 Okay, that's right two o'clock on my end, so I think we'll go ahead and get started. If you're joining us from the previous session where we discuss the WHO packages and what the initiative is, then you'll see that this is a continuation where we're going to speak specifically about the TV tracker packages as well as the use of tracker for TV in Tanzania and Mozambique. We have a number of great speakers that are going to share with us. We'll get starting off an update from Tomas at the WHO that is going to give us some sense of what the goals were for these packages and how they can be used and we'll proceed from there taking a look at the TV packages and then hear from Tanzania and from Mozambique. So I won't talk too much longer, I'll just turn it over to you Tomas to take us away. Thank you Mike. Share the screen. Okay, can you see it? We're seeing it, but we're seeing your kind of presentation view instead of the full slide. Okay, there we go. Okay, so thank you everyone. Thank you Mike for the introduction. Now I think we may have lost your slides at this point, sorry. At least I'm not seeing it. Now I'm seeing you. Once again, does it work now? It's back to that presentation view, although I can see it fine, so maybe we just go with it like this if we're having troubles because we'll be able to see as you flip through the slides anyway. So thank you Mike for the introduction and thank you everyone for joining this session. I'm Tomas Matas and I'm working in the WHO Global TV program in monitoring and evaluation unit and I would like to walk you through the collaboration we have done on the WHO TV packages with the University of Oslo during the last couple of years So the short history of the collaboration, it started in 2015 when we have developed the platform initially to support countries to analyze data. We have conducted two regional workshops in Africa, but very quickly we learned that the DHS2 platform is in high demand and we started developing the WHO standard package for the aggregated data. We as well provided countries the TB Historic platform where it was meant for countries in transition while they are waiting for their home instance so that they could use it for safeguarding of their historical data or continuing the data analysis while in production in their own country. In 2017 we joined the Strategic Initiative on Data funded by Global Fund and the Health Data Collaborative Group which focused on development and dissemination of the standardized DHS2 modules across all the diseases. So we talk here not only about TB but about malaria, HIV, immunization and so on. We finally managed to publish the aggregated DHS2 package for TB together with the TB curriculum which is basically set of guides and example exercises to support the data analysis and use of the dashboards which are embedded in the TB aggregated module. We have done the regional installation workshop for six African countries. We have done another two additional workshops in Latin America and Asia and we started developing the WHO standard TB module for case based surveillance which was recently published in August. We as well do the workshops on data analysis and use which usually follow up on the implementation installation of the TB module and our team uses the platform for the epidemiology reviews of the countries where we have a need to analyze the country data in standard way across all different countries. So here's the quick overview where the DHS2 was already introduced. It doesn't mean that all these countries are using or will be using the DHS2. What it very often it helps at least to trigger some follow up actions. For example in countries where the TB surveillance have already existing working system but they don't have any visualization, they don't have any dashboards and indicators and people have to basically extract the data and use another statistical software or R. So this is one or another opportunity for countries. It's not just to implement the DHS2 but as well maybe just to take the idea of the routine data analysis using the standard indicators and dashboards. So in general the purpose of the DHS2 modules is to promote the health standards across all the administrative levels. We know that if we are lucky we get the guidelines and best practices to the national level but then it's very difficult to disseminate those to the lower level. We would like to promote the routine data analysis and use at all the facility levels because currently the lowest levels they are basically detached from the data use process. They only compile the records and aggregate and report to the higher levels. So we would like to really use this opportunity to enable or to give access to the data to all levels in the country. As well to enable to secure the historical data to save card historical data to enable the long time and the trend analysis over time to understand the epidemiology situation in your country because or to link the DHS2 to use it as a DHS2 warehouse and to link it to your existing system and to extract the historical data in this way. We can as well import the historical data from Excel spreadsheets. Why the standard modules were developed because as I said at the beginning we learned that there is high demand and each country started developing their own system or they own TV module. So we take this opportunity to promote the standard baseline module which we recommend as the core. Then to promote the collaboration between the countries. We try to organize the annual meetings, installation workings, etc. We believe that it's not only us or other partners going to the countries but it works very well when the country talks to other country and they can discuss their bottlenecks and what are the successes and share the stories which we will actually hear during the upcoming presentation from Tanzania and Mozambique. Basically about the aggregated module, it's based on the 2013 recording and reporting framework. It includes standard quarterly data forms, standard set of dashboards with core indicators required by Global Fund and WHO. It has all other functionalities as standard DHS2 and we have one additional feature which I hope it will be available for the core DHS2 app which is the side-by-side comparison of the national level data. Now about the case-based module, of course Yuri will discuss or describe this in details. I just wanted to say that we have developed this for both for DR and DSTB. It has some interesting features as a working list. It has some draft dashboards currently and it has the link to the aggregated package which we still believe that would be the baseline for the data analysis whether you use the aggregated data or the TB tracker. Of course each country can edit and add more variables as well on the dashboards. The dashboards are just understood as a baseline information. You can desegregate further the indicators or add the more indicators depending on the country needs. Yuri will as well discuss or showcase the constants which we use which will enable you just to simply turn on and off different options in the tracker. There is a build in automatic classification of the cases which is a very useful feature. There is as well automatic feedback on some of the actions you are taking during the use of the tracker and so forth. This is the current situation of the implementation of the WHLTB modules. We have the dark blue are the countries which are using currently the aggregated case-based system. The blue one are the countries where we are piloting or in process of integration. One of the modules and the red one where we have used as I mentioned the epidemiological review and we are as well engaged. A future next steps quickly. We are basically from the headquarter we are trying to support the countries as much as possible through whether directly or through the country and regional offices. There is a new strategic initiative on data funded by Global Fund which I believe most of the countries are aware and we really wish to support implementation and the uptake of the WHLTB standard packages. We are able to organize another installation workshop. We are planning to do more in-country and regional data workshops and we as well plan to start doing the readiness assessments where we would like to understand better what's the current situation in the country and how the country is ready or is not ready for the implementation mainly of the case-based solution. As well we will keep updating the WHL modules both because we have new guidelines on treatment regimens and on drugs and on testing coming so there is still a lot to be done and we are working on the new DHLTB modules as the DRS module for the drug resistance survey lab module and LMIAS modules. So thank you, thank you everyone for your attention. Please if you have any questions or you would like to follow up let me know and I will be happy. Thank you everyone. Thank you so much and reminder to everybody the link to the community of practice where you can post questions is in the chat and we will have a bit of time maybe at the end for some live questions but we'll see how that goes. So turning the time over now to my colleague Yuri and implementer with us here in Oslo who has been working with Tomas and team on the configuration of this set of packages so he'll walk us through that for a bit. Hello everyone. Can you confirm that you can see my screen? Yep. Yes, okay thanks. So I'm very happy to introduce the WHO-TBK surveillance tracker package which we published in August 2020. The release was slightly delayed due to several factors including a COVID outbreak but we are sure that the result is worth the time we spent on it. Well the module is a baseline that as Tom said that follows the minimum requirements for data surveillance and as you will experience it has a lot of program logic built into it but at the same time it provides simple workflow and support for end users. The module can be used on both web and Android platforms as I said is a generic package which requires some configuration but the process is simple and well documented but I will get back to this topic shortly. So the package can be also easily customized to the country needs. So the TBK surveillance track is aligned with the WHO definitions and reporting framework 2013 and it is designed to capture case-based TB surveillance data. So in other words it's not built as a patient or data management tool but we'll see what comes up in the future. The TB tracker comes with a long list of indicators that are designed for quarterly TB reporting on notifications first line and second line treatment outcomes as well as the GTB report but I will get back to the indicators in the later slides. Here's the overview of the program as you see we're following the enrollment which captures the necessary attributes and the enrolling facility we move to the TB registration details where we capture the baseline information on the patient the risk factors and the HIV status there's a very extensive laboratory stage which is repeatable for each sample that is tested in the lab and as you can see on there the list of available tests is is long and I will get back to the to the setup and the configuration in the next slide. Then comes the treatment stage where the drug resistant classification is recorded and the treatment regimen and the status is captured and stage four is the health outcome where we register the outcome of the treatment or the notification in case the case is not a TB case. Well to question other configurations so one of the design decisions for the TB case surveillance tracker was to provide countries with a set of available diagnostic tests and anti TB drugs and then let the countries configure the package according to their requirements. So the option of adding or removing parts of the package with help of constants makes the package more comprehensive but at the same time easy to localize, adapt and change. So let's say if in 2020 the labs in the country are not using a certain test let's say LPA but then they start using it in 2021 it is possible to add that test to the data entry form just within one click rather than creating sets of metadata and indicators from scratch. The same applies to removing a certain parts of the forms or hiding them without actually having to delete the metadata. So this process is documented in the installation guide which is located on the DHS2 website. We have another feature in the TB package which can be very helpful and is quite new and these are the working lists and the line lists that enable filtering patients by certain criteria or they just help provide support for follow-up. So the working lists these are the lists that you see at the enrollment the registration screen and there we can filter by all the current patients by patients that have not started treatment yet, patients that don't have outcome record or patients that have actually finished enrollment but they're still not marked as completed and then on the dashboards we have the line lists that provide further details and overview of the patients based on the event data. So the data that is entered in the lab stage treatment stage and the outcome. So here we're looking at let's say patients with unknown HIV status or patients that have not started treatment or have no recorded treatment initiation date, people that have a delay in treatment initiation or patients that have no outcome recorded. So these tools can be very helpful for for clinicians and end users. Another thing that Thomas already has mentioned is the program logic. It summarizes the entered data and provides a lot of instant feedback to the user. This includes certain date validation rules, the feedback messages, warnings, errors and in addition the program processes the data that is entered in the forms. I will use the example of the case classification. So the data that is entered in the laboratory stage is being processed and then the program classifies the patient as clinically or bacterial logically diagnosed, drug susceptible, drug resistant, rifampicin resistant, mono-resistant, poly-resistant, MDR patients or XDR patients. So this data of course is then used further in when producing indicators but at the same time the clinicians that they have the opportunity to override this automatically generated data if necessary. So this functionality is available in the program. As you know the enrollment in a TV program can take several years but so it is possible that the patient changes the facility within one enrollment. So here we can have several examples. Let's say a patient moves from one place to the other and needs to be transferred to another facility or a patient gets tested and is an MDR resistant patient and then needs to be transferred to an MDR clinic and then we have in the tracker the option to refer or transfer that patient permanently from one place to the other whereas all the data still remains recorded with that patient or with the tracked entity that we're referring. Another kind of transfer can be a one-time referral of the case well in the best example here is the lab stage so where lab specialists get access to the event of entering lab data for the referred patients and then the patient actually remains registered in the initial facility. So Geri, I'm just going to give you a two minute warning here. Yes thanks thanks Mike. I'm skipping some things. So well many countries are using or are familiar with the WHO TB packages for aggregated data so the data that is entered in the TB case surveillance chart is aggregated well in alignment with the data sets in these aggregate packages and the data can be then seamlessly transferred into the dataset reports from the from tracker to the aggregate. There are several ways to do it. There are scripts that we will provide and then there's a great app which is in the app store of the DHS to developed by his Tanzania. So this also means that if let's say part of a country is using aggregate data packages but then another using the tracker then the data aggregated at the high levels it remains consistent. The packages the package supports the decentralized workflow which means that we provide user groups and different levels of access for certain for different areas of the program lab and or analytics data admin or metadata admin and so on and so forth. And last but not least so the Thomas also mentioned the DRS survey this package will be published in October and a lot is aligned between these two packages and it comes with it will come with a lot of monitoring dashboards that could be useful in the countries. So yes I would like to thank all my colleagues from UIO and WHO and his groups in the global community for their support and thank you for your attention. Great thanks a lot Yuri and these slides along with all of them from the presenters will be uploaded to the session so you can have the links there and spend a bit more time looking this configuration. It's new hot off the press so we're very happy to have people have access to them and the DRS one is coming soon. So I would just like to add that well if anyone is interested in more information and then demo well the we have a demo of TB case surveillance but then don't hesitate to contact us at any time and we'll guide you and help you. Great so that will turn over to Dr. Zoena Kondo from the Ministry of Health in Tanzania a monitoring and evaluation officer to talk to us about their experiences using Tracker for TB. So please Dr. Zoena. Okay thank you guys good day to all my name is Dr. Zoena from the Ministry of Health Tanzania working with the national TB and lepros program. I'm going to share with you a little bit of our experience with the use of the TB tracker. So this is just a background of Tanzania for those who are not familiar with it it's a fairly big country with around 900,000 square kilometers population around 56 million people and we have a total healthcare facilities around 8,000 but majority of them are at the lower level. So the healthcare organization is organized in this way from the mayor the lower levels the community the villages and then the facility health facilities and then the district level regional and the national level where the Ministry of Health sits. So what happened as Dr. Asma had clearly said during the opening of this conference that if we cannot measure progress we cannot make progress. So this is actually what happened in 2013 when WHO had assessed our TB surveillance system and found out that actually it cannot not really measure the progress which we need to to measure. So the main finding was that we have we had a paper and an electronic kind of a system mix. I have read but the electronic one which was we were using was really not functional optimally and and also we had faced challenges in upgrading especially because the expertise was not in country and but it was also noted that in the country the Ministry of Health was rolling up the DHIs too for the healthcare service the routine the routine data. So it was recommended that for us to move to the electronic recording reporting so that we can really able to measure the true burden of the of that disease in our country. So we said how are we going to tackle this because we had a previous experience at this time we said we don't need just a system but to really need a system which can be sustainable meaning that the system will stay with us over time and we can be able to maintain as we continue with it. So we theorize that if we have a correct design and the correct resources availability at the right time and we go through the correct processes like engaging all stakeholders especially the lower level stakeholders the users and the bottom up approach and and also making sure that we have appropriate strategies and policies which can back us up then we will be able to have a system which can really give us an output which we are we are desiring. So this is what happened because we had an history of using the DHIs too with our ministry so we contracted our universe of the Islam which is part of the his his Tanzania and we decided on DHIs too for all the the good reasons you know and we were able to get the fund from the global fund and also programmatic technical assistance from the USID. So we went with all the processes we did the assessment and then we called the stakeholders and did the requirement gathering and and the procurement of of the hardware but in place we we there were some guidelines which really backed us up such as the ICT policy because of this we have the country has a fiber optic which is supporting to make sure that areas so many areas they have internet access but also we have our e-health strategy which which guided us and later on in 2018 the minister had developed the health information system guideline but also the country's ruling party manifesto actually has a target collectinization of their patient information. So having all these strategies and guidelines really supported us. This is just a snapshot of our journey as you can see what's to note here is that during the 2013-20-20-20-14 we started with the aggregate with the aggregate system but 2016 that is when we embarked on the TB tracker and we were able to do the pilot for two months for three regions and our programmatic technical assistance did the evaluation and we were given a green light. So came 2018 we rolled up this system country-wise. So since 2018 we are using this system we also enter the 2017 back load data so that we can get the outcome. So since then this is the system we are using and Yuri has talked about the system and Thomas so this is basically we have three registers the TB register MDR and the culture DST this is the laboratory part which I'm going to talk about this tomorrow I have a session of that. The data entrance is almost from three thousand areas where we have TB clinics and the main the data entrances are the main district coordinators but also there are some facilities around 15 percent which can enter data directly. So the district coordinators every month they go around all facilities every detail C has around 10 facilities they go around and making sure that they enter this data. As previous speakers had said the system has variable like the coded variables the program rules the quality checks I can see the Yuri was calling them the working list we call them the quality checks list and all that. So this is an example of our system you can see that a little bit more because we have leprosy as well and we get to get all these beautiful visualizations and also because with the systems with WHO we were able to archive our data since 2019. And this is just an example where the healthcare workers really used these outputs to discuss the trends for our TB situation when and we were doing the situation analysis for our completed NSP and we were developing our our new NSP. So what happened as I said we were very cautious at the very first so I did an assessment last year to find out if we are going to live with this system. As you can see a lot of factors giving a green light for certain ability like using a local developer this was easy easy to get them easy to read them even the language we understood each other but also the policies the guidelines place really supported us the beautiful nature of the software the DHIS too but also the fact that they're at the users level there's really support in in ownership you can see the users mostly a permanent staff around 54% of them and also they had also had previous basic computer knowledge which was very essential and they had an actually on-site maintenance for the ICT for the small small issues like troubleshooting and all that there's higher sections all the interviews were accepted that the system is useful to them and actually you can see now reporting we get the reports 14 days after a quarter ends which we usually had to get them 40 days after but also the fact that even the private facilities all are using this this system well we still have some red lights and danger our sustainability part like the dependence on the DHIS to support per se the dependence is still up at the national level or at the developer directly so we don't have this capacity at the sub-national but also the internet cost for those peripheral areas where we do not have a good connect connection but also on the use as you as you've seen a lot of have accepted that the system is good to them because of obstruction of the report simply because the reports are the ones which are being imposed to them but really they they have not mentioned much of really their own use but also procurement we noted that all of the most of the of the hardware which were being used were procured by national level only in very few facilities where the pieces are from the cancels themselves so from that I can say that we have been living with DHIS to fight some time almost seven years and almost two and a half years for the TB tracker part so sustainability of the electronic health management information system is actually can be actually realized and but we need the existing structures to be strengthened and yeah thank you so much great thank you so much Dr. Swain it's really great to hear the good work that Tanzania is doing so next we'll we'll move to our colleague Zephirino Zephirino has many years working with the HS2 supporting a number of countries he also is the his Mozambique South Digitus Group and they have been working on implementing a TB tracker right alongside the work that we've been doing together with WHO so we'll be really interested to hear how things are going there I'm not sure if you can see my screen yes we can see it we're seeing it the same way that we saw Tomas with the kind of slide preview but if if that's difficult to switch that's fine we can still see it oh that works okay so yeah thank you very much my name is as I said my name is Zephirino Zephirino and I'm leading it's in here the group of guys that we are considers as a sub is the OHHS expert that are supporting them in the phone community so I'll be sharing here the experience that we have while supporting the implementation special of the tracker or TB patches of and then special looking at the example or the experience of Mozambique that adopted the HS2 in 2015 and then the national TB program was one of the the program that started adopting the case-based surveillance and this system as actually the TB packages have been considered as a good start since there were a lot of guidelines already embedded that my colleagues previous colleagues have mentioned and the current of the system is in use and it's been launched and then they used on pretend the national electronic tool to to track to be patient or cases across the country and then the support is done by us and then the investor also and then I now I think my colleague I've mentioned about the features that are special you mentioned that I'm not going to go through the Mozambique was one of the first the package as was mentioned it was launched this year but we have been using this package since the start sometime in 2015 2016 and then the country was one of the first and then some of the experience that we get we were we bought during the customization of these orders brought back to the developers and then to improve the the tool and recently we the country also embarked in the new the system because of the different or the number of higher cases especially the country now decides to do a cross-section survey which is the plan is to get this data to also be used for along with the treatment procedures or the routine data that is received so this guidelines also they use the guideline that were developed by W Show the guidelines where the guideline we adopted and then adjusted a couple of years ago but now with the with the package again as you as you mentioned the package is going to be released in October but we are worried using the the package and then the actual on Monday the start the implementation starts so there are two clinics that are going to do with the survey so there are a lot of experience lessons that are going to learn and also bring it back to the developers so with regard to the lessons that we from the national national TV program perspective I think that the implementation of the package allows them to adhere to the top or standard packages for example there are some protocols that are defined there were doing that the usual when when what they they have and then also compared to what is the the package brings and then there is always a process of negotiation discussion in order to both to to to adjust the to the package according to what the this presented by the by the users as well as looking at what the package can bring to the benefit for the for the for the users so that also that the package somehow brings a lot of ability as this was presented here by my colleagues my previous colleagues there is a possibility since that they are all all country are using the same package then is that there's a possibility of sharing the experiences since the indicator that I looked that I used are the same the calculation methods mechanism are similar it's easier to to look and then to compare the the data so there is also the smooth delivering goal of a comprehensive digital tool since especially for example when we started customizing the chibi truck again the country was as they had previous experience that they had a platform they had a plan or they were the platform that we are trying to implement but they couldn't do that because they were failing to to to to implement or at least to deliver that package the the the company that we had that so by by using this kind of package it helps to digitalize the the processes and then also the since they are daring to the guideline it's very easy for them to have everything incorporated on the on the system um we from the perspective of customizers so we think that okay the right package they are very good place start and then but it brings some challenges and especially we as I mentioned before there are ntp representative that are not familiar with the guideline so in this case you are there to show them on the develop based on guidelines and then please let's look at what we have here but I don't know and there are they do have tools that were already designed and then some of these tools they are not aligned so the guideline I said so there is a need of sitting with them negotiating in order to come up with the best way of incorporating sometimes you have to to to to to adjust the tool and add some we did have experience previously with the tb the case based and they even not uh variables that were uh provided by the country in order to be to be added into the the generic package because the generic package as you know that is still uh when the package is still under development or for example it's yet to be published there's still some uh information that is not yet there and then there are experience like for example that we can we will get during the implementation here that we can provide to the generic or to the developers that way to improve the package so those are the the different challenge that you usually face when you are doing one more actual uh when you are the first to to to at least to adopt the package uh yeah you have that you have to deal with that um of course uh the the last point is talking about that the approach is not yet there the this is mentioned the the packaging approach that um uh it was not in place when back on trade tool 15 to 16 when as mentioned as matta mentioned uh that the process uh they are still starting to think how the the package can be developed and then provided to the country so we started at that point to temp the packages and then this is also bringing other uh challenges that need to be uh addressed uh of course as i mentioned this is puts us into dilemma on how to to leave the process of negotiation so you need to see the local needs against the generic package sometimes you have to uh remove what is not required the features that are not required and then add new features but now for example as it was mentioned again by ure currently you do have this we are using constants you can go there and then just plug and unplug and then plug when you need in the beginning we didn't have that so you have to go there to remove that that element all you have to use that and then try to prove representative those are not familiar with the guide that this is important so those are the things that you also need to uh of course take into into account uh of sharing this all these needs uh all these requests with the package developer so that they can they can improve the package as well as for example take bringing those guidelines discussing with the ntp representatives trying to understand to see what what is the benefit of using those guidelines uh some of the lessons that you have learned uh so far during the adoption of this uh generic package with that uh i would say uh i hand thank you very much for listening great thank you zephyr you know and it's uh yes it's adopting the packages uh in the early on stages can can lead to some challenges um but uh it's also been helpful for us to see the real uh experience of most mb because they go through it's led us towards some of these decisions to try to make the adoption of the packages easier so we have just about six or seven minutes left uh for questions i see a couple of them in the community of practice that we can address but also if you feel like unmuting yourself at some point and asking a question uh please do so uh the first one uh that i would bring up and then feel free tomas to jump in on this but there was a question about the link between the standard package and gen expert um and whether we can uh do an automated link there to receive that data this is something we've been in discussions uh with the the gen expert people around the and a previous solution that has made this kind of a connection um and it's something that we do want to do in the future but we haven't done it yet uh i don't know tomas did you if you want to add anything to that yeah we we have basically it's because of the covid we we lost the pilot projects because everything was booked on hold so without that uh we would have more information to share currently we have piloted this solution in in two countries and we were hoping to learn more but uh during the covid situation it it's unfortunate that we have fun not more to share but there is work being done and we hope that uh we will share more soon okay great there was another question in the community of practice about the script that we're using to push data from tracker to aggregate uh Yuri do you want to mention about the script and anything about how it works or how people use it well uh i'm i'm just about to publish the answer to on the community of practice well uh there the script itself uh it's just basically looks at the uh at the codes of the uh program indicators and then the codes of the um uh aggregate data elements and then includes the reporting period and the organization units and basically that's that and i'm sure that uh different countries use different ways for that script we are currently developing a kind of a generic script that we can publish alongside our packages that will be available for everyone but i will share the information on the community of practice uh so when it comes to the tv package that the the published package has already uh got all the mappings done so that the program indicators can uh we can be transferred to the data elements of the aggregate packages so if that helps that's that's what i can add now yeah great thanks for that uh i don't see other questions in the community of practice is there anybody that's listening that wants to unmute themselves and ask a question maybe while we we wait to see again we just have a couple of more minutes but zephyrino i have a question for you so with the packages process even when people are adopting the fully published package the the first step that we always are recommending is that of course the the country sit down and review their own national guidelines in comparison with what is in the package um having the information about what the recommended WHO guidelines are and that that process can take quite some time um in order to ensure that you know what is in the package is what the country wants to implement and it's adapted to their needs could you give any thoughts about uh how you handle that those discussions uh was there kind of a a clear process for that with mozenbeek or uh how long do you think it would take to go through that process for for the tv package um any any insights there about how that process went thank you my actually there's no clear direct answer for that because it's the take depends on the the the the perspective or the needs of the people that you're interacting with so i will just do a generic for example when you started we at some point we were apart from the track track a tb track and then the drs we did have the hello can you hear me yes we can hear you yes yes i was saying apart from the tb track and then the the the the drs we did have the dashboards uh actually the dashboard they are the easiest part to to do but when we went to the to the ntp we went there we found they were they were having a list of 235 indicators so that those those indicators were not in the in the in the in the in the in the in the in the package so there were there was a process where we had to go through all these indicators and then see what which indicators are in the package and then try to see how are they going to use if they the indicators are linked to any decision-making process that they are there they are going to the usual go through then we found that uh some most of the indicators are not they were just defined in there because some some of the the the day partners they were asking at some point those uh to to to those kind of information and then so we had to go through all these processes together and then i identify all this the day they get everything in the definition and then select those ones that are coming with the package and then mark them and then the rest discuss see how we can generate that the the the one that they they do have that are not coming with the package so if i can answer directly there is not there's no clear process on how you can go through depending especially if there are uh individuals that are that are that they know all the existence of the package and with the areas uh and then there was when we started doing the customization or when we the program approached us and then we knew that there was the the the the discussion for them we start discussing with the the investment also and the WTO and then they they they they they came up with the with what the the form that they were they were planning to use and then at that point we said that okay there it will be uh there is this the package that has the means that is being conceived uh to to to be used and then at that point we have to look at what was in the form what was in the package and then luckily in the team the NTP there was someone who knew about the standard the guidelines and then it helps a lot for us to like to to convince somehow the the the the the for the the NTP that some of these indicators that they are requesting they are not necessary because they are doing a survey some most of the information that they are they wanted to to capture with survey is already captured by the routine information system so it was based on that we could identify say okay no this information you can get from your routine system now you want you want you are you are going to do a survey so we can only focus for example on the specific information that you cannot get on your on on on on your routine system so there are several issues that need to be taken into account but uh it depends it varies from place to place from the individual that you are going to interact with if they are they know or the the the guidelines they know since the guideline the the package that developed on the guideline they know the information system here and then also ultimately they know how are they going to use that information that is going to be used for something and if they don't they are not clear about the output it's going to be very difficult for you to define to discuss with them what they the input I think the system can can can can that can be ready to capture thank you great thanks we're pretty much then out of time I would just on that last point say that a big part of the reason that the you know where we and WHO are promoting these packages is actually to help with some standardization in countries and also help adherence to global recommendations and guidelines so it may even be a good idea to think of you know initiating national guidelines conversations when the process is starting for adopting these packages having the package there that contains the the global guidance as part of the configuration can help those conversations but also thinking what that really means in terms of time and what it would take to get around to implementing that can be quite an extensive process so again you may you may need to be careful about kicking off a national guidelines conversation so with that we'll have to end this session those of you that are planning to attend the HIV case surveillance and HIV tracker session that's starting up in the same link in just another five minutes but we'll we'll take five minutes ourselves to be able to make sure that the next presenters are connected and have their audio and video working so thank you everybody thank you to the presenters very nice to hear about all of the efforts behind tv and yes we look forward to the next session on HIV