 All right, so yesterday we had you have a look at this register form and take it and kind of convert it into the DHS to data model. So actually, here before I proceed too far ahead. I'm just going to make this resource available to you so you can also view it. Okay, so if you go to the tracker terms and data model section. You'll see that I posted this Excel sheet here integrated ANC delivery PNC registry conceptual design. Okay, and this is just going to be actually a filled in sheet with all this information and we're going to use this to kind of review things today. So you can have a look and download that and follow along as we're going through this. So we kind of asked you to have a look at this and decide how to, you know, move it over to the DHS to data model, and also to think about some of the indicators you could potentially form, if you need to maybe separate data sources. And I know that there wasn't enough time for the exercise, I might apologize for that, but it was really kind of to get you in that mode of thinking how you would work through this. So let's say what I'm going to present it's one way to do it doesn't mean it's the only way. Right the thing with tracker programs right it's completely dependent on the procedures that you're following, you know on the routines that are there in your country so me showing one particular way of setting things up. It doesn't mean it's the only way of doing it right there are often multiple ways to do things and not none is right or wrong necessarily. So there are some best practices we can generally follow. Okay, but, you know, depending on the routines that the procedures and everything that you are kind of looking to implement. You know things could be set up a little bit differently, and we'll talk about some of those differences as I go through that. Alright, so the first thing we're going to do if we just review this sheet here and I'll make it bigger so we can all see. The first thing I had you kind of do is look at the track and T attributes and identify the program stages. Alright, so if I have a look at this. I also have some dates here as well, which I know this through some of you off I was kind of jumping between the rooms and just listening in on the conversation. Okay, so we have a couple dates. So we have the enrollment date, which is the date of registration. Okay, and that's just taken from this first column in the form. Okay, this is the date of registration here. And that's going to be the date that we use as our enrollment date. We have this. Sorry, I realized there's quite a few short forms on this form and I probably should have given you the definition of this. This LMP date is called the last menstrual period. This is what initiates a mother coming into the clinic for their ANC visits. So we're using this as the incident date. Now I kind of mentioned in the directions that sometimes you don't need the incident state. There are many programs where it's not necessarily something that is required. Okay, but in this case because we have something that initiates the sequence of events. So we have an incident state. Right. And then, basically, these here are the attributes. This one, I knew this might throw some people off. Okay. And, you know, you might have identified it as an attribute could be theoretically wouldn't be wrong necessarily. But you know I decided to put it in a one of the program stages right rather than have it something that's registered on the person because you know if they come in, if you register them with those details it's not really you know could change right they could have another pregnancy, the data delivery will change. Okay, so, even though it's part of this registration information section it's a bit of a dark horse right you can kind of put it in a different component, depending on what you're doing with your program. So that's what I've laid out here just has a handful of these attributes here. And for the village attribute. Okay I was going through and hearing some of the discussion around this. So I've made village a option set. Okay. And, but I was hearing some of the discussion around some of you had opted to make it an organization unit. Okay, and it could be the case, theoretically, if you're in a very large country, unless they have those villages as organization units set up, you know this could be 10s of thousands of villages perhaps. So you couldn't really set it up as an org unit right because if you use org unit as the value type, then you will have to have those org units in your system. Right. So just kind of keep that in mind when you're setting these types of things up. You could also have it as free text maybe as well. Sometimes it's hard to get your hands on that village list. This would perhaps reduce the amount of usefulness of this attribute, because if you, you know, spell the village name wrong in a couple places you can't really aggregate that data. But you could still use it to just register the individual. Okay, so there's a couple ways you could handle this kind of depending on on what you need to. Right. So the next thing I kind of asked for is identification of the program stages. Okay, so if we have a look at this, there's basically three program stages that we can identify, and they're just split up basically into these headings. So we have the routine ANC visits. And this is one that you know the mother comes back receive ANC services, prior to any of the delivery. Okay, we have the maternity and delivery here. Okay, and then we have the postnatal visit. Okay, now if we look at this sequence of events. So routine ANC visits, it occurs multiple times right and they're receiving the same set of services. So they can come, you know for a first visit a second visit a third visit a fourth visit. You know, now I think the recommendation is, you know, eight visits or more right so they can come multiple times to receive sentinel care. So you could actually just repeat this information. And what we do by repeating this is, you know, we don't have to set up all the data elements and everything over again. It'll just be one program stage with several events. Okay, if we remember from our data model that we discussed the other day. Right, so this stage could be repeated. Right. The other stages occur once in this sequence of events. Yes, the mother can deliver more than once, but you know they would be maybe enrolled in the program again. They're going their second pregnancy. Okay, or third pregnancy. Right. During the sequence of events they only deliver once. Right. So this is a one off event. So there's only, it's not repeated. And the same with the postnatal visit this is a one off event. And they only come once for this postnatal care in this sequence right. So in these cases, these two stages are not repeated. So we generally go through this, you know, we're going through this to kind of decide, you know, how we would actually build this into us too right and for any use case that we kind of are working with, we have to make these types of decisions or kind of have this discussion right to kind of figure out what it is we're going to do. So next thing was identification of the data elements. Now I didn't expect you to actually write all these down. But I've given you in the sheet that you can download from Moodle, just so you can see for reference. Okay, all the different data elements that are part of the different program stages. All right, and I've identified also the option sets that would belong to them. All right, so we can just go through a couple. You know, just see for review. But I saw some of you actually just, you know, you were having no problem with this I think there's more of a time issue right and it can take a bit of time to identify this. So, for each of these programs stages right basically most of these columns are our data elements right and some of them, like this one HIV test result has an option set syphilis results has an option set where you'd select from either positive, negative or unknown. Some of these boxes you have to be a bit careful because each of the programs, each of the events within the program stages will have an event date if you remember we kind of cover this briefly when we were opening up the TV program and reviewing the events within the program stage right. It's something that was covered a bit quickly, but so you might have missed it to be fair. You know, for example this date of visit that could be the event date right doesn't necessarily have to be a date element in the maternity and delivery section though you have two dates. Right, date of delivery and date of discharge. So in all likelihood the date of delivery would be your event date, and the date of discharge would be a separate data element right so when are they discharged from the hospital after the delivery right. If you look at all the events, it's dealing with the delivery itself right mode of delivery the sex of a child the status of the child at birth with the breastfed etc etc right it's all kind of dealing with the delivery and at the end, they're discharged. Okay, so that would be a separate data element in the section, and we could use the date of delivery here as our event date. Now if we look at that postnatal visit. This one can was a bit of a tricky one I guess. So for the most part this this part is pretty straightforward these are data elements, some of them have option sets. And here's the event date right when the mother came for the postnatal care visit. If we look at the family planning options one. Okay, some of you might have identified this as having an option set. But if you look at the options, you have options for both male and female right there's male sterilization male condoms female condoms, and several options for female sterilization right so or other options for for kind of family planning for females. So you could assign more than one of these right at that time, because you could assign something for the father something for the mother, or you could, you know have more than one one method. Fortunately, when you create an option set you can't select, you know multiple options. Okay. So, in order to do this you'd actually have to create all these separate data elements basically under the current model within DHS to. And you can just create tick boxes for example, but you'd have to create each of these options individually because you could assign more than one. Right. So so this one was a bit tricky. I think through you know how it works in DHS to, but you wouldn't necessarily use an option set. So that's what I've identified here. All these different types of family planning methods are identified as yes only data elements essentially right so what that means is it'll show up as a, as a tick box in the data entry screen within DHS to. But next thing is we can look at the sections right and this is not immediately present from the registry itself, but it's something we can use to group the data elements together. So, once again you would probably talk to somebody, you know, within the program, or if you have that expertise to kind of you know make this work a little bit based on what you're seeing. These headings are split up on the kind of registry itself the paper registry. Okay, but when you're in DHS to it's you can also kind of further kind of section check section off these these various items, just to make it a bit easier and group things together for the person entering data. So if we look at some of this, you know, some of these are closely related like here weight height and blood pressure pressure for example, we're taking some you know vital markers of the mother to kind of understand, you know her current health situation right. We have some lab results lab tests for running on HIV and syphilis. And then we have these here. These are kind of prophylaxis methods for deworming for malaria, LLIN is a long lasting sector cycle and that's an iron right so they're kind of prophylaxis methods that we can kind of group together. This requires some knowledge of course so of the delivery of the program itself so it might not always be immediately apparent, right, but we can when working with others, try to identify, you know how to section these off. I'm just kind of sectioned off some of them here. And this is, you know, for when you create the data entry form, you know, you could essentially section them off the same way. Okay. And you can just have a look like all the family planning methods are grouped together. All the different status of the child. So if we go to the next section here, right the sex the status the weight the length. And once again, this is one way to present it. There's no right or wrong way here. Absolutely right. I'm just showing sharing, you know, something we typically come up with, but how it's actually structured, you know, that's that could be very different depending on your needs and your requirements and, and how you use this information. Right. So I'm just giving you an example here, but you could section it off differently, and that would not be incorrect necessarily. Okay. So we'll just have a couple indicators here. And I wanted to kind of talk about, you know, this, because it's quite important to try and identify these. There's just a couple here. If I look at that form, there's there's quite a few, you know, probably hundreds. Actually, we could extract from the program data we have based on what we're seeing, but I just wanted to extract a few just to discuss them right. So so we can have kind of very simple ones that just take the exact data from from the registry and kind of create counts, you know, so we could get a count of still burst we could get a count of the number of vacuum extraction. You know, delivery by vacuum extraction, the number of HIV positive test results right we could count each of these things for any of these parameters that we're seeing. Right. And that is one way to kind of define basic indicators about this is just to kind of create aggregations create counts from our individual data. Right. The other way we can look at this though is combining those with other parameters whether it be population data, or whether it be ratios or rates within the information that we're currently collecting. For example, ANC for coverage or ANC for plus coverage. So there's one option here. Right. ANC visit. Sorry, that should be for plus I guess. Okay. And we could count the number of ANC fourth visits, right. But then we would have a denominator for that for coverage, right. And you know, in this case I put expected number of pregnancies right. It's not actually something we would collect in our tracker data. Right, this is an external variable, we would have an estimate of the number of expected pregnancies within a certain period, whether it be, you know, maybe for a year, for example, we have that number that you know is calculated through surveys or other types of demographic tools that would be made available to us and we could use as our denominator. Right. And the same thing here I've identified here in these cesarean sections. So just to have a look at two different methods of looking at data. Right. So one is taking the total number of libraries that have been recorded. Right. And you can take that from your tracker data right from here. Right. By counting the number of cesarean sections where the baby is alive. Right. So you would combine information from these two columns. Okay. And then you know you'd have a denominator where you're just taking the number of children that are alive right to get a proportion. Right and you could do the same thing though using the estimated life first right and this might be some other demographic information that you pull in from another system or another source. Okay. So when you're thinking about or thinking through these things you know it's often useful to think will not just not just about okay. When I'm looking at the program directly. This is the information I have right in front of me. And these are the things I can do with it. But you can also think you know DHS to you know quite allows you to pull in that information from other sources it's quite a powerful tool to kind of create this this kind of analysis across these different you know variables. So you can also use you know different denominators depending on the program you need for example to create calculations. You can combine data across the program right so in this example we're combining data from you know the type of delivery whether it's a C section or not, and whether or not the child is alive. Right so you don't have to have single parameters all the time. And then you know you can use different denominators based on what's available to you at hand and what you are calculating and what you need to do. Okay, so the whole idea about this was just to kind of think through that a little bit because it's quite important right and often when you write down your indicators as Brian kind of mentioned in this presentation right the configuration needs to match right. If you say okay I need this indicator calculated, but you're not collecting the information or you don't have the denominator available, then it's going to be different difficult for you. So you have to kind of make sure that's incorporated into your design. When you're thinking through this a little bit more right. So lastly we have the option sets, and I've just laid them all out for you. I didn't expect you guys to get through all of this, but just so you can kind of see where they're taken from. It's just, you know these fields that have lists here, for example the mode of delivery has normal vaginal delivery vacuum extraction cesarean section, the final diagnosis has all these different types of diagnosis that I could potentially select from. Some people asked about this yes and no type of variable right to a trade an option set for yes or no. And that kind of depends. Okay, I often do actually because I, it makes it easy for me to count the nose. Which might be a bit of a strange concept the way I'm explaining it, but there is a yes no data type within DHS to okay, so you could use that and it would not be incorrect. Okay. There is you could create an option set for this. Okay, so an option set being yes no as well. It just kind of depends, you know, how you want to use that data right so for me I find it quite easy to aggregate the option set so that's why I often use it, but using a yes data type or a yes only data type is also correct theoretically just depending on you know how you want to use that thing. So we would go through this whole process before we do anything in DHS to and you know did this is generally true of any use case that we would kind of take part in right and this is just kind of documenting the kind of. We haven't gone through and documented all the requirements necessarily actually what we're doing is, I mean, the indicators and the metadata is really what we've done in this exercise. As you go through more parts of the configuration, you know, we'll talk about some other requirements that you would be thinking about, you know, as you're kind of going through this as well. Right. But you know it's a start right and we really have to kind of think about these things before we go into DHS to save us a lot of time and makes everything clear. And also you know for anyone who's not necessarily a DHS to expert, but they might be a program expert of some kind we might have a lot to contribute from service delivery side, you know it helps them to understand they're actually, you know how things are going to be laid out. And when you can review it with them in this way you know they're probably used to seeing stuff, you know it can develop workflow or an Excel sheet or things like that right things that are kind of people are familiar with right. And it helps to kind of do it this way rather than present something in an overtly technical manner. All right. So, so yeah, we've gone through this process at a kind of rapid pace. And often this this might take a little bit longer in practice to do. You know there might be a bit more back and forth between the people kind of developing for implementing this inside of DHS to and you know the people that are kind of responsible for the service delivery aspect the subject matter experts who kind of understand what indicators and data need to be calculated from this etc etc. But, and there could be a back and forth right I will also say, sometimes it's not perfect when you start. Right, so you define everything and you think all this looks great. And you go to implement it all people review it and then you know, there's changes that are required. And that's often the case, especially when it's kind of conceptual to begin with right people don't really. You know that experience DHS to person might have some idea what the end product might look like. But you know, for the most part it's kind of hard to conceptualize for a lot of people until they see it on their screen and then they can make adjustments as necessary so there is a bit of back and forth here, as you deal with this design process. All right. But yeah just try to you know when you're thinking about it in the future. And you're kind of working on these types of programs, you know, go through this process of kind of making sure that you've identified you know, to the extent you can right, don't let the perfection be the enemy of actually, you know moving along. But, you know, to the extent you can have identified you know some of these requirements, and you know, you can refer to this then, you know when you're building something inside of DHS to. All right. So if there are any questions about this topic. I know there's been some activity in the chat here. Okay. You can also ask us on slab. Okay, about any of this. All right, so we're going to kind of keep reinforcing this concept as we go through the various sessions so it's not the last few seen of this conceptual design. But we do want to kind of use it now to actually design our program inside DHS to. So that's going to be the focus of today. So if there are any questions about this, let us know.