Health data from 20 countries collected in Oslo

The system is specially designed for registering health information in low- and middle-income countries, and it contains all routine information that is collected within each country's health care system. This provides an overview of information such as vaccine coverage, AIDS patients undergoing treatment, and outbreak of diseases. The World Health Organisation (WHO) is actively promoting the system in potential user countries.

Overview of health status and health services

Professor Sundeep Sahay, University of Oslo. "The software helps to standardise health information and integrates input from different health services, making it easy to compare information across geographical areas and health services," explains Professor Sundeep Sahay of the Department of Informatics at the University of Oslo. "This gives the authorities an overview of the population's health status and of how health services are being administered in different areas. Then they can more easily assess the need for measures and provide the population with better health care."

The software has been developed through an international network of countries in the South, coordinated by the Department of Informatics at the University of Oslo. WHO and Norad are also participating in this effort.

Free software

The information about vaccinations, diseases and births that is registered is stored in a central database available to health-care workers and the authorities. This facilitates comparison of, for example, the spread of various diseases both within a country and internationally.

"One great advantage of the program is its flexibility, since it can be customised to local circumstances. While much of the software can be used in a number of countries as is, the system needs to be adapted to each country's health care, political and administrative frameworks."

Fundamental to the information programme is that the software will always be provided free of charge and all its programming uses open source coding. Training and servicing related to its application, however, may be paid consultancy services. Professor Sahay points out that this helps to create jobs, build competence and promote innovation in the IT industry of the South.

Action research

At any given time, the Department of Informatics in Oslo hosts more than 20 doctoral fellows from cooperating countries in Africa and Asia who are involved in the project. At the same time, independent Master's programmes have been established in several cooperating countries, with funding from Norad.

"We intend to build up a strong international community around the system, and we are investing heavily in education and training. It is essential to disseminate knowledge from researchers to Master's candidates and out to the health personnel using the system," explains the professor.

In Oslo some 200 doctoral and 50 Master's candidates have submitted theses related to the health information programme. In the cooperating countries, broad-based expertise has been acquired within the field. Professor Sahay stresses that this had been made possible by funding from the Research Council, Norad, and the Norwegian State Educational Loan Fund (Lånekassen) support scheme for students from Central and Eastern Europe and the developing countries.

The professor believes the health information programme is an excellent example of action research. "Through research, we are actively working to solve practical problems."

Started in Africa - Asia revving up

India is one of three Asian countries that are currently using the system. Gitana is a nurse at a mother-and-child hospital in Trivandrum in Southern India. (Photo: Siv Haugan) In 1994 South Africa had just gained independence, and the new government began reforming the national health care system. In cooperation with local health activists and financed by Norad, the health information programme was developed and pilot-tested. The result was so successful, the system was quickly implemented across the entire country. Today it is the national standard.

Over the years many other African countries have joined: Mozambique, Ethiopia, Tanzania, Botswana, Malawi, Nigeria, Zambia, Sierra Leone, Liberia, Namibia, Gambia and Burkina Faso.

In Asia the system is now being introduced in India, Sri Lanka and Vietnam, and more countries are at the starting line. By the end of 2009 the software will be implemented in every Indian state.

Under ongoing development

"The system has undergone continuous development for 13 years, and given today's requirements for web presentation, maps and so on, development efforts must now be further stepped up," says Professor Sahay.

The Department of Informatics is also involved in developing SMS-based registration of health data. "Using a mobile phone, one can register and transmit health information by text message. This is especially suited to health workers without access to a computer."

Funding from the Research Council

Sources of funding for developing the health information system include the Research Council's programme on Global Health and Vaccination Research (GLOBVAC), the SOUTHAFRICA programme, and the ICT-related VERDIKT programme.