PEPFAR has made significant investments in HIS in Namibia that have led to a broad uptake of eHealth systems. However, HISs were developed based on immediate needs and available capacity in the absence of strategic plans, which has led to numerous unlinked systems lacking interoperability. This has been problematic as epidemic monitoring requires data collection, integration, and linkage from multiple sources for optimal patient management, cascade analysis, HIV case-based surveillance (CBS), accurate reporting, and service delivery quality management (QM). Additionally, successful eHealth strategies require a skilled, experienced, and sustainable health informatics (HI) workforce.
In this application we propose to improve overall HIS, HI, and QM capacity in Namibia and the Ministry of Health and Social Services (MOHSS) and to increase collection and uptake of health information, improve clinical outcomes, support HIV surveillance, and help Namibia maintain 95-95-95 targets. We will focus on five core strategies: (1) develop and implement standards-based interoperability between electronic systems to improve data linkage; (2) develop national sustainable, MOHSS-owned, and costed HIS masterplans; (3) build HI human resources and skills to sustain HIS; (4) evaluate the effectiveness of HIS in improving health outcomes; and (5) strengthen QM systems. These strategies will result in increased: country capacity and ownership for HIS design, implementation, and evaluation; interoperability of HIS ensured through use of international standards (HL7, ICD and LOINC) and open-source interoperability frameworks (e.g. OpenHIE); data linkage to support programs and CBS through developing unique identifiers (UID) while protecting patients’ privacy and confidentiality; costed eHealth strategies backed by relevant policies; ability to train, educate, and sustain an HI workforce with relevant skills and competencies in Namibia; data use for program improvement and measuring progress towards epidemic control; and functioning QM systems to improve quality of health services.
UCSF, with its multidisciplinary expertise in strategic information (SI), HI, and QM, has repeatedly led development of well-functioning HIS ecosystems and especially understands HISs at all levels to make informed decisions. For this application, UCSF will lead the Namibian Technical Assistance Consortium (NAMTAC) in partnership with the University of Namibia (UNAM) to address the above objectives. Both have successfully collaborated in the past with CDC through cooperative agreements, including with CDC Namibia. UCSF currently provides technical assistance (TA) in SI and HIS to nearly 20 PEPFAR-supported countries and has worked in Namibia for over 10 years supporting SI, surveillance, QM systems, and HIS development and implementation, as well as building HI capacity within MOHSS.
NAMTAC will provide TA for standards-based data exchanges, UID, and Master Patient Indices. Together with MOHSS, NAMTAC will critically assess existing HIS and recommend/support development of (open source) alternatives if needed. It will develop HIS training curricula including, shorter term pre- and in-service training delivered through UNAM and implement systems supporting CBS and national data repositories. Additionally, NAMTAC will support development of the national eHealth strategy with policies guiding HIS design, development, and implementation and ensuring data security and patient confidentiality. NAMTAC will propose HIS evaluations, the results of which will identify efficiencies and be incorporated into strategies. Lastly, NAMTAC will develop and operationalize a QM strategic plan and use HISs to evaluate the quality of delivered health services.
NAMTAC has the experience and skills to meet all the goals and activities defined in this NOFO, and UCSF has an established dedicated office in Namibia.