data flow is the data was captured by the PSO, the provincial level. And for the lower level, they just send the data to the PSO. And then PSO, they will enter the data into the login one program. And then for further for the center, they will extract the data to the central level to enter the data again for further produce for the data and analyze to look at the outbreak and the investigation. So this is the data flow for the own program. But it's slightly different from the picture two. Picture two is the HSI-2 surveillance. This data have applied to many level. I mean, for the HSI-2, the data capture is captured by the health capacity worker. So this means that before we using the HSI-2, we have reduced capacity of, we have reduced work for the PSO staff or central staff. Because the HSI-2, we can apply to the all level, right? The health capacity person, they will enter the data directly into the HSI-2. It's compared to the own program. PSO will do data in pre-bottom cell. And then we have to do the data quality and many things on, yes, and very slightly different. And for the HSI-2 at the moment, PSO, they have more time in inter-soptic DQA. And even though the civil and epidemiology staff, they have more time to do the DQA before they produce the data for investigation and this is less fun. So it's coming. OK, just please be patient. This is a technical issue. OK, this slide, we will talk about the data and pre-bottom document. Yeah, the data and pre-bottom cell allow especially for the epidemiology department. We use iCapture to capture the data. Because I think it's different from the many countries yet. You are using the iCapture data and pre-bottom cell, which is pretty easy to use. But allow the surveillance for especially for the EC surveillance because 18 notifiable disease. We use iCapture, which is even capturing. So many detail in the paper form, we have entered into the iCapture app, which is like a password is really hard for the user to enter the data as you know. And there's many conditions. That's why we have been harding in terms of using the DSA2. One thing is because there's a limited scale of the user as well. And as you can see, surveillance allow we are capturing the data by the event. And then we also have the cello reporting. We have case and cello reporting. Because why is that the cello reporting is very important for epidemiology as well? Because we would like to know the cases that that's happened in the dairy, right? So if you don't know, so how can we detect the outbreak and the medication for the disease outbreak? So the cello reporting is important as well. So every day the health worker, they will report. No matter that they don't have any cases, so they have to report to the DSA2. And then we will look at the dashboard to see the data. If there's, if some data they have the case to report, so it's outbreak. So it depends on the disease, right? If a vaccine is a disease. So just one case will be other. So something like that. And here in the right top of the screen, you will see the list of the several diseases allowed. We have also, we have 18 diseases. That's the government, especially for the HCOE. They are monitoring. And they have two for every day for 18. One is AP, AP and the second one is people at last. These are very common diseases that are currently allowed. And also the next one is DENKI. DENKI is very, very popular at the moment. And also we have COSYSTEM, I mean the DSA2. If compared to the own program, right, you want, the data just seeing, watching it by the central level. So then these results from the own program to the DSA2, where the diseases have been entering into the DSA2, all of the healthcare, they know they are aware of that. So then they know like what is the outbreak of that area. So this DSA2 is very important, really key, really like COSYSTEM, that's for correcting the data. Yeah. These are the least of the diseases that we are allowed. Next slide please. Okay. This one. Yeah, these are, I'm talking about the training approach. Before we are using the DSA2 already and we have conducted so many training that happened in that time. And including the TOT, PSO, and the SO training, and the central provincial repressor training as well. Because this is due to why we have the repressor training. It's because maybe most of the country is maybe aware of the DSA2 have upgraded from the old version to the new version. So that's why we have the repressor training. Yeah, okay, I'll make the next one. Okay, yeah, and these are the collaborative process. And this one we have here, we cannot stand alone for this new system. So we have supported for many personnel like a DPC department of professional planning and maybe WSO, we were together closely with implementation. And this picture, you will see that we have another database to monitoring the data quality or maybe even the TOT repressor training. Or any activity that we have captured in there and we have to follow up. And then for any activity, surveillance activity, we have the data to support, such as like a new and get a production and you don't need a pacific and also Australian repressments. All these activities that surveillance allow, we have support from these are done on the next slide. These are the data to action. Yeah, before we are talking about the system and then we have to talking about the data to action. Again, for the DPC surveillance since 2018, we have been using the DSA to ask our original system. And in April, as I just mentioned, in April 2020, the government allow have announced that DSA to use the DSA as a main system already. So for detection, for this detection, so we have using the dashboard to follow up. So it means every day, either proving or the health facility worker when they deploy the data, they will use the dashboard to look up the DPC's outbreak even there. As you can see, the number of the danki last week, we have like 232. And then the health facility, we have now, then we have to look at the low level. So these are the specific one. The low level, they will see the list of the proof that those data are outbreak. So they will see that this dashboard will allow the health worker or maybe the proving that they have report in the data. So they will take this data in the dashboard to take to evitigation and to DPC's response. And also we also have the map to track the data. As you can see, it's very important as well. Many people, many workers allow they are using the map in tracking the DPC's outbreak. Yeah, next slide please. Now, it is another dashboard. Let's be use this. We have developed this for the outbreak monitoring. This screen, you will see the latest one. It will alert on if some health facility that exceeds the outbreak is then the dashboard, and then we will use those data to monitor and for further evitigation. This is a really, really good function. I think many country here have already been using the email notification from the DHS2 to the email. And also it allows, we already tested and already used our product, this outbreak. It will send to the user or recipient will receive the outbreak directly from the DHS2 to the email inbox. And you will see the first picture. We can detect that the disease that exists in this health facility. And then for the further evitigation, the user have to look at the data to DHS2 as well. And then this is the height of the email notification is in table. It will summarize the data from the week that alert. Next slide please. For this one, from now, we would like to share some experiences that we have been using this is just some points that maybe many country here maybe are facing the same issue. This is just something that we would like to say because it allows, as I mentioned, the health worker or health worker, they have limited in terms of the technology. So when we go to the fields, many, many, many problems that we are detect in the field, like we have the this capacity between the data when we are checking the data from the logbook it's a logbook. And also because in the DHS2, we don't have like a data quality checking app. So we're still using the Excel to compare the data to detect and to get off the data. And also many, many things that we are fighting in law when we are doing the supervision side visit. And as you know, there's a lack of there are no monitoring being conducted by PSO or many things. These are just some issues that I would like to share. Next slide, please. Yes, lastly, I would like to talk about the challenge. Actually, many countries here, you are facing the same issue with the laws. One is regarding the DHS2 system. It's a 20 hour run analytic. Yes, we can determine, we can set up the analytic, but sometimes the DHS2 analytic fail, it will affect today the time three person. Because for example, for the server run, we are monitoring in single minute in every day. If you see if the system is fail in the line analytic for that single minute, it will affect to the health workers staff as well. Let's see if when they are doing the time three this time and the system is failed. And there's a data to display in the dashboard and they don't know what happened then. You see, it's very, I know this for the developer is maybe cause a little issue, but for the user is breaking problem for them. So these are still challenge for the, maybe not only the server run program, but maybe another program as well. But especially for the server run is very useful. And the next challenge is the DHS2 upgrading. Yeah, for the old version, what I mentioned earlier, what we have to have the refresher training is because of the DHS2 upgrading. Because it's up to the data time three app, right? People they just recognize that this data time two app, they used to use it. And they just, they remember just only one. But before the own, for example, the own version of the DHS2, the event data in T app is slightly different from the iCapture, right? And then people they are very confused. And then we have to organize the refresher training again for all, for all the country. So it will cost you in terms of the budgeting as well, because in law, we don't have many donors to support. So let's see if in the future it happens again. So if there is no donor to support, so that's training will not happen. And the health worker they will have, like they have, they will start on in terms of using the DHS2. So this is the point that I would like to say the challenge is very important. Yeah, and then the next one is regarding to the user. Yeah, in law, we have like because DHS2 is the news, new database for the for surveillance allows and many people they have like limited software technology is one. So every change is just a little bit. So it will change the behavior of the user as well. And then we will get a lot of the feedback. Yes, we know because a good feedback, and we also get the best feedback as well. Yeah, this challenge that I would like to say for today. And the lastly, this is the next step for the surveillance. At the moment, we are like a different means of the dust brought and stuff. So that's not the problem because actually we, we are helping with developing this data report, but it's not complete yet. So we have to continue to together with the personal to improve the weekly report, which is we will use the Solan epidemiology they will use for weekly report. So it's not complete yet. And the second one is, yeah, improve the outbreak. Other that I just saw the last minute for the email notification, because in the email notification is, doesn't support for law like this. And it's only also, it only supports for the table, table of the disease, but it's not support or it doesn't support the site or map, it doesn't support it, yeah. And to, and next is our ongoing improve, yeah, the data credit for like a for a company-ness, completeness and accuracy. Yeah, it's in surveillance allow, we don't have that yet. So we have to continue to develop for that. And the last one is integrating or the routine surveillance, we call it even based on, yeah, these are the even based on is also one, one module that we are developing into the DSI-2 for detect the outbreak that we can have because at the moment the EBS program, just we already developed in the DSI-2, but it's not completed yet, but we have to continue to develop, yeah. That's all. Thank you for listening. Okay. Very nice. Any questions? Thank you. So before we go on the question from Arne, you used an online, if you are interested, can you turn into the presentation? How is the current use of surveillance data and district analysis different? Yeah, at the moment, we are using the data to detection the disease outbreak together with the low level. But I'm not sure that's my answer, call it spotting to your question or not, because we have a phone call team, maybe can answer that question. Can they help? No, they can't help. Yeah. We take it in the dashboard. Part of the dashboard is to show that some of the control levels, that they also have the same report for each problem in the district, or all the different problems. Thank you. Thanks, Arne, for your share. Yeah. Thank you. You're all right. Because the dashboard that we have developing is depends on the user. The user, they will use the data, but it's at the same temperature, but different level, right? For the PSO, they will see the data and they will use the data, but just at the same temperature, like a weekly report, they will use the same data, but just different opportunities. Yes. No. So thank you. So we're just going to shift gears real quick. So I know there are some other presentations that will be available. So I'm actually going to start off with another slide. I will be able to end here. No, that's not all. I'll share my, yeah, there's no way more from there. There's no way that I'll do there. Yeah. Good afternoon, everyone. So I have a session. We'll try to wrap up a little bit. I think we've had a lot of super interesting presentations over the last three days. And thank you to all for presenting your counter stories. I'll try to see if this works. There's a little bit of delay, but they should, not just a little bit. Let's see. What do you see on yours? There we are. We have time. I'll do a relatively quick presentation and then I hope for some interaction with you guys to get some of your feedback and thoughts. So while we have talked a lot about different kind of program areas, HIV, TB, surveillance, immunization, I'll try to come back to some of the core topics around integrated HIS and some perspectives on that. And then some of you were in the parallel session yesterday where SORA event should have been presented on the maturity assessment and some of the plans around there to support integration. I'll repeat that a little bit and then talk about how we can work together with partners, investors, donors to get more funding for HMIS and integrated HIS systems. And then talk a little bit about how we can kind of build on some of the recent investments, innovations from COVID, potentially into more routine HIS work. And then I just have a summary slide with a lot of links to resources from our global implementation team that can help your implementations. It goes all the way to Norway and back here before it shows there. So I think what we have seen in a lot of the presentations this week and also the trend that we see from other countries or the regions is that we see more and more kind of DHIS systems, DHIS instances popping up in countries. It's no longer just one HMIS but there are many, many different program, disease program specific instances, separate tracker instances. And then you have things like surveys, facility assessments, immunization campaigns and program specific data repositories, data warehouses. All these are implemented in DHIS in many countries and often in different databases and sometimes also supported by different teams within the ministry, which can also be a challenge. And I just want to remind ourselves a lot of ISPs in the room and I'm sure that especially you from HMIS also agree on this that it's really a core objective to support integrated health information systems and to build core capacity and enable data use across health programs, integrated data analysis and not this fragmentation. So of course, we are partly to blame on some of these trends because we worked a lot with WHO programs to develop all these modules or packages or toolkits where they have many names for each programmatic area, for aggregate and for tracker and you see a lot of them, ah, shit. Okay, let's see. What? Hold on a little bit. So we've seen toolkits for disease surveillance, toolkits for immunization, in immunization, there are many toolkits within and then HIV TB malaria. So if you see here on aggregate, you have all these programs listed with different kind of modules or toolkits and metadata packages on tracker, we have the same and even more and many more than what's on the screen. And it's all designed to fit within, if you see the dotted line, it's all designed to inform part of one integrated system, one DHS database, that's kind of the purpose of the design behind it. But sometimes these programmatic toolkits can lead to fragmentation because it's tempting to take just the HIV tracker, put it separate and then the HIV, no, the TB program maybe want their own separate and they implement the toolkit and then you end up with multiple databases that if you don't pay attention, don't talk to each other, right? It's a lot of work then to make sure they link that they share the same facilities with the same identifiers that the tracker data matches the aggregate data and that data is being shared. I don't think we see a lot of challenges in many countries with this. Yes, it's faster now. Thanks. So I think one reminder is that it's important to plan holistically and towards this goal of one integrated system that can support data analysis and of course all programs in the ministry. And of course, there may be good reasons for having more than just one instance. Could be two, three. Sometimes you have very sensitive data, for example in your HIV tracker where you really want to control access but then at least make sure that you can produce aggregate data that can then be shared with the HMI instance. And sometimes you have very kind of a load sensitive or performance sensitive tracker systems like we saw during COVID for example, the vaccination registry like Pamoud was explaining in Sri Lanka covering the whole population. Sometimes those that will need a very, very powerful server and maybe you don't want to mix that with the monthly routine reporting and data analysis. So it makes sense maybe to have that separate. But again, get to some, make sure that you plan upfront so that these systems are linked, share the same metadata on organids, on indicators and that you can share data between them on a routine basis. And it's not just the data that's fragmented, often it's also the people and the technical capacity so that we worked over many, many years supporting ministries to build strong technical teams, core DHS2 teams within the governments. And this is a very challenging task. And if you have a separate team in HIV, a separate team in malaria, a separate team in IDSR and a separate team in HMIS, you have four times the challenge, right? So it makes sense to try to integrate that as well so that we can work. You can have one very strong team whether it's in the HMIS, HIS or IT division that can potentially support all the health programs with that kind of expertise. And it's a little bit of a kind of dynamic between the HMIS or HIS and then the programs, right? Because to succeed with an integrated HIS, you need to get all the programs on board and they need to trust the data before they're ready to do that. At the same time, all these programs as we see in this kind of diagram depends on the same kind of foundational aspects, the same kind of core team, the same metadata, the same kind of capacity to train end users. They all share this kind of same foundational aspects and it makes sense to try to pull them and then have kind of programmatic data on top, leveraging on kind of common foundations. So we have developed over the last year to get with Global Fundman Gavi and the HIS groups in the resource level developed a new assessment tool for the HIS called the maturity tool. And we tried to really highlight this idea of one integrated system building on foundational aspects. I don't know if that's the point, you can't really see it, but the foundational aspects are here and I hope you can read it. Kind of talking about leadership, governance, strategy, security and compliance, strong core team, good metadata, capacity and logistics around training of end users, facility data and the infrastructure both the server and also at the end user level across the country. And then kind of on top of the foundations you have all the aggregate components, the core HMIS but you can also have special aggregate data for different programs like HIV, TB, malaria, immunization, all the things we talked about this week kind of building on top of that foundation. And then you go to the next level even higher up in the house, you have the tracker data, the patient data across the same programs. And the logic is that it's the same as a house, you're building a tall building and then kind of up in the penthouse you have the tracker instances that are more complicated to run and then you have aggregate and then you have the foundation. And you can think of this maybe as the HIV tracker instance but if it's standing on a foundation like this it's likely to fail, right? It will fall over. So you need strong foundation, strong foundation, strong kind of ground floor before you can build the floors on top and that's really the kind of logic behind the maturity assessment tool. And we often see then very concrete linkages that it's very difficult to succeed especially with tracker implementation if you don't have strong infrastructure, strong capacity, strong focus on data security, et cetera. And overall having good governance, good strategies to scale I think affects kind of all this level both aggregate and tracker. So with this assessment tool we also help, we want to provide guidance and help to the ministries to plan how they can strengthen the DJI's implementations. So the tool itself kind of promotes the integrated approach as I mentioned. Gavi and Global Fund right now are funding his groups to do these assessments in more than 40 countries and the tool is open, it's available so you can also of course do it on your own initiative and also invite his groups if you need some help with that. And as part of doing the assessment together with the ministry his groups will also try to bring in future priorities, roadmaps. We've seen a lot of them this week. You have your way forward slides. How do these kind of way forward and your goals match your current state especially at the foundational level and the idea is that the hisps will utilize these results of the assessment look at your capacity at foundational aggregate level and discuss with the ministry what are your plans and then provide some key inputs to your kind of DJI strengthening plan. And the goal is that this can feed into kind of one holistic plan where you can bring all the priorities across the ministry into one plan and then work with the donors that are funding implementations also so that they can align around one plan instead of kind of providing separate funding for HIV system separate funding for data systems in TB etc. Better to fund one system and also pool resources especially for the foundational level. So as I said his groups will work with the ministry to do the assessment and then on the left you kind of have the results of the assessment where each of these components both foundational aggregate tracker will be highlighted with a score and kind of maturity level varying from not yet achieved to early progress adequate and mature the colors are not great here but they're supposed to be coming from red to yellow to green and then the hisps will do an analysis and provide some recommendations how to strengthen the foundational level they will also as I said collect priorities from the ministry and try to discuss them critically assess this and say is it realistic to do the HIV tracker when the core foundation is very weak or what are the steps to get towards that goal and try to provide some inputs to your plan that maybe you need to focus on strengthening infrastructure data security some core team trainings before you can move to kind of tracking level implementation for example and I think all this could be very important input and recommended activities into a DJI's country strengthening plan and as I said the idea is to try to get I think both across the ministry different departments but also of course the one investing whether it's the government itself or partners like Gavi Global Fund World Bank aware of this plan and we are working with them from kind of global level we've developed a tool together with Global Fund and Gavi we also had discussions with UNICEF with World Bank so they are aware that this process exists and they are familiar with the tool and they expect to see kind of plans coming out of this at country level and then I think the idea is that if you can add this one plan how can we then convince donors to put money into this plan and not into all these fragmented initiatives and we have some funding for his TA to strengthen your systems both through the Global Fund Regional TA mechanism that sort of explained that his Asia hub has funding for supporting the DJI's in countries in Asia that's a little bit limited there's some kind of key TA that can be offered there that can address maybe the most critical issues but I think to really go further and especially to fund kind of operational costs like end user training, infrastructure etc you need to access the country grants from Global Fund and Gavi and as they are very much aware of this I think it's a potential now for the next kind of planning cycle especially with Global Fund that the HMIS and the HISPs can help to influence this so that it's more funding for HMIS more funding for DJI's coming through those grants and as I mentioned we're talking also to other partners like World Bank, WHO, UNICEF and others that are very positive and they like to see this approach where they can kind of pool resources and more effective investments and I think all in all that can maybe change the dynamic a little bit from very programmatic parallel investments into more centralized HMIS focused investments so I think it's a good time now to focus on this and I think many of you have already been contacted by the HISPs and maybe by Global Fund to conduct these assessments and then we look forward to a good process there so changing gears a little bit I mentioned in the intro that we can talk a little bit about kind of how to go beyond COVID I think we've seen a lot of both rapid investments and also rapid innovations during the COVID pandemic there's been a lot of emergency funding from partners like Gavi Global Fund and others that have helped the HISP network to work with you over the last two years to quickly set up both surveillance and kind of vaccination systems how can we then build on this to leverage this and strengthen the HMIS and the routine system so we've seen a lot of infrastructure scale ups new service being bought more equipment being bought and then you have all these innovations around learning how to do large scale trackers like demonization registries more lab integration has been taking place a lot of innovations around certificates both for tests and vaccinations and more focus on real time monitoring and use of data and there's definitely kind of an opportunity to build on this increased interest in data and data systems I think across ministry but I think also beyond across the government there's been a lot of increased interest in health data in governments all over the world and I think let's build on that to get more focus on the routine systems as well and there's a lot of kind of similarities and we're working with Gavi both on surveillance and vaccination and we see that a lot of the innovations and work that has gone into covid surveillance can now be used to improve routine surveillance like we just talked about and then same with the covid vaccination on the DHISP side it's very similar to the child demonization registries and we see I think we saw a few examples like from the Maldives where they implementing the the DHIS module for the child demonization registries and I think that there's a potential now that you have a lot of experience and infrastructure for covid vaccination that this can also be leveraged in the EPI program for child vaccination and the same I think with the data use and monitoring a lot of new dashboards that can now be leveraged for routine data for HMIS as well yeah so the last slide is just to and you will get these slides, it's available in the Google Drive shortly give you some links to some of the global kind of resources we have to guide your implementation so we've talked a lot about the WHO toolkits this week I've shared some link here to the website where you can kind of summarize everything and also have more dedicated documentation where you can read about what is available in these toolkits how to use them, how to implement etc and we also have a live demo where you can go in and play with the toolkits itself and kind of what it looks like in the DHIS and then more generally to guide the implementations we have a DHIS implementation guide with a lot of different chapters on different aspects I just highlighted here a few relatively new chapters in that guide around server hosting and also a security starter kit that can help guide your security officers to strengthen your security and compliance on the implementations and then I've talked about the maturity tool today there's a spreadsheet person that you can download here and have a look at exactly the questions and how that scoring works we also have a more dedicated guide on planning implementations and budgeting implementations and I also wanted to mention that we are planning a new academy course next year that you're all welcome to join that we focus more on these kind of implementation aspects and budgeting aspects of routine health information systems and the DHIS to implementations and finally I think you should have mentioned a few times that the DHIS come into practice there's a link there as well as it and then I hope we have some time to also get your experiences on this I think especially would be interesting let's stay away from that interesting to hear your kind of experiences from supporting integration integrated systems especially working as an HMIS but we also have a lot of programs here and I think it would be good to hear their perspective as well and how to kind of implement an integrated system and then also maybe some comments on this idea of having one maybe that's a dream but this idea of moving towards more alignment in investments and planning prioritization under this one holistic DHIS plan so I want to invite Dr. Chancellor first from Laos I think Laos is a very good example in terms of building integrated information systems so great to hear your experience that's quite a bit I think it should be thank you so thank you for such a great life as a little bit of time when we are going to have this one we have to be successful in finding the integrated all the program is there one way so I think first is as you said we need strong support we don't have leadership leadership means we have first we have we need to get this platform to become a national platform for the whole country so otherwise the program will work for us and probably in this leadership we don't have in Laos we need a different contractor in Laos we have one for the health sector in Laos and that there are one pillar of health we are talking about strengthening the health that we have so we have already gained support and we also have for our department we also develop for the health for the health for the strategy 5 years and then we can have a different base on that we can think really strong advocacy we will start one program we already in Laos we have market and child program so we introduce that because they all have very well-prepared steps just customizing those steps and rolling out to the whole country not just either just the whole country and then we do that essentially and then we organize to show all of them on the head of department so the other program we can see we can see that one program is open with Laos and the other one is simply similar we know that by that time in Laos we have a very complicated program we also have the old program we also have the old software very complicated and then also we start with one program so that they can think about it and then the second year we are also moving to another program we are starting from Malaria with small BPCs for Malaria so Malaria is simply next year we are moving to GD so we can try to move it so we take a point of advocacy and also because we also this program need to be also in line with the government what is meaning that the government are tracking this indicator to be putting that on providing the the information to the reader to get the trust from the reader so the second thing that I think is very strong meaning that I don't understand the meaning of curiosity because they allow us to have a global fund because we enjoy funding together and because of we are joining the funding together also without this and that we also have the help from the students two people funding for the world bank two people, other people from funding for the road bank another one funding by CHI or ADP it's getting in one you may put together this is another we have to work with the strong government and also the part of the support because because of this part we are working together to build a very strong associated aspects of the quality this quality meaning that we have also the expert team also providing because of the different funding support so different part of the support of the system some part of the support the construction staff some part of the support providing the internet to the whole country thousands of years other part of providing server other part of the creating one problem for the building funding but same the same platform so this is my experience from now thank you I think it sounds like you have succeeded with all these ideas already other countries have a lot to learn from now other comments or questions I guess we all want to get out here and on the beach Lars has a comment I'm sorry everyone I don't get to talk a little bit about this in the latest version we have this aggregate data exchange which is really meant to help you in this process of moving data between these I think you remember back to the slide you talked about using analytics source and moving data you can use that to move data from track data and move it over to the edge that might require you to set up what we call program indicators which you can map to aggregate data and that way move data from track data to team monthly quarterly data or of course aggregate data so you're also trying to help you in this process we just recommend that you check thanks Lars yeah yeah actually based on our experiences in my country we don't say that he is a health secretary so he always support to us as a secretary of the young history that is the world part so Dr. also should take lead from especially the development project and another thing my concern is sometimes donors should think about to be ending the IHIS especially for the global if the global start to collect the data from the TV center from the IHIS center then if it happens if the donor take the data from the last IHIS then all the programs should come to the IHIS and just just carry the data I think so one thing and another thing is program decision always can be involved program decision concentrate on the IHIS together and validate data they have the IHIS data we have the aggregate data just validate that type of practicing start the hybridization but main thing is program decision I am not blaming blaming to anyone but since like that program decision sometimes maybe because they have to receive the more money from the donors so that is why they should collect the data from the center not for the program I think and other parties in my country only the HMIS is the authorized authorized health center who provides the data for the ministry as a planning commission even though all the process can be but donors are far from gods thank you I agree let's take a question but I can comment we are working very closely with the WHO in the headquarters DDI division focusing on IHIS there are many countries that have IHIS focal points and we are trying to work with them at regional and country level so I think there is more awareness and I totally agree I think they can play a very important role in aligning I am providing this kind of guidance forward to Jordan thank you my question is there is a specific question but I have to ask when you talk about the case case of the HMIS structure does it put that about physicals you mentioned I certainly without the case based surveillance just to start with that and then on this I think the expert on that is there but I think just in terms of my slides I think maybe that was on the COVID slide I mentioned that case based surveillance yeah in the second slide we talked about not the traffic but something about the lab so I am not sure if it is in the lab or the lab in particular the traffic should we talk about the surveillance in a second but I think in terms of the maturity module I don't think we have a dedicated component for the lab but I think what we are seeing is that many of the track based programs TB and case surveillance are now integrating kind of a lab stage and lab data in there but of course what we saw during COVID is that they are able to connect automatically some of the lab information systems directly to the DHS tracker so that you have this kind of automated integration I think that helps the timeliness of the data yeah maybe you can talk a little bit about how we had this session now on the surveillance package is there only one online sorry yeah in terms of integration with lab systems and starting up with lab information there is two components to this one is this direct integration with another lab information system and getting that data directly inside of DHS too and that is quite mature in practice it does take quite a bit of effort and resources to do within our broader surveillance frameworks we also just have kind of general lab information so both for COVID or for any other types of surveillance for each of the diseases we survey we have basic items on lab requests and lab results and lab tracking sample specimen tracking so you can take each of these components and just kind of enter baseline information it's not meant to kind of replace all of the components of a laboratory information system by any means but it is meant so you are able to track each sample that you're collecting for the disease that you're surveying and finalize the results and confirm the case and that's really what that's meant for so it is meant as kind of a broader part of the overall disease surveillance kind of package but it is in practice a bit simpler to implement if you're not linking to the lab system at first let's say and you want things like the results you want the type of tests that they performed you want to make sure that you're able to track each specimen that's being sent to the lab for testing so it's just meant as kind of a basic precursor for that lab information and not as a replacement but as a next step perhaps you know when you're a bit more mature and as part of that maturity assessment when some of those infrastructural issues are kind of dealt with then it might be time to integrate the lab system to be able to bring that data in directly instead of someone having to enter it again perhaps from another source. Does that clarify? Okay great thank you. So actually we had just one quick question online for Dr. Chance Lee so they were asking how you work with partners in the ministry and get them all to work together? Yes because of maybe because of our department our program department is a planning and international cooperation that's why all the planning all the support from partners need to be gone to our department so that's why we have the authority to gather all the partners to work together before they can work with respective program or department. So maybe this is the one thing as I already mentioned that because the nature of the system meaning the DSSU because of the beauty of DSSU it's not only the collect information but also collection, store information also analysis and distribution in one software is not we don't need other software but even though other software also can integrate too. So this is I think the main thing we can buy in the partner to use the system. Thank you. Hi, I know thanks, thanks Sula. It's okay to go to the next session which is tea break. So that is one question. I know like if people are tired to go out. So what I was thinking this next is just the feedback and few quiz which is nice and easy and we can just like continue and then do the tea break and go home. Is that okay? Sure. So then like we can just quickly wrap up the whole session and then we have more time to swim. So now is let's just see how many people are sleeping because it's a quiz. Okay, everyone. So this was the first time we've had this type of conference in this region. So we just wanted to get a little bit of quick feedback from you all before we proceed and then as John mentioned we have a short little quiz as well just to make sure you're all paying attention. So please if you can go to menti.com and enter the code up at the top and our online participants please feel free to also join us in this exercise and we'd also like to hear from you. So the code is 734-3282 I'll just leave this up for a moment and you can use your phone or your computer please don't use both at the same time. Yeah, so just a little couple questions for feedback and then we'll have a short quiz as well. Just give everyone a second to join. Everyone able to join anyone having any problems? No? Okay, let's get started. Okay, first question the conference met my expectations and we have a couple options for you to select. Please be honest it's our first time so we want to make sure okay some mixed responses it's fair enough. We appreciate your honesty. We'll definitely look into how we can improve. The facilitators were able to assist me in answering my additional questions so if you had questions outside of the conference materials anything on your own implementation for the person who answered blue we'll have to try to help you better next time too and please if there are specific areas that we weren't able to support you with I encourage you to contact us if you're here or if you're online please just send us an email I've sent many emails during the last couple weeks please just reply and we'll try to help you better. I was satisfied with the time and pace of the conference. So running from nine till five and with the breaks three days I guess we'll have to figure out for the last little bit if it was the sessions were too long or there wasn't enough time I achieved my goals in attending this conference okay okay so there's still quite a bit of room for improvement I would recommend this conference to my colleagues and peers so room for improvement but we can all see potential. We have some people who would not which is okay so here's an opportunity to provide some more specific feedback so this is an open-ended question so I feel the following improvements would improve my conference experience please I'll give everyone a bit of time to put in a reply here more time for swimming. So on the technical side I can understand maybe there's more we can do there it's not a typical academy format where we have a lot of hands-on sessions quite a few quite a bit of feedback on more hands-on more technical sessions less time in flight layovers I don't know if we can help you there so much technical team more practical exercises contacts for participants that's still something we can see if we can share I think we have to make sure everyone's okay with sharing their details inclusion of non-DHIS2 community members shorter time someone wasn't too happy with the location more donors and development partners there's still feedback coming in so I'm just going to leave this open for a little bit a quicker response in your registration food and the coffee okay this is very good feedback thank you all for helping us here okay and this is also open-ended and I think it's also the last question for our feedback in which Asian country would you like to see the next this Asia hub conference so some of you had a little hesitancy about the location and flights so is everyone just going to select their home country Thailand the responses are still coming in Malaysia Middle East that's a big place oh wow someone's very excited about Vietnam Mars very interesting okay thank you very much for the feedback I'm sure everyone for your feedback I know that there was some challenges logistics in coming here but we will try to improve upon this next year and we take all your feedback very seriously so we'll make sure to review this and we will also share that with you when we have some more responses to this okay so now we'd actually like to just have a little quiz okay so you'll have to enter your name for this one doesn't have to be a recognizable name as long as you remember it okay I'll just give everyone a second to register their details so now you'll have to enter a name so for just while you're doing that I'll just explain the rules a bit okay so for each question you'll have 15 seconds to answer all multiple choice questions and there's a bit of a leaderboard so friendly competition yeah oh you have to press it so yeah if you're behind you might have to press an additional button apologies so looks like we have quite a few participants so you have 15 seconds to answer each question and if you the quicker you answer the more points you receive so it's both about speed and being correct so we'll start with the first question yeah which his page a group what was the champion of the 2022 his page a couple no no it'll do it at the end okay good try everyone yeah it was Vietnam this year yeah first time so whoever's Pato S leader next question as it relates to DHS to what does HISP stand for very good I often get this one wrong myself okay leader hasn't changed but it's a close race next question what is the DHS to toolkit this one's a tough one yeah so what we're trying to promote is the use of standards plus configuration right so you're also writing implementation documentation training and capacity building materials that are all combined with along with the configuration alright so just keep that in mind when you're looking at this that's a tough one I know maybe a bit of a trick question we might have a new leader now a magical Rhino in the lead next question which country is not using DHS very good well hello is this they just all presented it's alright it's alright still magical Rhino okay next question how many of his groups are there worldwide currently there's 17 groups that are listed you can have a look at the material to see the different groups worldwide in both in Africa Latin America let's see how we're doing okay very close race at the top next question what does DHS stand for close okay Oceana takes the lead hey next question what should the following are apps used for analysis and DHS to and you can select more than one response okay we'll just select one that is correct musta musta so the data entry apps can't really use to analyze data so much it's very close now second last question in which city was the first his page conference conduct okay okay okay let's see how we're doing close at the top okay Oceana is holding on okay last question hey everyone ready what are the DHS to building blocks okay good good okay let's see the winner okay magical Rhino okay okay Oceana oh no the next one's Ola oh watermelon who's watermelon okay Oceana Oceana okay so we have a small gift for Oceana so good now let's say a few more slides and then like we are done then we can go just want to give a bit more like the closing and then also the what is the next step next one so basically like for his special hub there are six groups which we have mentioned his Vietnam Sri Lanka India this presentation is also there in the conference folder so you can actually have if you want to contact anyone you can always like all the email addresses are there so you can write to them the next one his Bangladesh Middle Asia and his Pakistan all the details are also here so if you want to contact a specific group of the people like you can always do that but if you want to like to say like I don't really know which country where in Asia belongs to or who's going to support it then the next one you can always just write his Asia hub at hispindia.org if you write to this one we all will receive the email doesn't matter whether it is hispindia we will go to hisp vietnam, hispacia, sorry his Bangladesh, Indonesia, Pakistan and all so if you have any question okay like I want to start DHRs in this particular country or I am in this particular country can you please help us in setting up this one so you can just write to hispacia hub at hispindia.org so we can all can help and support you on that so this is just about upcoming academies and calendar so we are actually thinking of having the tracker configuration this is hands on it it's an actual academy it's not about conference so in academy it's just like people come around we sit down and like we go through the all the configuration and also help on your own configuration and if you have any questions the other one is design for data use so as we know like everyone talked about how much it's not only about collecting the data and just making reports and charts but also how best we can practice use for local action and planning so that academy will be in the third quarter of next year and then that was one of the question like where will be the next hispacia hub conference so we are planning to have in the fourth quarter of next year some of the countries which you have listed out maybe Maldives or Indonesia or Mars Mars will be good we have all the the Mars can everything perfect next one this also is like if you want to reach out for the some of the materials like the community of practices we have the impact stories so we've been very good in doing the work but we are very bad in advocating so even in your place like when you have things please write to us like if we have this particular stories and other things we can actually put that one in the impact stories we also have DHS newsletters please go around there and you can subscribe and like if you want to share experience of DHS to things in your own country you can also contact that we want to have a small writer follow things on our implementation story which we think it would be useful for other purpose to learn and see you can just like all do that is that okay any questions and then thank you see you again and this is also the batman or tournament his special cup the winners and the man of the the tournament okay thanks thanks all thank you thank you and thank you everyone to our online participants we'll be closing the conference now if there are any questions about anything you know how to contact us so please do so but thank you very much for attending please let us know how the online facilities worked for you if you had troubles connecting if there was issues with sound quality I know in some cases the video as well we'll look at fixing that in more in the next sessions thank you very much for attending and we look forward to having you attend in person and virtually next time