 So, what is the basic architecture of an HMIS? Here we see what we call the hierarchy of the HMIS. You can see the triangle begins at the community level. And community data, especially data coming from community health workers, is foundational to most health programs operating in a country. Community health workers are the frontline health care workers in many countries. Capturing disease data, they're capturing maternal and child health data. They may be capturing data from vulnerable populations. They could be capturing community infrastructure, community health programs. They could be representing many different community groups, for example, traditional leaders, traditional birth attendants, mothers groups, other vulnerable key populations as well. Community health and community health data is very broad. And we want to make sure that that data is feeding into the HMIS. The community health data feeds in via what is typically referred to as mHealth or mobile health. These are various applications, SMS reporting, various electronic means or sometimes even paper that is captured in the community and then feeds into what we call the integrated community health information system. That the integrated community health information system is where all of these various community health programs data is brought together. So you get one clear picture of all of the health programs happening within a single community. Maybe it's not a community, but maybe a facility catchment area or community health program. That data is then fed up to the facility HMIS. The facility HMIS is representing all of the community data, but it's also capturing all of the clinical services, infrastructure, HR, modities, resources that are supplied or happening or being provided at health facilities. Going up a level beyond that is the district health information system. We find that in many countries, districts have a very prominent role in guiding, directing and planning different health programs, ensuring that health facilities have adequate staff, that most districts are having some kind of routine planning cycle that should be informed by the facility data as well as the community data. Not represented in the picture here, but it can continue to go up. So from district, different countries have maybe chiefdoms or provinces or regions and then you go up to maybe national level. And each level has a very specific role. Maybe more data is captured as you go up. We find the most data is captured at the first two levels, the community level and the facility level. From there on, the role is less data capture, but more analytics and data used for planning cycles. The entire structure here, community, facility and district, is represented in the HMIS. Now going to the right side of the screen, we see the kinds of data that are reported at different levels. Of course the HMIS is not limited to this data, but these are very common kind of categorizations of data that the HMIS would capture. For example, we see disease surveillance being a very prominent role for the HMIS and capturing disease data from community, facility and district levels. Of course, most health programs are providing a broad suite of routine health services. So for example, anti-natal care, immunization, outpatient and inpatient services, and these are all happening either at facility level and oftentimes as well, community level. And as I mentioned in the past, we also want to make sure that we're getting human resources data, supply chain data, facility financial data if applicable, and population data. And often, the HMIS is serving as or is interacting with a master facility registry or master facility list. This particular functionality is the HMIS being the central repository for all of the health facilities. Just knowing where your health facilities are, what kind of status is in, how many people work there, basic health infrastructure data for all of your health facilities. This is known as the facility registry or master facility list. And in many countries, DHI's too is serving as this. In many countries, there are also other more specialized systems serving as a master facility list that feed data into DHI's too. So let's take a look at an example reporting flow from community health workers level all the way up to district level. Let's start on the left side of the screen with the community health worker. So in this scenario, a community health worker receives a patient and they're receiving patients on a daily basis often. They're capturing some details like the patient name, some maybe their symptoms, they're maybe also diagnosing depending on the country, they might be actually diagnosing certain kinds of illnesses like malaria, fever, diarrhea. And then they could also be administering drugs. So they could be giving out antimalarials. They could be giving out anti-diarrheal medication. And they are, again, in most countries, the first stop for clinical service delivery. So in this scenario, the community health worker is receiving patients daily, but then they are required to send in a weekly aggregate case report. In this weekly aggregate case report, they report on how many patients they've seen, what kinds of ailments the patients had, what types of drugs administered, and maybe there are available drug supplies. Different countries have different means to report this data. Some are still using just simple paper registries. And those paper registries are then passed on to health facilities or maybe straight to the district level. As technology is advancing and mobile networks are maturing, we're actually seeing now that many community health workers have the ability to submit data in what we call mobile to web or M2W. That's where they have an application or they're using SMS or some other electronic means to actually submit data directly into the HMIS. The next level is the clinic level. So here we see clinic staff doing something that's broadly similar to what the community health workers are doing. Clinic staff are providing clinical services. They are aggregating those reports often. Sometimes they may not be aggregating the reports, but actually inputting individual patient level data and increasingly just like with community health workers, we're seeing this being done entirely electronically. So many health facilities are still capturing paper records, but those paper records are being supplemented or augmented with other electronic means, for example, tablets, PCs, cell phones to be able to report the data. We also see that clinic staff play a very important role in supervising and supporting community health workers. So maybe they're not only just reporting on their activities that they're doing at the clinic, but they're also reporting on the supervision and support that they provide to community health workers. Often facilities, at least in terms of aggregated data, are reporting less frequently, so they only maybe report monthly. But it really depends on the program. So maybe for Z surveillance, they're reporting daily or weekly, but maybe for routine clinical or outpatient services where they're reporting monthly. The next level up in this scenario is chiefdom or district level. At this level, districts are conducting monthly planning meetings. So they are looking at how they're performing over time. They're looking at those key indicators. They're doing data quality assessments. They're looking at available commodity reports, issues with supply chain, and they're using all of this data to come up with action plans. And ideally, they are submitting those action plans to a higher level, maybe regional, province, or national level. Also is the best practice that they are submitting those action plans back down to the facility and even the community health worker, so that there is good transparency in what the district plans to do at all levels. We often find that in many countries, traditional leaders also play a strong role in the health sector. So in this scenario, we have a separate area for chiefs. In many countries, especially in South Saharan Africa, chiefs play a very important role in organizing health programs at community level. And in this particular example, we have here chiefs that are working with village health committees to come up with action plans as well. They're also submitting what those plans are and communicating those plans, not just to higher levels, but also down to clinic and community health worker level as well.