 From his side, or from your his PIO side, we recommend that countries who are doing the tries to have what we call a three layered governance mechanism to support your details to systems. I'll talk a little bit about that. Those three levels are a governance committee or governance body. Some operational management day to day management and the core technical team who will do the actual technical work. So clear governance and coordination mechanisms, they are critical to put in place to enable the tries to as an integrated health information system. And the reason for this is that very often there are multiple competing needs. You will have this program wanting that you will have those program, those people wanting this you will have an minister wanting that. So there will always be a lot of competing different wishes of what you should do. But if you have one team that can work with the highest to you don't have time for everything all at once. So you need to prioritize. So having a good governance structure in place is important for that. And you also need some strategic thinking again to plan for data use to make sure that you are supporting the different levels of the health system. All the way from local from facilities through local administration up to the national so this governance structure or committee they needs to keep this the whole picture in mind when planning. So we recommend this three layered governance model. And then through the different the different topics. This is to again have a well coordinated prioritization. That's a difficult word prioritization process that is understandable from the outside. So when program X is coming and screaming why don't we get our program you promised you can say that okay but our principles here in this country is that we will prioritize this type of systems first. If we can do this then we will do that if that is clear to everybody it's more visible and it's it's easier to understand. A strong operational management is to guide and mentor the technical work so you could think like a project manager somebody that can make sure things are on track it's moving as it should. We're having a dedicated technical team carrying out system improvements these are the people like the Palestine team here they know how to connect all the wires and fix the fix so that it's working. But it's not it's not enough to only have a strong technical team I think I think you also need some governance above that to that can set some priorities. In other countries we can find countries with relatively strong technical people, but if there is no leadership around that. Then suddenly, you will solve a problem that your cousin is coming with or whoever person that has the biggest bag of money suggests, but it might not be the best for the country. So I'll go through these layers. So let's have all the priorities that's the best right. If you're doing priorities it means that you have to not do something and somebody needs to decide what that is. So we recommend that this governance committee or governance body consists of key stakeholders within the ministry and also representatives from programs. We should have a holistic as strategy across the ministry they should work on aligning partner interests, they should talk to the, to the, to the different programs to the govies to the global funds to the whoever has interest in your health information system. And it should consist of people typically with some public health experience or expertise, some health information skills, and maybe some it your information system management skills. And it's important with good representation from from around the sector. It needs a clear mandates. So it needs to be like an official committee that people know that this is the committee they are meeting at a regular interval they're meeting every the last Wednesday of every second month. And this is the agenda they will discuss ABC. This is how you come with suggestions to this committee so make it like a visible, a visible body. And they need to work closely with operational management. People leading the core team to say that okay we have now discussed we would really like your team to focus on these three strategic areas going forward. If there are any big problems, please let us know and we can help to reprioritize or change the operational management. This is typically like people that have project management expertise project leader. And they are the people who are responsible for implementing the priorities set forward by this governance committee. So it's not up to them to say that. Okay, I think we will do tuberculosis individual data collection across the whole nation. That would be the government's government governance committees. But they will be responsible for having the task to be individual data across the nation. Go, how would you they would plan how to train. They would figure out what technical work needs to be done, what kind of equipment needs to be bought, etc. But it's not for them to decide that this is the priority. So this operational lead. It should be like internal government positions, ideally, not coming from the outside but it should be somebody sitting within the ministry to ensure this long term sustainability. And operational lead should work closely with the team carrying out the technical work. Sorry, I see the heading is wrong. Apologies for that. They should work closely with the technical team to see if they're on track. How is it going? Do you need anything? Do you have the skills that they need to perform these priorities that you are responsible for making sure happens and monitoring progress. The core team I will not say a lot about that because we will have another session on that in detail but they are responsible for the day to day technical development of the system. And they also need clear responsibilities that my colleagues will talk about later. Typically, we say like around four to six people in a DHS two team is ideal, if you can have that, and they need to be continuously trained have a capacity building plan and be invested in and importantly get paid. We also see DHS two teams around the world where people don't have salaries. So like it's something data costs something and you need to pay people to do this job and give them the time to do it. For our technical team, we advise that you have positions such as data security or working on data security or working on server administration. These people don't necessarily have to be dedicated only to the details to two team they can have a security role for many different domains or projects, but it needs to be somebody appointed for security in your core team. It's good that you would have somebody in the team that has strong computer science skills that they master typically like scripting work, or web app development. But it's also quite useful to have your team have little bit public health knowledge. So I mean just the exercise we did on day one, like, give the core team an idea of what is the domain you are working in. We do the same or we try to do the same with our soft team in the that is developing the details to software. Also that people understand what are you developing for. So this core team they can be external or internal to the ministry it's not critical that the core team is sitting within the ministry it's preferable. But it's important again that this sort of project management roles and governance roles are located in the ministry. So in summary, we recommend a three layered approach. You might need to establish some new positions within your ministry. It's not easy to deal with recruitment of skilled IT staff in any country. But you need to invest in people and have long term capacity building plans. And there are some guiding sort of principles and frameworks that you can use to manage your project or manage your team. If you can go back to your mentee thing now there is a two mentee questions in the end. It's the same code as before. So now I want to I want you to think about your own countries where you come from. So if you have a new data sets or set of data to be collected from health facilities in your country, who will make the decision. Whether that data set can be introduced. Do you know it can be a name it can be a position it can be a department I don't know but do you know who to go to if you have a brilliant idea you now want every health facility to collect the number of babies with red hair. Can you just introduce that or who will make that decision. To whom do you send that email with your good idea. Many interesting questions or answers here. We have somebody who said the minister. Can I ask who that is. You will have to ask your minister of health to introduce new data. He should sign in the end. Yeah, yeah. Okay. The bind. Yeah. Good. Good. Yeah. Also in Tunisia, the minister is signing off. Okay, cool. Somebody wrote the donor. No, it's a national issue. I don't have to ask who said the donor. It's not maybe the ideal situation that a donor should decide which state I should be collected. Yeah, the digitalization office. Okay. Technical staff from Ministry of Health. They can decide to to give more to give new data sets. Yeah, yeah, yeah, but I was just interested in what is it in practice in your countries because I think there are a lot of different ways of thinking about this. This is great. There are some there are some varied practices around the world. This was interesting, right. Okay, next question. Are you ready for the next question. Can a health program in your country introduce a parallel technology or system to collect and analyze data. So if I'm coming from the program of a vision and hearing. And my cousin has made this really awesome technology. Can I just introduce that in your health system to say to the to say to the clinics now you have to collect data with my amazing software. This is really interesting. It's the reality. Yeah, it's the reality. Isn't this really interesting. So the majority of people answering here they say that if I'm in charge of the program for vision and hearing and my cousin has made this really nice shiny blinking software. I can just go to all the clinics and say you have to use this. It's not ideal, but it's a reality. So if you have a good governance committee on top. That can set some strategy and say, in my country, these are the principles by which we introduce new software to health workers. That is good. It's not always the reality but it's, it's beneficial. And you could say that it would be good for if you're a health worker. You can just imagine if you are a very pressured health worker. And you have 20 different softwares that you have to use every week to report your data. It's maybe not ideal. If you have. I mean, now I'm selling the tries to because it's a DHS to Academy, but if you have one software that you learn, you know how to use it. And then all the different programs. Ideally, use the same. Then your health worker, you have to train them on one software. You don't have to train them on 20 different software. Because just collecting the data is challenging enough and tallying is challenging enough. Yeah. Maybe it's worth from the countries to perform what is called build or buy analysis. So they have to decide if that this is really the technology that they needed. And this is depend only, not depend only on the technology rather than the maintenance, the support, etc. So, yeah, build or buy analysis. This is an exercise that should be conducted before build or buy details to or other software. Yeah, that's a good point. So one thing this governance committee can should keep in mind is what kind of skills do we have in our government to maintain all these systems. So if the policy is that each program can introduce whatever they want. Then you need to make sure that you have the skills in house or you're nowhere to buy that competence to maintain the system not only today and tomorrow but maybe also in five years. So that's part of the government, the governance committee's task to have a clear idea about that. Yes. So this is where the bigger challenge comes in. Sorry, where that. Yeah, much as I understand that government having a clear policy direction is the most ideal situation. But I just wanted to give a different perspective with regards to a program being responsible for introducing our systems. I'm saying this is where there is a bigger challenge, especially for Malawi. You know, introduction of these systems. Most of the times are driven by the needs from the programs. And this is where donor funding is also being channeled. And you'll find that in most cases programs okay they will look they will look at whatever they are doing and then they identify the need. And then they reach out to donors to say we need support we need these services to be digitalized. And then probably the donor says okay, I think learning from other countries they are implementing system XYZ, which can address this challenge. And then you'll find that, you know, they go ahead to develop concept and then later on they would want to implement that. And then when Malawi was trying to streamline these processes in terms of introduction of these systems, there was a very big debate whereby the digital health said, okay, you can discuss whatever you want, but at least involve us so that we also provided the technical support for the introduction of that system. However, eventually you find that the digital health take the lead in the implementation of that system, leaving the programs. So that's where we are facing a lot of challenges because you find that in most cases, even the demand that okay we need this so much package, we would want this to be channeled through our structure so that they can also support towards the development and the like. So, yeah, we are in a trigger situation whereby internal ministry departments or programs are fighting towards the funding because that's what they are looking forward to. Each department, considering what that fund would do or what fund, what that funding will do in regards to the needs that are on their table. So it's a, it's a, it's a hard way. I'm not saying it's easy. Yeah. So it's of course a little bit of an ideal situation that it might not be super realistic but like to work towards something looking like this where you don't have where it's not up to anyone like crazy town to introduce things left and right that you cannot maintain. I think there might be one last question that many of you have answered already. Yeah. So if the technical team working on health information systems in your country, they have too much to do, who prioritizes their work. Do you understand the question. So if your IT team working on health systems in your ministry are overwhelmed, they have too many tasks on their table. Okay, you can leave this rather work on this. And I answer. Yes, sure. I believe the product owner which is Ministry of Health. Yeah. It's the best. One can answer which is the top priority prioritize items from the list. So there is no clear answer here I think, but it should be maybe a combination of the team, the team lead and higher up committee. So of course if it's just like, oh this task is stressing me this is stressing me I have a bit too much to do of course internally in the technical team you would solve it. But if you really see that we cannot both do the TV tracker and the immunization tracker at once then it's up to the governance layer to say okay. We will wait with immunization tracker we will focus on this first. Thank you. Okay. Yeah, last comments before tea. Last comment. We're also on the communication line between the team and from where they got the points or the request. Yeah, sometimes they are working with several departments. So it should be clear the communication line and the team working with several units should be organized well in this issue. Yeah. I think I will stop there and thank you all for very good inputs and good men tip participation. And now we have tea. And the next session I believe is capacity building so how to help train your core team and your end users on the trust. Thank you. Okay everyone if you could take your seat. We're going to get started. We're going to get started.