The HEALTHMPOWR project aimed to demonstrate the feasibility and effectiveness of transitioning the health information system for maternal and child health in Palestine, from a traditional paper-based system, to a digital health registry – the maternal and child health eRegistry. eRegistries are used by the care provider at the point of care, and integrates multiple automated digital health interventions to optimize the use of data to better serve the women, their care providers, and the health system managers.
The main scientific objective of HEALTHMPOWR was to undertake large scale cluster-randomized trials to generate evidence for the effectiveness of eRegistries, in improving quality of care and attendance to antenatal care services. Specifically, we aimed to test (I) digital checklists with clinical decision support vs pre-existing paper maternity records; (II) targeted client communications with SMS messaging individualized by eRegistry data vs no messaging; (III) quality improvement dashboards with feedback of performance indicators to care providers vs no feedback; and (IV) the potentially synergistic effectiveness of II+III.The HEALTHMPOWR project developed the eRegistries in the free and open source CHIS2 software used by 71 low- and middle-income countries, and collecting health data on almost a third of the world’s population. The project succeeded in co-designing and implementing the DHIS2 eRegistry with Palestinian stakeholders, despite significant delays due to the need to develop multiple new software functionalities, as well as an Israeli ban on 3G technologies in Palestine that forced us to install fiber cables to clinics, and periods of war, civil unrest, and restriction of movements that slowed implementation progress. By the end of the project, eRegistries have been adopted and deployed as the new national health information system across the West Bank and Gaza.
The HEALTHMPOWR project has demonstrated feasibility and effort of transitioning from paper-based health information to eRegistries. We developed the eRegistries in the free and open source DHIS2 Tracker software, and shared all methods, technologies, and comprehensive implementation guidance with the global community of health informatics professionals using DHIS2 (dhis2.org). As result, DHIS2 eRegistries are now being deployed to support health systems in maternal and child health, immunization, tuberculosis, and child nutrition programs, and more, in multiple low- and middle-income countries, including Bangladesh, Ghana, Botswana and Rwanda.
