 we wanted to take this opportunity to provide our community some updates around the COVID-19 delivery and vaccination plans and the toolkit that DHIS2 has been putting together to support this. So we'll reemphasize a bit of what we see as our strategy for supporting the COVID-19 rollout of vaccine and delivery plans in countries. So at the University of Oslo, the DHIS2 global level, we are expanding our WHO immunization toolkit for the COVID-19 vaccine requirements. And so we'll share what's included in that toolkit during this webinar. So it's a number of standard metadata, things that can be installed in a national DHIS2 instance with system design guides, installation guidance. We'll work through some end-user training templates and basically all of the things that a country might need to help them get started on the ground as rapidly as possible to develop some of these solutions within their own DHIS2-based systems. So in addition to the global goods, we rely heavily on our regional hub support network. So there are 13 different HIST groups that work really quite closely with many ministries of health and they are equipped and prepared to deliver training of trainers or support ministries of health to either customize and adapt the toolkit to the national context as needed or also to develop some new or innovative solutions, custom solutions that might be required as well. So we'll cover a few of those. You know national implementation, of course we see ourselves as being able to support the national core teams to be able to implement this toolkit in their own systems and many times that means working closely with a core HMIS unit within the ministry of health, but probably also with the immunization programs. And lastly for our subnational and frontline worker support, we have a number of solutions that are integrated into the global toolkit and we see the challenge here is being able to cascade and decentralize this data collection and analysis to subnational levels. So all of these tools here can be implemented for national programs, but very much with district and facility and lower levels in mind. This is actually a map from the COVID-19 surveillance toolkit rollout. So I think many of you are familiar with this. We just put the map up again. So we did have 36 countries who adopted the DHIS-2 toolkit solutions for COVID-19 surveillance and response. But in addition to that, we've collaborated with national immunization programs for many years. So according to the data we have, there are roughly 45 countries that are using DHIS-2 for their immunization data already. And among those 30 countries have actually installed the WHO standardized EPI package metadata package. So for many countries, they have established immunization systems in place already. And our goal is to help them to integrate these COVID-19 requirements into those systems and be able to reuse the infrastructure and the platforms that they have for a more effective and efficient response. So this was a little bit of our mapping of the WHO's national vaccine delivery and vaccination plan guidance, the NDVP. And out of those, we identified six key areas where DHIS-2 solutions or toolkits could support the operationalization of these national plans. So in order to measure uptake and coverage and equitable distribution over time by geography, we actually expanded the WHO EPI module to accommodate the COVID-19 vaccine data. And this can be routine data on vaccine utilization. It also includes things like wastage, cold chain and outreach data, as well as that key population data that's needed, particularly by the different risk groups in order to measure coverage. We have a couple of solutions for supply chain readiness and improving the traceability of vaccines, particularly down to the points of service delivery, which we know is often a gap for many electronic logistics systems. They might not be at the facility or where the vaccination site may be. So this could be a hand-in-hand solution or also a backstopping for countries that might not have a fully-scaled electronic LMIS at this time. We also have several individual-level data solutions. So there is an electronic immunization e-registry in order to longitudinally track and follow the individuals through a multi-dose regimen. And that includes options for notifications and reminders, and to really help support monitoring those individuals until they complete their entire schedule. We've looked into quite a few different innovative solutions around electronic health certificates and how DHIS2 might be able to link with those for the digital vaccination cards. And we also know that there's probably going to be multiple distribution strategies. So DHIS2 has been used for supplemental immunization activities, such as mass campaigns in the past. And so we have a set of core aggregate metadata around vaccination that can be shared across different types of strategies. And I think this is somewhere we would like to learn as countries update and develop different distribution strategies to see if different sets of metadata might be needed. And lastly, we have the really key important of vaccine safety monitoring. And for this we have, we have published in December actually, the WHO adverse events following immunization tracker. And we have now most recently updated that tracker with WHO requirements for integrating COVID-19 into that program. So it's fully integrated across any type of adverse event for any type of vaccine in country. So I'm sharing here a slide from our colleagues at WHO, Afro, that might be familiar to some. And this is sort of the immunization data landscape. And the WHO DHIS2 immunization toolkit for several years has been addressing the various components of this landscape. So when you look at your EPI data and having the surveillance of the immunization components and then all of the different types of systems and data collection that might underlie that. So as you can see, it's really quite complex. We also know that many of the systems in countries are also complex. But our goal is to be able to work in a harmonized way and to be able to enhance countries ability to do integrated analysis across their surveillance and their immunization program data. And so for the 36 countries or so that have adopted DHIS2 as one of their surveillance solutions for COVID-19, it's going to be, I think, catalytic for them to be able to bring this surveillance and immunization data together quite easily without relying on many complex interoperability solutions. So within this landscape, we've kind of mapped out what is our toolkit and where does this support this different types of data. So if we're looking at our COVID-19 data and the two core pillars of that being both the surveillance side and now that we have effective vaccines, the immunization side as a response to prevent, to stop the pandemic and then to prevent reintroduction. So within these components, our surveillance toolkit covered several aspects of case-based surveillance. So the core case-based surveillance program that links with laboratory data as well as some other surveillance and response components, such as contact tracing and points of entry. And then we also had sort of this COVID-19 aggregate data. So to be able to support those routine, timely, aggregated reporting, particularly where there are settings that the data, there might not be the infrastructure to get the case-based electronic individual level data. This is sort of a stopgap to be able to bring all of the data together and support those routine situation reports. So then on the right-hand side, we have now been expanding our DHS2 immunization toolkit that's been underway for several years. And with support from both Gavi and NORAD, we've been able to reorient this existing immunization toolkit and adapt it for the COVID-19 requirements that are coming out of the global community of experts, as well as quite a lot of engagement with ministries as they're developing their national plans and with our HIST groups who are experienced implementers and have been giving us feedback about these designs. So what we'll talk about today is our kind of COVAX core package, a core aggregate package, an immunization registry, the adverse events following immunization, a couple of solutions for vaccine stock management, and then we'll also cover a couple of innovative solutions that are not necessarily core components of the package, but ways that we see people to be able to link this requirement for things like digital certifications of vaccination with their tracker individual-based data that might be in DHS2. But we wanted to bring this here to remind everyone that we're not looking at COVID-19 immunization data in isolation. We are looking at it holistically between the surveillance and the immunization data and then particularly those linkages and integration between COVID-19 vaccinations and these existing systems for immunization programs nationally in country. So with this, the last time we talked, we had quite a few prototypes and I just wanted to give a quick update of what we have developed. We'll share different links with you, but we have several of these packages now published as metadata packages as a work in progress. And what that means is that we've developed these packages, we've made them published so that they can be downloaded, installed, used for demos and other things. But we know that WHO and other partners are refining some of the monitoring guidelines and other frameworks. So we do expect over the course of the next couple of weeks and probably a couple months that there will be some updates to these. So my colleagues will go into more detail, but we did want to let you know we now have some sort of published solutions for our COVAX core package for the immunization registry for the adverse events and also to cover logistics. So I will cover what is in our COVAX core package. And so this is the aggregate package that contains dashboard, standard indicators, analysis and aggregate reporting requirements that have been developed according to the WHO draft monitoring guidelines for COVID-19. So this is really designed to inform strategy adjustments and bring all of this data together. So the focus is really on analysis. It enables countries to be able to capture their population estimates for uptake and coverage denominators. We also hope the dashboards will enable a rapid detection of uptake trends and show us some red flags, dropout rates, things that would need improvement. With the different kinds of maps and GIS functionality and DHIS2, we have this geographical distribution of the vaccine rollout efforts. And this also enables a place to integrate that stock management and quality data on wastage rates along with the vaccination vaccines administered to different types of groups. So another important part of this package is that we do believe that probably in many countries where they're introducing electronic registries, these might not scale throughout the entire country right away. So we are expecting many countries might end up with some hybrid systems with paper-based data in some places, electronic immunization registries and others. And this is a way to promote standards for data analysis so that it's always possible to bring the data together, use DHIS2 as the platform for disseminating that data analysis throughout the health system. So from national level all the way down to district or even sub-district levels. So we can also emphasize that where there's other digital tools or frontline health worker apps being used in countries, this is also a way to help focus your integration and interoperability efforts because these kind of standards for data analysis are maps to what the WHO has been recommending that countries are able to capture in terms of core indicators to monitor the response. So with this, I'm going to just quickly give a little update of what this looks like in our demo server here. And this one might be familiar to you. So the way that we develop these packages is in an integrated way so that many countries might already have this immunization, this key immunization dashboard. And I'm seeing now that my internet might be a little lagging. So I'll show here that the vaccination dashboard has been based upon the EPI standards for analysis that we've worked on for many years since the ready countries have adopted. And this brings together some of the key data around vaccinations by different age groups. It will also help countries to start measuring vaccination uptake rate and then also eventually the coverage. And then we also have the different key elements around dropout rates but also things like wastage. So bring able to those wastage indicators alongside the vaccination data, bringing in those reporting rates so you can see the completeness of reporting from different facilities, bringing in some of the core data around adverse events following vaccine and by type of vaccine. And then lastly bring to being able to integrate in some of that logistics data. So it could be coming from DHS2, but it could also be coming from other systems and we do recognize that. But the point of this dashboard is to really be able to bring all of those components of the data together to support integrated analysis of the entire rollout at country level. So I think with that I will hand over to my colleague Mike to talk us through some of the tracker based individual level solutions that we have started working on for the COVAX toolkit. Great. Thanks, Rebecca. I'm going to go ahead and start sharing my screen. So I wanted to give you a look. We've done a couple of previous webinars where we showed some of the things that were work in progress. I thought I'd give you a look right now at what the COVID vaccination registry would look like. We won't go very in-depth, there's not that much time, but I wanted to at least give you a sense of the types of tools and decision support and things that are being added in here. So as Rebecca was saying, we do think of this all in the context of existing systems. There will be a healthcare worker or vaccinator that potentially has access to multiple programs and multiple services that they provide. The COVID vaccination registry, let's say I was a worker here at the Cardinal Hospital, is just one perhaps of many different programs that I might have access to. But if I open up my vaccination registry, you can see that the first thing I have here is a list of my clients, a list with those that have a schedule to visit, a list of those that have an overdue vaccine dose, and all completed clients. Any one of these I would be able to click on and immediately open the record and get a sense of what services they've been provided and when and where. This of course is customizable. These potential lists can change depending on what is useful for the workflow that your country is supporting. In fact, for even displaying the list, this can be turned off depending on the context if there's a reason for not displaying a full list of patients to the user immediately. And just like all tracker programs, there's both a search and a registration page. Search is integrated into registration as well to try to prevent duplicates. But just to give you a sense of what the search functionality looks like here, I can do a quick search and pull up the existing record. I could also decide that this might actually be a duplicate of another record and I can flag that. But let's say that today I'm actually going to just register a new individual. You can see immediately populating the data of where this is happening, the date that it's happening. And we have it pre-configured also to generate a unique system identifier for COVAX. Again, this can be turned off or it can be modified to produce a different kind of code depending on what the country needs are. And of course, there's also the possibility to add in information like National ID or any other unique ID that the country is using. We can go ahead and register maybe Rebecca. Just do a quick registration here. Give Rebecca a date of birth. Let's go back in time. Let's say she's one of our older cohort that is getting vaccinated today. She was born on January 16th. So it's going to automatically start calculating for me the age. Of course, I can put in things like the mobile phone number address and a few things that can be helpful for analytics such as a breakdown in what type of area they live in. We'll say that she's urban and is actually a healthcare worker as their occupation. So now it's going to tell me, look, there's already a Rebecca Potter in here, but I'm going to say no, this is a different person. I'm going to register as a new person. And you'll see that immediately in her record, it starts to populate some of the indicators. It's going to warn me, you know, this is a healthcare worker. It's going to give me her age of 73. And we're going to say that we're providing a dose today. We'll answer a few questions to begin with, questions that might have an impact on what information we request. So if we had said this patient, although 73 happens to be pregnant, then we would be asking about any underlying conditions, pregnancy, gestation, and weeks, putting in first trimester, second trimester. So this, all of this decision support is based on the guidance that we have so far. We're working closely with the WHO, running this by Gaby, speaking with the Brighton Collaboration, a number of different groups that are actively working on the different considerations and concerns with the COVID vaccine. So just to say a lot of that is pre-programmed in here. For example, has the patient been infected with COVID-19 in the last 90 days? If I say yes, I'm going to get a warning, it's recommended for people who have been free from COVID for at least 90 days. And again, these kinds of notifications, they can be changed for your location, they can be changed based on the language that's being spoken or on the protocol that the country is following. And then I would choose from the list of vaccines. Here we have pre-populated with three different types of dummy COVID vaccines. Some countries are only going to have a single COVID vaccine available, at least at the beginning. Others may have more than one. They may have different considerations. So if I offer up the COVID vaccine number one, you'll see down here, it already started to give me a specific recommendation about when to do the next dose based on this vaccine. It's saying that in the next 10 days, if it was COVAX number two, it would say 21 days. Again, this should be modified based on the vaccinations that you're providing, and then it will be able to generate the next recommended date for the follow-up dose. But we'll stick with COVID number one. We capture some information like the batch number, which can be very helpful with adverse events. I'll talk a little bit about that in just a moment. Put in the date of expiration. We'll say this one, we have a couple of years available on it. The dose number, I'm going to say this is the first dose, confirming it's not the last dose. And then I would complete the record. And at this point, it's going to remind me about that date of when to schedule the next one. So I'm going to go ahead and hit complete. It's supposed to be given in 10 days, which was going to be on the seventh. I'm going to stick with that. And I'm just going to have her scheduled now for a follow-up to receive the second dose on that date. So she would now populate one of the lists that you saw before about upcoming COVID vaccines, second dose. You can also at this point have generated an SMS notification to remind Rebecca to come back in in 10 days with the date and the location of the hospital and why it's important to come in to receive that. And then in the background, what's going on is that we have all of this data that's coming from the system is being fed into the analytics. And if I get to my analytics past the Zoom board, okay. So then we have the dashboard that is associated with this, taking in all of the data and giving us, again, as far as we've been able to find the analytics that would be useful for managing the COVID vaccine rollout. So of course, this can include the number of doses given last month, mapped geographically, you can scroll over and look at the different locations and how many we're talking about, total number of doses, a summary of the doses by location broken down by male and female, cumulative number of doses given. And in every one of these, you can also, those familiar with DHS2, know that you're able to open them up in the Visualizer app and go in and change things around to take a closer look if you're interested in, you know, a specific organization unit rather than looking at the country as a whole, et cetera. So there's quite a lot in here. Again, I'm not going to demo everything, but I wanted to give you a sense that this is an available module now. Every country when they download these packages, just like all of the other WHO packages that we've created, should take the time to do a review and adaptation based on the national guidelines, based on the vaccines that are being provided, based on the population that you're aiming at. So no different than the other packages, this one would be one that you would want to start reviewing the contents of with the national programs and making sure that you've got every adaptation required before rolling it out and conducting training. Another thing to mention, of course, is that like all DHS2 programs, this is also natively adapted for Android. So you could have a mix of users, some that are going through the web, some that are on Android. The Android application is what provides the offline support. So if the network is not good in a location, Android is definitely the way to go. The records are all stored locally and then synced to the server whenever a connection can be established. Just to mention a little bit about the adverse events. Again, this is something that we're doing more trainings on and we're sharing more information on in the near future. So I won't spend a ton of time on it, but I did want to show a little bit of what that looks like. This adverse events following immunization package has actually been something developed over the course of the last year, year and a half, working closely with the World Health Organization and others. And all we've done in regards to the COVID vaccine is to make sure that we include the list of possible COVID vaccines in the list for reporting an adverse event and a sum of the possible adverse events that weren't previously listed. For example, Bell's Palsy. This form matches the reporting form that is recommended by the WHO, which many countries use already. So we capture all of the required information to conduct an adverse event investigation, including the date, time, batch, dilute, and all of this different information. There's a lot more that I can show about this in terms of who it notifies in the analytics, but just to say that we will be conducting more webinars and trainings associated with this. We have previously as well, this package is already available. And as you can see, it covers, you know, the range of possible vaccinations, not just COVID. So again, a very integrated part of the COVID vaccination strategy would be to allow this to be a part of reporting all types of adverse events following immunization. I wanted to spend a couple of minutes talking about producing digital testing or vaccination certificates. This is a topic that I know many countries are investigating and wanting to include. There is not currently a native approach within DHS2 of just generating a test certificate, but there are many ways to do this anyway. We've already seen from a number of countries that they had created a simple application under the testing protocol to be able to generate testing certificates and travel certificates, to be able to add a QR code or bar code, extract whatever information is required from the data elements and the attributes that are in the program, and be able to generate, you know, these, as you can see these examples of travel certificates or testing certificates. The same approach can be taken for producing a vaccination certificate. In fact, there are a number of countries already working on this or putting it into place. Sri Lanka is prototyping a web app for vaccination certificates right now. Rwanda is planning to reuse the app that you can see in the middle here that produced the testing certificate. They're just adapting it to be able to also provide a vaccination certificate. The Hismos MB group working with South Omei and Cape Verde is also producing applications associated with this, and it's a fairly straightforward process. DHS2, we've done a lot to make sure that it's building an external app. It can be very simple. We have an SDK associated with it that can be used, and there are a number of people in the community that you can also be put in contact with if you want to try to adapt or adopt their solution that they've provided. At the same time, we are looking into establishing an integration with a solution called Daibak. This comes from a nonprofit group in India called EGov. They have been for quite a long time producing digital certificates around health in India and in the Southeast Asia region, and they have been working to create a global vaccine certificate that can be associated with COVID, but of course could also be used for all vaccinations. They are a free open-source solution as well. They have a set of microservices that we can connect to through the APIs. They're following the W3C credential-based open specification that can be aligned with many global standards, and again, this is something just like DHS2 that the country would host and be able to keep control of the data. We've got just a bit of a model here of what it is that we're working on, where they would extract the data from DHS2, do the verification and certificate generation in Daibak, and then be able to integrate that back into DHS2. The certificate, of course, can either be digital and sent via email or text, or it could also be printed if that's something that's available. Just to say there will be multiple possibilities for the countries that want to produce these test certificates. We'll be putting out more information about the Daibak collaboration as it proceeds and if we're successful with it, but that's something that's being prototyped right now and that we're working on. We're hopeful that with the range of functionality that I've just shown that we're covering this longitudinal and individual kind of health record-based COVID vaccination schemes, this again is very much context dependent from the country about what level they're able to digitize. Are they able to have a device, Android, or laptop in front of them or nearby when they're doing the vaccinations? Are they going to provide those to each of the vaccinators? These are questions that should be answered before deciding exactly what to do with your digitization. The aggregate and event packages that Rebecca was describing are very adequate for collecting a lot of the data that are needed, but we know that of course there's a strong interest in being able to follow the two doses longitudinally to provide people with a vaccination certificate and so these are the solutions that we have. They're integrated with the adverse events module as well and one thing that I didn't mention about the adverse events that I should is that we have another collaboration ongoing to extract the data from the adverse events reporting and link it to the global repository for adverse events following immunization. That repository is called Vigibase. It's supported by WHO and there are actually a number of countries that are already reporting adverse events to this global repository. We did a bit of a landscape analysis. We saw that there are at least 35 DHS2 countries that already have the mandate to report all adverse events following immunization to this repository and so we've worked to create an integration with that as well and again it is available. It's something that we can start working on with the country right now. If they want to use that adverse event module for reporting the COVID adverse events we can help establish the link to the Vigibase and allow them to do the global reporting that way. So with that I think I will turn it over to my colleague Breno to start speaking to us a bit more about the stock management options that we have available in DHS2. All right thank you Mike and all right so I'll give you a very quick overview of LMIS and give you some general points and then I will pass on to George Maguire who's our LMIS technical advisor to present some features that are already available. So first just to highlight the first point that this is not an end-to-end LMIS solution but that we're focusing then on facility and health worker level point of care where we're capturing then logistics data. Of course point two then leveraging the use of mobile and tablets for this data capture rather than using paper-based fairly standard logistics data that we're capturing normally and in paper but then having this directly digitally captured. We'll then look to incorporate this or develop interoperability with an upstream LMIS system which can then manage supply on a larger scale and the final point that then the intention is to improve the quality of health delivery and in this case immunization and that is always the focus of these developments. I pass on to George now who then can show you some practical features that are already available. So George if you would like to go ahead. Okay thank you very much. Good afternoon so my name is George Maguire I'm the technical advisor for LMIS. So what has been developed what is available is a data entry form that you see on the screen now which is based on extensive consultations with WHO and as Rebecca mentioned to provide a comprehensive solution for the COVAX 19 package. So the idea is to develop a very simple to use form but that captures all the essential data and allows to provide all essential logistics data to staff at the site but also to anybody else at other sites so that's the favorite term in logistics is visibility but also to provide this information that is entered at the end user level ideally in a mobile device to upstream logistic services also a district or a provincial or national store so that logisticians and planners and purchasers at all levels have full visibility of the stock levels throughout the country and can plan their work on the complete stocks rather than just on logistic stocks at the central level for example. So to explain the screen on the top you have this is a special especially for vaccines you have the number of doses that are available from one vaccine so here is a screenshot an example for vaccine number one only where one bile will suffice for four doses so you can and you can change that if you have the user privileges in the in the first table on the top and then you can see now in the on the middle table the long table you have all the essential logistics data so you have the opening balance that is basically carried forward from the previous previous day at the end of the yesterday for example and is populated automatically in THS2 then if you received vials today so I forgot to say so this is a daily entry screen normally stocks are recorded once a month but in this case it's done on a daily basis so here you can enter the vials that you have received from the upstream logistic services in this case 10 vials corresponding to 40 doses then you can enter how many vials you have distributed during the day that was yesterday then you have the possibility to enter vials that have been redistributed let's say you had a shortage at a nearby healthcare facility or at a vaccination site and you have distributed two vials you can enter that so those two vials have been given to another stock and have not been actually used in your site that is reporting so you can differentiate that then the next column you are able to enter the discarded stock so you have any losses in this case it's the closed vial wastage so if you have stocks that expired or that were damaged through the cold chain or damaged in transportation in the logistics change chain hopefully not too many you can record them here as losses you will have to discard them from stocks but they are commonly referred to as losses and then you have the open vial wastage the next column so if you are recording this directly on the point of vaccination and you have opened the vial and we're not able to use all the dosage doses then you can record it in so in to differentiate as commonly done in vaccination between closed vial and open vial wastage and then this is a screenshot but if you are using the this2 and you can check it out on the demo instance then the closing balance will be automatically calculated so you have seen you had 90 vials you received 10 vials so you had 100 and then total total stock issue was 25 vials so that leaves you 75 vials that are left and the last column you can record the stock on hand and ideally the closing balance should match your stock on hand then you have no then all your recording is correct and if you find the discrepancy then you need to adjust for that discrepancy and then the last column you have the possibility to record stock out days so if you had a stock out during the day you can you can record this and this is a common logistics performance indicator used for any item to record how many days during the month you had a shortage and then the last table at the bottom you can see some cold boxes and some syringes and safety boxes because you will need more logistics supplies and only the vaccines so you have a list this is just a selection of essential items but you could and you can customize this table and you can add any number of items that you would like to that you need for your on your vaccination site and then also track them in the same way that you see in the table in the middle except that for the normal logistics supplies of course you don't have doses anymore okay so this completes the data entry form that you can use on the web portal but ideally on a mobile device directly at the healthcare facility so Mike if you can please go to the next screen so there's also a tracker application that has been developed and we just mentioned it briefly so you have first of all the possibility of creating a simple product catalog so that health professional logistic profession you can provide a picture of the vaccine with some basic information let's say on the storage conditions or any kind of medical information so very simple catalog but powerful because it's you can share the data with your health staff throughout the country from a dhs2 server and this tracker program using the mobile android device called the capture app allows to use a barcode scanner on your mobile phone or your tablet pc to identify the item so you don't have to type it and then you can see on the third screen that is a data entry screen so here the data is captured in real time you have the stock on hand you have the received stock and the distributed stock and the discarded stock on the fourth screen the stock issue reporting shows you how to issue your stock so you will scan the barcode this will open this screen you just type the number of files that you have distributed and then click the save button and that will then be recorded on the server and the beauty of this system is that contrary to monthly or daily reporting this actually gives you real time information on your stock on hand so anybody in the logistic supply chain or health professionals who want to work who want to know how many files you have left right now at 239 a european time they can go on dhs2 and they can see that in real time you don't have to wait until the until the afternoon or the evening when the monthly when the daily updates are done so this data can be shared in real time so this uses a barcode which avoids eliminates the need to search for the item in a long list it gives you real time calculations you can calculate the average demand apart from the stock status allows you to determine how many days or how many months of stock you have left at every facility you have seen the dashboards earlier it also allows to program automatic notifications for example you could determine that if the stock level of the covax vaccine drops below 50 vials then an automatic notification is sent by sms by email or both to certain people to notify them especially in the logistics chain and as mentioned this is of course the principle of the android that it provides full offline support so you can record all the the stock issues and as when if there's current if their internet is currently not available and as soon as the internet the internet coverage resumes that data will then be shared again with the server thank you very much that concludes the part of logistics okay then i will say a few words about implementation and funding of of these packages you can go to the next slide please i see there are several questions here in the chat on how how to implement this and if this is available to every everyone so dhis too and the and the associated modules and packages they are free and open source to countries however it requires some costs for different activities to make it operational and these are technical assistance costs that includes customization of the packages to local routines and guidelines and requirements in country there is a need to do field testing to ensure that it works as planned in an actual setting and also to build capacity within the core team in country and conduct training of trainers and these are costs that uio has available funding through gavi and norad grants to help cover these technical assistance costs however there are also operational costs to cover things like user training infrastructure such as devices and its connectivity and this needs to be financed from other sources such as local donors or investors and the university of oslo and the his groups we have a lot of experience in planning and budgeting these kind of projects and we can help to help to create budgets and plans to help to advocate for this kind of funding we know what it takes but we do not manage these kind of funds ourselves and then it's really important to highlight that a key principle to achieve a sustainable implementation is to closely coordinate this with ongoing initiatives in country to leverage existing investments so for example where are there already deployed devices to collect other types of data what kind of trained personnel are already out there and and his groups they have this local knowledge in countries so please do connect with them to do this kind of planning you can see on the right here this is just an illustrative country implementation budget taken from our budget guidance i'm not going to go into the details here but you can have a look on your own when we share the slides later to see the different kind of costs associated with working with these kind of packages next slide please thanks we do have a range of different resources that you can access yourself we have a website where there is a lot of information about our covid vaccine delivery content that you can you can read there is also a demo site here you can play around there is a test data here that we wipe now and then so feel free to just to just play and enter and and and do look at this and then there is a website here to download the packages and please contact your local his group for technical assistance they can help you answer most of your questions if you don't know who your local his group is you can email us at covidatthehous2.org and then we will route this information to the right to the right people and answer the questions that you might have i think that is it for me i'll give the word over to max over back up our questions it says sir will your i can answer that first will your organization be able to provide support to remote areas such a specific region due to travel restrictions i mean a lot of this work we're able to do remote that's how we work these days no one is traveling anywhere basically so i would say yes we can do a lot of work remotely that is not a problem so thank you so much mike and anna and breno um we've been checking the questions in the q&a here in the chat and maybe while we have anna here there were still a couple questions maybe around support um so maybe we can start with with that um so what what technical support is available and maybe if you're able to jump back one slide i'm not sure it would be helpful um but to continue to kind of clarify around that so at the global level we support um kind of the the package itself so we support the software the dhs2 platform and the android app um and then we support these metadata packages and we will continue to update these and update them for new dhs2 versions and develop the implementation guidance and the customization guidance um but when it comes to um programs really implementing this in the field in in general their technical assistance support if they request technical assistance support that's largely delivered through the hisp network so the 13 different hisp groups that are based across um latin america asia africa um and if you're not aware of who your his group or contact is um we do have a contact information the generic email so you can always be welcome to to send us an email we can put you in touch um with a his group that's more closer to your region and can work in in your time zone in your own local language as well um so the the kind of country deployment side the technical assistance is is provided generally through the hisp network um it can also be sourced outside of the hisp network we know sometimes there are ngos and others who who support dhs2 implementations in country um but just to be able to separate those two a little bit and then in terms of um the actual country country support we do generally see this as as a ministry led initiative um and so the level of the technical assistance we provide is really dependent on on what the country really needs and what they're asking for um how they need to cascade do they want to adapt some training materials would they like to um be able to customize the different forms and things like that so i hope that helps to clarify a little bit um a couple questions about you know is it is it free or available can we download and practice um so these metadata packages so they are just that they are dhs2 metadata and it's an installable jason file um but you need to be able to put this into a dhs2 instance so dhs2 so we don't have any sort of global repository um countries have their own database they have their own instance of dhs2 in most cases there might be a couple countries who are looking at dhs2 for the first time so that would mean you know setting setting one up um but the idea is that um these packages could be integrating into existing instances that are used in the country for example maybe the hms for all of the immunization data is already stored maybe it's also getting some of the COVID-19 vaccine data so sometimes that's a little point of confusion that dhs2 it's not a global instance this is really country led um and history of health led and they they own those uh and the data that's within it in terms of being able to download and practice so we've shared a couple links um we will continuously be generating these package upload uh these jason file packages um we still have a little bit of content to update based on you know the evolving requirements they're still changing quite a bit um they're still being refined and finalized and things like that so we have a few of these packages available already to download and practice in in your own testing instance or your own dev instance um but if you don't already have a dhs2 instance or you're a little less technical uh we do have uh the um it's an integrated demo site where we've moved all of the packages with some different dummy data and so that link is also in this presentation so anyone is welcome to go to that site and be able to test out the data entry look at the analytics and things like that it's a it's a space that we support um to be able to play and so how do we create a user account in order to access the demo um so uh we generally keep the user accounts listed on the landing page although i noticed maybe just in the five minutes before this webinar we did an update and we kind of lost those user account info so we'll have that back up in probably about an hour so we do apologize for that um and so those user accounts we make them available in in many different languages um at the moment the metadata so the covid 19 vaccination metadata the data entry forms and the dashboards are currently only available in english but we are working on um the translations of these into uh french is a high priority so french spanish portuguese and then other languages are likely to come along as well so there was also one one question about you know is the surveillance module um is it a prerequisite for the immunization modules and the answer is no as Anna said in the in the chat all of these components of the toolkit the surveillance side and also the immunization side they are developed in a modular way so that countries can take whatever parts of that package that's relevant to them um so if a country already has all of their covid 19 surveillance data live in dh is two in their country it might be really beneficial for them to be able to integrate the covid 19 packages because it enables the users at all levels so at national at subnational levels to be able to analyze the data coming from the surround side and the immunization side together so there's really no need for any interoperability solutions or pushing pushing the data into other data visualization software the users will be able to access all of this data natively in dh is two and customize their dashboards or do some ad hoc analysis um so i hope that answered the question one more point on languages i did see our our colleague marco from his columbia uh has offered to do a spanish version i think of a webinar and we will also be working on a french version of this webinar um so we know there's a very high demand to make this um more multilingual and to get our communications out there um in the languages that are most appropriate so um we will announce some of these things on our community of practice um to have some more language specific webinars and also language specific resources available um so those were some of the big questions i will uh ask many my my colleagues mike do you want to say something about the server requirements yeah there were there were a couple that i'll i'll try to address here so so on the server requirements this it's there's never an easy answer to that it has a lot to do with the size of the implementation do you already have a data center are you running dhs to wanted how many users how many clients so there's there's many different considerations that go into this we do have documentation for setting up dhs to infrastructure available on the website dhs2.org we're also just to add to this we're doing uh very massive scale performance testing on these packages right now because we know that for for some countries this is really going to grow to be much larger even than some of the existing systems that they're used to running and so we've we've really maxed out and tried to establish kind of limits and where we're we're seeing you know bad performance based on running it against five five hundred thousand different organization units with you know millions of registered entities 200 000 users so we're really trying to to generate some more information about what the limitations are and hand in hand with that be able to produce some recommendations about the proper setup um so i don't i don't have the exact answer for you there are many people that are on this call that are dhs to experts that support many of the countries around these are our hisp organizations and networks they are the ones that in in many cases are running already running the dhs to national instance and would be the the ones that can speak best to the the local environment and what can be established there so it really encouraged you if you're in a country that is already using dhs to to be in contact with the the hisp organization with the moh it department that they can provide you some some input as well on to what would be needed there another question has come up in a couple of places was about deduplication and matching so just to describe a little bit about how that works dhs to you define what attributes a patient where a person has so we have put in some of the generic ones such as first name last name date of birth phone number any any number of things national id these can all be used as part of the matching and duplication strategy so it's again preconfigured with a set of them but there can be more easily added for your country depending on what identifiers they use and the system then when you are trying to register a new person or intentionally conducting a search these attributes attributes which you have selected as searchable are compared with the the entire data set to confirm whether any a similar or matching entry is already available it presents that list to the user you can put some limitations on it to say that you know if the possible matches are over 30 then they need to enter more information before running a search so there are different ways to try to utilize the strategy so that the person at the the point of data entry is actually very confident that the person in front of them is is matching the record that they're looking at they also have the ability to to flag any of the list that they see in front of them as a possible duplicate so this would be a flag in the data set that you would then be able to later use cleaning tools on and identify and either merge or remove possible duplicates so it's it's a number of different ways of trying to make sure in the first place to prevent the creation of duplicates and then to provide a flag in the server so that you can later clean those duplicates out just looking to see if there are any other in the list from my side so there were a couple of questions about desktop versions devices what would be used so again android is the version that we would recommend for those areas that don't have a quality network connection android can live offline for days and days and then sync back to the server when possible i would say that you really ought to think though if you're trying to to digitize an area that does not have appropriate network it it may not be the best solution because you do want to be able to track these things in more or less real time you want to make sure that the person is receiving the second dose that they're supposed to and so maybe not be so aggressive in trying to extend digitization out to to periphery where it's not possible but the android version of dhs2 is being used widely in the community health worker context it's being used in areas with very poor internet connection it lives offline if you have a dedicated network connection if you have laptops if you have a computer then this can be run through the browser that is a real time update of the server so that as you're entering the information it is immediately going to the server and even if the connection at that point were interrupted all of the data would already be on the server so that is definitely an option you know of district levels and above many places where they have a strong network where they have laptops or computers already this is dhs2 is not primarily a local service it can be set up for example at a hospital as just its own instance with you know several different terminals that are connecting to it but the the typical use case is to have a national instance and that all of the data is being collected from many many different devices that are networked so that's the kind of key use case for this maybe that's the last that I've seen I don't know if anybody else had some questions that they identified that they want to have an answer to from the group there was just one around AFI and it was asking about kind of an open reporting solution from all citizens that's maybe separated from AFI reporting so I just wanted to say that that the package we currently support does not support that use case it's really designed about the kind of more standardized WHO recommendations around the AFI reporting and investigation and classification so I think this sounds like a very innovative use case we haven't really come across it before and dhs2 it's quite flexible so there are a lot of ways that our community has used dhs2 to tackle new use cases but just wanted to clarify that that is that is not the one currently covered in in this package but it's probably something that that could be done so we have only two minutes left if any of my colleagues wanted to jump in they can but if not I think we will in terms of next steps we will share this webinar recording we'll also share some of these links for you I do want to be very open and transparent we notice we are trying to get these things updated almost in real time because the requirements are coming at us also in real time so it's a lot of updating so we're trying to be as responsive as possible because we know that the ministries of health are making their COVID-19 vaccination plans they want to know what's available so the test credentials for the demo they should be up momentarily they just got lost in the hour before the webinar so one of my colleagues is working on that right now so those should be up in about an hour or so and we will continue also adding these packages to the to the package downloads page you probably won't see all of them right away but probably tomorrow there will be quite a few but we'll continue to update these here so the the different packages we have to generate a new one every time there's substantial content updates and then we have to go through a process of updating them for different DHIS2 versions so for the aggregate we'll support 2.30 to 2.35 for tracker-based packages we plan to support 2.33 to 2.35 so if you would kindly be a little patient with us as we're trying to meet the demands here but continue checking we'll have a lot of these uploaded and we'll continue to upload them there and the last piece is that if you're not a member of our community practice already we do invite you to join the COP we will be updating the Q and A thread with a lot of the questions and answers we just covered at the end of this webinar and it's also a really great place for you to be able to connect with other colleagues across countries or regions with with different solutions including solutions that we might not have covered at the global level so I very much appreciate everyone who took some time out of their busy day to come spend with us and learn a little bit about what we're doing and we look forward to keeping in touch through the community of practice and many other channels so thank you very much