 Hallo, alle. Kan anyone hear me? Yes, it's from everybody. Yes. Very good, very good. OK, then. Let's go ahead. Today we are talking about, we have a one hour session on DHS2 Research. And let me please share a screen. Ah, you cannot start sharing while the other participant is sharing. Oh, I'll stop sharing that now. Yeah. OK. I am now sharing a screen. No? Try now. No, I try. Yes, let me see with my PowerPoint. Yes, can you see me now? No, yeah. Do you want to try again for me? Not seeing you, Jørn. Clicking on share screen. Invisible. Always invisible. Ah, I'm clicking on the share screen feature. OK, what do you see? I see probably your screen or something. Now we have an expert here. So you should have a window with lots of, with all the drill windows. There we go. Kan du se me now? Kan, indiit. OK. Well, we have some technicalities, but from the beginning. This is, this is, can you not see everything? You are visible, Jørn. That's very, very, very fine. So today's session is about research on DHS2 and health information systems. Vi har en forpresentasjon fra typisk forskjell, eller typisk forskjell fra DHS2-verden. Hva er topikk? Hvordan turner vi normally DHS-projekt og forskjell til forskjell? Det er topikk av today's session. Og hvordan vi kan bestudje DHS2 og hans aktie og effekt. Så problemet er ofentlig at... Det er svært å se, hva er data, hvordan vi kan ta det til forskjell. Og alle dette er en part av en projekte til å developke forskjell og forskjell. På veldig mange av DHS2 og hans forskjell og projekte. Vi kaller det DHS2 og hans evolvøs og dokumentasjon projekte. Vi kaller det heritetsprojekt. Det er å dokumentere hvordan vi er nå og hvordan vi går og hvordan vi har vært. Mange master og PhD-studiene har gjort forskjell i DHS2 og hans ekosystem. Fjellverket har vært kallert i mange løde og middelkommende lander. Og det som er ofentlig svært er å turnere dette... ... kjellverket og fjellstudiene til forskjell. Hva er forskjell og projekte i disse cases? Og hvordan du dokumenter og lærer det med disse aktiviteter? Hvis det er fjellverket i Mozambik, Indonesia, Indien og Norge. Hvordan lører vi forskjell og publikere data fra disse projekter? Det er å bli et forskjellartikel. Når vi prøver å kjenne forskjell, hva vil vi finne ut? Hva er denne case-narrativene og forskjellperspektivet? Hva er det som er... ... at vi turner everything into something that can be written up... ... as research in the academic journal or conference? Det er forskjellperspektivet. Det er sometimes important for det å ha en analytisk framerik. Det er noe teori å bruke, etc. Så de er de ting vi skal diskutere i dag. Og i denne projekten vi kaller heritage-projekt, eller dokumentasjon-projekt. I dag har vi 4 præsentasjoner. Det er for eksempel case studies, case study research. Først ut er implementasjonen av DITRAs 2 for immunisasjoner i Indonesien. En problem her er hvordan du implementer systemet når du har loktat... ... og ikke er able to move on. Data use and DITRAs 2s for data use in Mozambik. Og det tørre er dokumentasjonen av data handling... ... og DITRAs 2s i Odessa, India. Og finally, there will be a presentation on the COVID-19 responses in Norway. Så, wouldn't I suggest that a police and Google is turning on their screen sharing... ... and start presenting and I will then stop share. Like this. Please take over Indonesia team. OK, thank you, Jørn. I'm trying to share my screen here. OK, can everyone see my screen? Yes, go ahead. OK. OK, thank you for the time. Yes, as Jørn has introduced, so our title... ... we pick a little bit different title than what Jørn has said. So this title is Information Systems Action Research in COVID-19 Time. This is our experience of implementing DHS2 for immunisation in Indonesia. And in this session we would like to present how we navigate our action research... ... in COVID-time and how this experience may contribute to DHS2 research landscape. Here I have my partner, Gordian Sanjaya from Universitaske Gemede. Or UGM, who has been a partner of DHS2 implementation in Indonesia since 2011. So, yeah, next. OK. So the immunisation programme of the Indonesia Ministry of Health... ... has been using Excel data sheets for data collection and the management of... ... its aggregate immunisation data for the last decades. And this has potential serious flaws to the data quality and the management. Derfor, the immunisation programme wishes to shift to DHS2... ... which has been used by the Ministry of Health to integrate data. And then also we have a One Health Data Policy in Indonesia... ... using the same platform, which is DHS2. So what we're doing here is we are standardising reporting form... ... and then we're aiming for a longer term integrated data warehouse. One of the key activities that we're doing is capacity building. Because as you can see here, we want to move from Excel into DHS2. And then from there we want them to be able to use the test boards... ... which is standard test boards. And also to improve their data quality and also assisting their monitoring programme. So this capacity building part is actually a part of my PhD research project... ... or more focus of my PhD research project. And we implement this project following an action research cycle. So this is the timeline. We started our project for this immunisation programme late in 2019. We started with assessment and from the assessment result... ... we decided to start by doing a PAL project in Dikai Jakarta province... ... which is where the country capital is lying now. And no, not end. But during the process the COVID-19 pandemic started to affect the country. We started to report our first cases. And then the country started to enact several local governments... ... and started to enact large-scale social restrictions. It's very mouthful. But this is not the lockdown, but still it restricts a lot of travel... ... from in and out of the country and also domestically. So because we have team members in three cities in Oslo, Norway... ... and also in Jakarta, Indonesia and Yogyakarta, Indonesia... ... we hardly seen each other since the start of the pandemic. So we started to pivot our strategy into online action... ... which includes online planning, online meeting and online training. And also here as you can see we also experienced management rotation in May. And then to date we have tested some of our instructional design... ... speaking about capacity building to the ballot province two days ago. So although this ballot project started several months ago... ... but just two days ago we had this testing. And then we will start doing our training for the trainer tomorrow... ... using the new style of capacity building, which is online, fully online. So to date our intervention employs strategies that are adaptive... ... to the changes caused by the pandemic. And this includes a research project management strategy... ... where we have a couple of weekly or bivigly online meetings via Zoom... ... and we are networking and collaborating together... ... in document development maximising the use of Google Drive. And also after the pilot project we are implementing a cascade training model. That's why we're doing the training for the trainer tomorrow, 25th of September. And then what's so specific about this project... ... is that we are closely collaborating with MOH. So our MOH counterpart is highly involved in this project. All the planning and all the implementation, we are involving them. And they are very concerned with all this project and also excited... ... because this is very new to them, but they have a big hope for this project too. And then also instead of doing the training fully synchronised... ... in a fully synchronised session, we are setting up a full LMS... ... using a model learning management system. So we have pre-recorded videos for all the materials that we are going to deliver... ... to our participants. And also we have all different activities to enrich our capacity building... ... which includes assignment slides, quizzes, etc. And these quizzes are supposed to help us... ... looking at which participants are the potential trainer for the next trainings. Her har vi gjort en matriculos planing... ... for both asynchronous and synchronisation... ... for we are going to train them in a very limited time. We don't want to mess with the schedule... ... because they are already tired with all of these online meetings every day. So we are supporting through WhatsApp Group. Also we have evaluation strategies through interview surveys... ... that you can see here. And then lastly, sorry. And then lastly, we have some issues that we are considering. So to some extent, managing an online project might not be a unique experience. Except that now this is our only option. It is imperative that we are using this strategy. And most people in the project are working at home... ... which gives additional challenges. Some people are really forced to do this. So maybe they don't really like talking through a laptop... ... or now they have to do it. So here in the research aspect... ... we are also challenging existing institution of what we call traditional implementation. And there are several familiar aspects to our people... ... in the implementation that change. For example, per GM, they cannot get it anymore... ... because they are not traveling anywhere. And then also social interaction with peers. It's lost now. Or in different way. And then accountability partners, face-to-face discussion. And now they have to have their kids running around them... ... while they are trying to even enter a Zoom meeting or share their screen... ... like what I experienced. And we hope through this research we would contribute to at least two things. First, the practice through the notion of adaptive project management. And the second, the methods of action research... ... with the notion of adaptive action research. Thank you. Thank you, Jørn. I'm returning this to you. Very good. And now... ... next one takes over. Nilsa and Seferino. Yes. Yes. Go ahead, Nilsa. Share. Yes. Thank you. Thank you for the time. Jeg tror alle kan se min screen nå. Perfekt. Ja. Jeg starter med å presentere teamen som er her med meg. Jeg er Nilsa Kvalensen. Jeg er med Seferino Solgena og Emilio Moss. Vi er fra Universitet Fidoar-Mundlana. Jeg er en av de PhD-studiene som er interessert i dette projekte. Så... Jeg starter med å presentere oss et sted... ... for å gi meg en brev om hva vi har gjort over de seneste 2 år. Så vår projekte i Mozambik har startet rundt 2.000. Og det startet i tre proverter. Og det var i den momenten... ... med den nødvendigheten, også med den PhD-programmet i Norway. Vi hadde forskere som var med i dette. Og projekten startet, men det var veldig... ... holdt opp, holdt opp. Og i 2016 var DHS-2 nødvendigheten nødvendig. Og i andre progrømmer, og det er stille... ... i veldig veldig veldig veldig veldig veldig veldig veldig veldig. Og det er stille som i veldig veldig veldig veldig veldig veldig veldig. Vi hadde mange PhD-studiene, og vi har forskere som var... ... med masterprogrammet vi startet i dette. Informatiske og mediske masterprogrammet. Vi har informatiske og mediske masterprogrammet vi startet i dette. Dette to mange dekker vi primerlig implementerte DHS-2 i høvken. Og vi har vært for å gjøre andre domene i vores og sanitariet i kultur og medis. Vi har gjort forskjellens fjell i disse seneste år. Vi gjorde to i de seneste to år, og vi har vært for i de siste progrømmer... for in the south and to in the north, so that we could evaluate what's the stage and what needs to be improved during this implementation. We visited as well 12 districts and several facilities and what was one of the major aspects that we found out during these visits that we did was related with the data use. We noticed that data use, data is being used and this data comes from GHS actually, but what it's not being used fully, used, is related with analytics and dashboard. So I move to the next slide where I show some of the innovative process that we are finding during this project that we are conversing at the moment. We found out that some of the practices that are being implemented by the ministry like routine and statistical meetings and different discussions involving several actors are indeed helping or supporting this institutionalization of the GHS in Mozambique. And other aspects that we found out is that actually they are very much interested in using these systems in the daily routines. For instance, we have seen in several meetings that they are using the data that comes from the GHS to monitor the activities from different facilities using indicators that are based in their population. But this leads to one of the aspects that actually is constraining somehow, because we have data from the government that brings out the population from the different levels of administrative levels. And we have this ambiguity on which population data we have to implement in that sense, so that we can calculate properly the indicators that will help this management to happen adequately. So in that sense, we still have parallel systems working on and working with paper and Excel, and also this comes with some technical issues that the users used to have relayed in relation with the technical support that is provided. Even though we have this capacity building happening, it's still not enough to support all the teams that are national wide. And we found out also the limitations are in relation with the GHS to implementations related with the use itself. For instance, in terms of visualization and that it's not that flexible and fit to use cases, in terms of functionalities that need to be there, such for instance the offline features that help the management manager to use the system while they are not online. This question, this issue in relation with the facility indicators versus the facility population that we have to deal with. And also some other issues that are related with customization in terms of dashboards and scorecards. We see that the people are using data and this data comes from the data storage that is the GHS, how it is being used now. And they bring this data to other systems that they use in parallel to make the outputs. And this should be addressed somehow. We see in this process different challenges. We have teams that are working with development innovation. Some teams that are working with support and capacity building. And we see also this involvement, these two groups of people interact while they are in the field and getting evidence. So we are also thinking on how to bridge this, all these outcomes into the research, how to address this and perhaps using this action research models to move forward. And some reflections that we are coming up with are related with how we can incorporate social approaches that bring out this together, the social context. And get it together in relation with the technical design that the GHS has following the last years. And also, how can we come up with reducing these limitations, technical limitations, by going through the different ups that are being developed in other countries that can be integrated with the GHS as it is now. And we think that we can do this by involving master students and other PhD students in research. And also these getting involved also in support, the teams that are in the field. So I rest and thank you for the time and your attention. Jørg, I give it back to you please. I stop sharing. Very good, very good. Thank you very much. And now we move to India. I don't know man. Yes, I am just. Go ahead please. Yeah, is it visible? Yes, yes, clear and fine. Okay. Thank you, Johan and everyone. So, I present the research study we've done in India on one of the old DHS to implementation states. So just to give a little context. So this is where India started DHS too much earlier than there was DHS 2 available. So it was even when it was 1.3, that's where it started. So Orissa is one of the states which adopted DHS 2 as the statewide system in 2008. So this study that we've done in Orissa is in 2018-19. That's when we've done. So this is one of the DHS states where we've tried to, the reason for doing this was to understand what are the sustainability qualifiers for these decentralized public health systems. So what makes these systems work? Because it sustained itself for over 12 years on its own without any support from outside. So what is it that makes the system sustainable? So, and this is where Orissa is on the map. And these are the partners involved in the study we did out of 30 districts. We took nine districts to work with closely. So there was Department of Health of the state of Orissa. From the national level we took the National Health System Resource Centre, which is one of the think tanks at the national level to support the governments on health. And there's Hisp India, which is one of the Hisp nodes in India. And at UIO, from the department, we had Anna, who was there, who's been active part of the study. And we had all our roles and contributions. So in the district level study, we've just talked to health workers, to data entry staff, to managers of health, to bureaucrats, and all the IT staff, which is at odd level. So, you know, decentralized system there at the vision level is a health center where there's a health worker, then coming above, which is block, which is for about 50,000 population. Then there is just the district. And then there's, and then the state. So that's the level. And then we've done individual interviews. We've had focus group discussions. We've been part of observing people's work, a following demo in the meetings. And of course, there's a whole lot of secondary data, which was lot of reports, meetings, minutes, et cetera. So this has been our data sources. So after all for the research, getting the data together. So we identified five themes under which we could, which helped us analyze and understand the findings emerging. The themes we identified was, one was the process of data validation, which also then tells us also about the institutionalization process of, let's say, HS2 in this. Then there's a process of capacity building, process of participation, process of data ownership and local action and process of local practices. And these processes, when I say, these are what we are all, I mean, just to go back to the research question, which is on the sustainability qualifiers. So this is one of our meetings in the health center. This is what our health center looks like. This is maybe one chair and a table and then there is this common room, everyone sitting on the floor to discuss. And this is the two health workers here. So for her, it was that, you know, the process of, let's say the data validation. So it was not only just the data which gets reported. They initiated the process at the village level. The village owns the data which is being reported for that village. So they had started a process of a village meeting every fall, where the health worker would bring in the data, which she is going to be reporting upwards and discuss it with, let's say, they have a village health committee there to make sure that whatever is data published from the village, everyone owns it. So, I mean, then to ask that, is it not too much? Are you not, isn't it too much of data? But then she says, in a village, they're not more than five to six pregnant women in a month. And they're not more than 10 children who are there for vaccinations. So it's not like too much of data which they are having to discuss. So the general, what we have in mind that this is so much data, how are they going to be working with. So this was to understand the process of institutionalization. Then there was this process of capacity building, which was that, you know, when there's a data manager who knows DHS too, but then he gets transferred out or leaves the job. What happens to the next person? So they had, on their own, initiated a very interesting process where the new person who joins in at whatever level at the district at the block at the PNC, is given informal handholding training at the state, at the district, whichever is the level above wherever he's posted. So, which was, you know, without any incentive from outside, but this is something which has been ongoing there for about 10, 12 years now. It's an institutionalized process. Then there was a process of what we identified as participation. And the examples they should give us, the health workers were having to report the same data in two different data sets. And the health workers said that, you know, why can't we just report the same data in one place rather than twice? And then it was their voice, which then they discussed in their village and block level meetings. And then it went to the district guys they discussed. And then from there in a state-level meeting till, and the process voice that, you know, they rationalize the forms that, you know, one data element gets reported only once, and so the health worker is not having to report it twice. So then there was, they did, given it was a system which was more flexible and it gave people space to make changes, which also then kept space for participation. It was not just like freezing, frozen in one place. Then we identified the process of data ownership. So this is one of the block person here. She told that, you know, when she was looking at, when she was to confirm the data and validating the data for anti-natal and IPN, she found that there was a data for severe anemia cases, and she thought that it was something wrong. Why do we have severe anemia cases? And she thought in case it was a validation error, typo error, et cetera, when all was checked. Having a meeting with the Ashas, who's a community health worker and A&M, which is the health worker, that, you know, what's wrong. And then to realize that there were actually cases of severe anemia who tested. And then the action there was that, you know, maybe the, because when you start to have IFA tablets, the first reaction is constipation and then a lot of time women discontinue that. And then here was Ashas that started with OK, in terms of mobilization as a community health worker. She would ensure personally that, you know, the IFA tablets are given. The woman eats, has the IFA tablets right in front of Ashas, rather than, you know, keeping it away. So that, you know, so that, that was also that, you know, if it was severe anemia cases in my district, so it's not about someone just changing the data just to make sure it doesn't look bad on the, it was also taking ownership of what data it is, and then action locally. And then this is the health worker who had her tab, who had all kind of registers and forms, which she had to fill in. There was a template which the government had given her to report. And then she still, of course, felt that the paper and her register was far more easier for her to manage. She could underline, she would mark, she could block the paper where she needs to come back to and allowed her to do much, many more things than just what a few, let's say tab would do, what technology is allowed me to do. So, I mean, yeah, so this was her viewpoint that, you know, whatever locally works is much better than rather than to give care, I should not be dependent on a tablet to show me the data. I mean, I should be able to do it in my own way. Yeah, and then from the research outputs we've had this. So there's the report we've submitted to the government with findings for the follow policy here. Then there's a report which was at UIO, which was submitted by Spindia, which was like what Jons heritage project is, the research project, which is to take the case study of what's going on with these, understand sustainability qualifiers. So the we've recently submitted one paper for IFIP per 2020 conference, which is on identifying the, I mean, the same research question, or such and the beauty qualifiers and the two research papers in pipeline. And then there is for this course at UIO, which is on ICTs for development, and then you would develop the use of the sake study for the course. Yeah, thank you. Thank you. I hope I'm not cross my time limit. Thank you. I'll stop to share, Jan. Thank you very much, Arunima, and we move over to the Norwegians. Is it Rangnil, or is it Johan first? Anyway, one of them. Yes, let's just have a year and turn off the sound. Yes, so this is Johan Sabo talking. I also have Rangnil Bassa Gunnarsen with me on this presentation. So our part of this is to fold motivation. First is to show us an example of research we do more of an international consortium with various partners. And to highlight the empirical base base research from Norway, Norway as a case. So this project is a newly started research project looking at emergency response to the COVID-19 pandemic. And its aim is to gather experience and support countries to respond to the situation we see now of very high uncertainty and rapidly changing information needs. Not just to improve our communities ability to handle the COVID pandemic, of course, but also to learn how to do this with future disease outbreaks in mind. It's a consortium with many partners. We have the Norwegian Institute of Public Health, Eduardo Munlan University from Mozambique, Colombo University from Sri Lanka, Palestine National Institute of Public Health, University of Ghana, and then the University of Oslo here in Norway. And the primary empirical base are of course activities ongoing these countries, but we will also draw, of course, on learnings from the wider community of DHS using countries. DHS is used for COVID-19 systems in four of the countries, Mozambique, Sri Lanka, Palestine, and Norway. And we also have Ghana as a partner, where we have the ability to also evaluate another system, another technology in the Sormas. So I'll leave the word now open for Erangne to present some of the ongoing work in Norway. Thank you, Johan. I am a fairly new PhD student with the Department of Informatics at UIO, and together with other researchers. We hope to unmute and present Erangne. Can you not hear me? Yeah, you can hear me. You can hear me, Johan, as well. I can just briefly go through this. So in Norway we also have an established surveillance system in place for quite a long time, but it has been a manual for using pen and paper. That's been the level of technology. And that has worked well for a kind of disease. Hi, we can hear her. I'm spreading the small scale outbreaks, typically things like intestinal diseases, or it could be some cases of TB or something, but not much. So the challenge, of course, was this rapid spread of COVID unprecedented scale. Hello, can you hear me? Yeah, we can hear you now. Super. Thank you, Johan. I am a fairly new PhD student with the Department of Informatics at UIO, and together with other researchers, including master students, we study disease surveillance and response, the contact tracing ecosystem, and the implementation of DHIS2 as the digitalisation of contact tracing. So how does this digitalisation affects both the contact tracing process in itself, as well as all actors involved in the contact tracing process. In Norway, our municipalities, 356 in total, are responsible for contact tracing and the follow-up of infectious disease surveillance of their respective residents. Thus, the contact tracing process is decentralised. We have worked with disease surveillance in Norway for around 200 years, but have very little experience with contact tracing of infectious diseases in the numbers we have seen these past months. During the weeks of March and April, the efforts to trace positive cases of COVID-19 was under severe pressure, as you all know. And to register COVID-19 cases, contact traces used pen and paper and some after a while spread sheets. This approach was impossible to scale when the cases of COVID-19 increased. A joint force between some municipalities, the Norwegian Association of Local and Regional Authorities, the Norwegian Institute of Public Health and University of Oslo was established. No one has no previous history of using DHIS2. But during the spring of 2020, DHIS2 was introduced as a software as a service for municipalities. Today, approximately 100 municipalities are using DHIS2 for contact tracing. During a time with high uncertainty and rapidly changing information needs, the DHIS2 team has established routinely meetings with user representatives every fortnight where they discuss user participation, user involvement and user requirements. And this will be a part of our research. Thank you. Over to Johan or Jørn. Yes. Thank you. Yeah, sorry about that. We had some challenges here. We had to turn off the sound and all the laptop avoid echo. Anyway, thank you for that. I'll continue with the presentation. Yeah, it was just one slide. We'll go to the next. So the approach in this project is then to evaluate the system development cycles and provide feedback to various groups of users. The health staff users, national team around both disease surveillance and of system administration and the global developers of DHIS and associated metadata for COVID. One thing we will do is to develop an evaluation protocol tailored for DHIS2 and COVID-19, which we will make publicly available. There are existing surveillance system evaluation frameworks, but they typically focus on other things, you know, the use and the validity of the data, not so much about evolution and the ability of the systems to respond to new changes. They also include assumptions that are not really relevant in our case, such as corroborating the quality of data with other data sources. In many cases there are no other good data sources for COVID. So hopefully this project is leading to some knowledge that will be of short-term benefit for all countries in adopting systems for COVID-19, but also for a longer term for improving systems, making them resilient and responsive for meeting new diseases. Thank you. Yeah, maybe I can just continue sharing my screen to bring up the list of questions on the community of practice. And you can also use... Yeah, hello everybody. Then we have been listening to the four presentation. Here we see there are some questions. Yeah, I see we have some questions already being answered and written by Anne here. We have some questions to Apriza and Nilsa from Anki Min. Maybe you can go first, Apriza, to respond to the questions coming up here. Johan, do you see your screen with status? Okay, can I start? Okay, I'm going to read it. Hi Apriza, how many days do you have really used for the capacity-building training or training of trainer for specific project-based DHS2 and what's the recommendation duration to conduct it? So I'm not speaking about recommendation here. We are still in a trial phase, but usually in the role-out we train in three days. Three days phase-to-phase training, that's eight hours per day. But for this training we're going to do it in three days also. But every day we're training for 120 to 150 minutes. And then between days, between session, we will have a couple of days so that our participants will be able to do their assignments, for example. So the first training that we're going to do with the MOH is spread into one week with three days training and it will be around two to three hours. I hope that answers will turn into you. Johan? Ja, that's very good from the... What do you call it? I'm sorry, your... Hi, hi, noi. To interrupt again. If there's anyone who's interested in about capacity-building, please just drop me a message or anything in the COP. Thank you. Thank you, thank you, Titta. And we have another question here. I can see for Nilsa. Can you see it and can you answer? Hello, yeah. Do you hear me? Can we hear you? Yeah, sure. I just have a follow-up question for Akresa. Go ahead. So regarding... You have told us about... Thank you for your experience sharing as well as... I would like to know the rules of assignment in the training session and... What's the rules of doing assignment? Let the participant doing the assignment and with or without assignment, would it have a difference? Thank you. Yeah, thank you for your comment. So the idea behind assignment is to make sure that people... We are able to monitor the competency of the people that we're training. Because we cannot see them one by one. Then there are different ways we would like to measure the capacity or the competency that we would like them to achieve. And this is achieved through different ways. Like assignment is one of the examples. So for example, we want them to be able to make data element. For example, then the assignment would be like a screenshot of the element that they have created. And this is a proof that they are able to create that data element. But also we have other things like quizzes. And then also we are following other things like discussion, et cetera. So yeah, do that answer. Yes, thank you very much. You're welcome. Yes, Jørn, can I proceed? Yes, thank you. The question is related to how we are... He's requested to share our experience on this transition from paper-based to using DHS as a source. So we are still in the process. But we are advanced somehow because we started by creating conditions in every district. So at least every district would have a computer and connection to the internet. So the ministry has managed to implement that somewhere along the way. So that the reporting comes in paper. And we have this instituted nucleus of statistics which we have a team of one or two persons that receive all this data that is in paper-based and introduced into the computer and sends it with the internet which goes directly to the database that is in the ministry of health. But this was only possible now that we introduced the DHS too. Because previously we had initially very much issues in this process because we used to do with mobile disks and diskettes and other drives that we used before. But with DHS too, the ministry created these conditions and we then implemented this system of collecting the paper-based information, put it in the computer and send it to the internet in every districts of the country. And for those districts that doesn't have these conditions, they gather the information and go to the provincial level or the district next to it so that everyone can report. And this is done monthly after those routine meetings that I mentioned before and after the statistic meetings that they have. So they collect information, they prepare it, they validate with all the stakeholders involved in the district. They report it to the district. The district organizes these meetings, discuss the data. And these goals, two ways, goes into the DHS and which goes directly to the ministry. And the other information is discussed in terms of use so that they can decide on approaches that the district can implement themselves. So this is still a process but somehow we are trying to move forward with this. But I have here also two colleagues that maybe can add something to this process. If not, I will hand it back to you, Jørn. Fine, fine. Thank you, Nilsa. And there's a question here from Maima to Arunima. How did Udisha government receive the findings of your research when you presented to them? Please, Arunima. Hi, Maima. How did they take it? I mean, they were partners in the research. So they did come along for a lot of these interviews. Taking forward is, I mean, at some places where we say, for example, on infrastructure upgradation, where we felt that, you know, there were outdated computers where some things needed, it also added to evaluation, was they've added to their, what do you call it, the animal plants. Some of it got added there. So then they added findings on in terms of, let's say, because they, I mean, the rationalization process, the given that we, the process they had for rationalization of data were very interesting. So maybe we suggested that they could also initiate a process of data integrity audit, so that to just see how much, just to check on redundancies, what data is not needed. Also to have a more institutionalized process of untaking health workers' view on redundant data which is getting collected. So that is on board. So that they did take in. So there is a process of data integrated audit, which is in process. So that's there. Also then there was like one of, another thing what we had recommended that if they could institutionalize a way of, rather than like, I mean, this was one in 10 years process that we did, but something which could be, you know, institutionalizing, if not an outset, in their own, not to review the way it's done with the meetings, but a process of looking at what data is getting, as in research as an institutional process. Towards that they are then working with, there's an institute of public health in Odessa, and then there is also an institute of medical research, which is there. Partnership, which was established in, as part of this research. So now they are as two local partners in Odessa who are on board. And, you know, so the idea is that they should be able to make these interventions. So some of these, yes, where they could, which does not cost too much money, but it was more on making partners and taking these steps that's being taken. But I think the larger ones, which needed let's say financial investments. So those decisions would be more pending. Yeah, does it answer your question Mahima? Thank you Aronima. I think we are thrown out from this space, room or whatever it's called. Yeah, one minute. Very, very short time. One minute to have 55. Okay, thank you all presenters. I noticed one of the research questions in Indonesia. How to do fieldwork and research on Zoom or online. So that is something that we obviously have to improve on. So thank you everybody and you can continue to pose questions in that link that is shared. Thank you.