Fanafana Ola – implementing DHIS2 in Tonga

Fanafana Ola is a traditional Tongan phrase that represents the first whispered words of advice given by a mother to a newborn child. These are words of wisdom intended to guide the child to good health and success throughout their life. This powerful expression is the name that the Tongan Ministry of Health has selected for a recently commenced Australian Aid funded project aiming to support the transformation of the public health system through technology and innovation. Key objectives of this project include digitising and strengthening the routine public health information system through the utilisation of digital technology and tablet-based reporting innovations throughout all health facilities in Tonga. The primary aim is to support ongoing improvement to the health, success and livelihoods of all citizens within the Kingdom of Tonga.

Initially commencing with the Reproductive Health section of the Ministry of Health, the Fanafala Ola project will continue to roll out digital health innovations for Non-Communicable Disease and Health Promotion, Community Health, Communicable Disease and Environmental Health sections throughout 2018. Central to the Fanafana Ola project is the adoption of a Tongan-led human-centred design approach to ensure the needs of the country are effectively met. As a part of this process, a Fanafana Ola Reproductive Health Super-Users Group has been established to guide all aspects of the planning, development and implementation of the digital health information system reporting tools and technologies that are to be adopted by the Reproductive Health section of the Ministry.

Key areas that have been identified to strengthen the Public Health System include the adoption of the tablet-based MediTrak application to support the rapid and digital reporting of essential routine health information; the adoption of the Tupaia web-based mapping and dashboard platform as a means to provide health personnel with readily available access to health information to support service delivery, decision making and workload management; and DHIS2 software as the backend system to be accessible by Ministry-based Health Information Systems staff. To date, the Fanafana Ola Reproductive Health Super-Users Group has reviewed all of their current Reproductive Health hard-copy based routine reporting forms, streamlined and developed these into a digital format, and are now currently guiding the design and development of innovative map and dashboard elements to be integrated into the Tupaia platform that are relevant to the specific needs of their program. As the subsequent health sections are rolled-out, relevant super-user groups will also be formed.

 

Current reporting systems, including the late submission and the duplication of data, are some of the main challenges faced by Manafonu Siola’a, a Senior Reproductive Health Supervisor with the Tonga Ministry of Health. She says “Providing more accurate and reliable data in a timely manner and being able to easily identify some gaps and challenges to focus on and develop improvements are some of the ways the Fanafana Ola project will really help the Ministry”.

Lepeka Moala is a Reproductive Health Nurse from Kolonga Health Facility in Eastern Tongatapu and a member of the Fanafana Ola Reproductive Health Super-Users Group. “Having to manually document everything and mostly duplicating the same information, having to grab all books and documents when going on an outreach, and calculating and tallying of numbers are some of the biggest challenges in my work” Lepeka says. “I think the Fanafana Ola project will help reduce our workload, [provide] easy access and timing and supporting us so that we can perform a better health care service by looking at our shortcomings through the charts and dashboards. I am most looking forward to reporting and displaying [information] on the dashboards. Because I think this is a way forward for our work in every level and its just so exciting adapting new things”.

 

The Fanafana Ola Public Health Digitization Project presents an exciting development for not only the Kingdom of Tonga, but also paves a way for demonstrating how the adaptation of digital technologies and innovation through a country-led human-centred design approach can strengthen health systems throughout the Pacific Region.

 

Tupaia is proud to be working with project partners Gevity Consulting to deliver Fanafana Ola for the Ministry of Health for the Kingdom of Tonga.