����ECHIS BASIC TRAINING

July 21, 2023

ALL MODULES TRAINING

����HEWS, NEW WOREDAS

Release-1

• Overview of eCHIS
• Family folder
• Maternal health ( ANC, Delivery &PNC)
• Family planning
• Immunizations (Child and TT vaccination)

2

• Sick children module/ICCM-CBNC/
• Nutrition Module
• TB and Leprosy Module
• Malaria Module
• NTD Module
• NCD Module
• HIV Module

Release-2

eCHIS Modules

Goals Of eCHIS

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Identification

• Create a digital link between unique identifiers and health information about households and individuals
• Prevent duplicative of records

Communication

• Allow HEWs to receive updates on patient status such that appropriate and timely follow up can be planned and carried out
• Facilitate referral linkage

Reporting and Analytics

• Automate existing manual reporting processes to reduce time, resources, and, potential reporting errors
• Present collected and aggregated data to allow for better-informed decision making
• Track and monitor activities of HEWs

Service Delivery

• Allow HEWs and other staff to easily review household and individual data to deliver tailored services for households and individuals.

Job Aides

• Facilitate HEW processes and work through digital tools
• Reinforce policy, procedures, and guidelines through digital workflows

Components of eCHIS System

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eCHIS

Electronic Community Health Information System

FAMILY FOLDER

DATA SYNCHRONIZATION

SERVICES

REPORTS

DASHBOARD

Household info, Household properties, Household members

RMNCH, CDs, NCDs, NTDs, logistics supply and management

Demographic report, Service coverage report, disease report, HMIS reports, CHIS reports, etc.

Charts, graphs, maps, indicator analysis etc

Data sync between tablets and to central server,

SETTING

data element list, data element to form mapping, user management, access to users, organization units

eCHIS Application Suits

There are 3 mobile applications in eCHIS system:

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• [PRIMARY] Health Extension Worker Application: support HEWs in Family Folder (Pouch) management & prioritized RMNCH service delivery and follow up. Each HEW has their own device with mobile application.

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• Health Center Referral Application: Supports Health Center workers to confirm referrals and provide referral feedback to HEWs. Shared device(s) for Health Center personnel and not meant to act as real-time service delivery job aid.

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• Focal Person Application: supports Focal Persons in providing technical and programmatic support to the HEWs. Each HEW Focal Person has their own device with mobile application.

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�The eCHIS Mobile Application System�

Focal Person

Health Center Worker

Client

Health Center

Health Post

Community

HEW

Tablets Distribution

Tablets Parts

On/Off

Sound up/down

Charging port

Back to previous screen

Go to homescreen

See all open apps

Launching the app

Locate the eCHIS application icon on the tablet homescreen.

If the eCHIS icon is missing from the homescreen, you can tap on the ‘Apps’ icon and look for the application there.

Review of the System

eCHIS Application sends data over phone networks to view on the internet in real-time.

Data is sent to a server by the mobile tower

Application’s Forms

HEWs and Health Center workers complete forms on their mobile device

Database & Dashboards

Allows data decision analysts and decision makers to access, review and download data

Another mobile device

Can share form data sent with another mobile application user!

Logging In

1. Enter your assigned username

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2. Enter the password

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3. Tap on ‘Log In’

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3

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Homescreen

Change the Language

Sync with Server regularly to ensure that:

• Forms are sent to the server
• Client data is updated from Health Center

Enter the application to begin reviewing information or to fill out forms

Exit the application securely to protect client information

Displays the last time a sync was completed and any pending forms

Syncing With Server!

• Pushes pending data from the mobile device to the server
• Pulls new data from the server onto the mobile device
• All users should sync with server at least 2x daily
• When logging into the app at the beginning of a work day
• Before logging out of the app at the end of a work day

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Logging Out of the App

• Why should users log out of the application at the end of the day or when not actively using the application?
• Protects client file data
• Prevents others from editing client data or deleting data from the phone
• Saves the battery

Menu for first time logging in

Initial Application Setup

Initial Application Setup

• only appears the FIRST time an HEW logs into the application
• captures the following health post-related information:
• # of ambulances
• ambulance driver contact numbers
• kebele name
• # of gotes
• gote codes
• gote names

Should HEW be able to make edits once this information is entered?

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Ambulance information can be updated by the HEW Focal Person

Initial Application Setup

Complete the Initial Application Setup form with the following information:

• # of ambulances: 2
• Ambulance 1: 0911987656
• Ambulance 2: 0977654321
• Kebele: Adama
• # of Gotes: 2
• 01 - GoteOne
• 02 - GoteTwo

Submit your

first form!

Highlight Family Folder To HEWs

HEW App �Main Folders

Registration of Household Information

1. To register a new household tap on the ‘Households’ button on the main screen
2. This will take you to the list of households of this logged-in user.
3. By swiping up you will get to the bottom of the list and see the ‘REGISTER NEW HOUSEHOLD’ button
4. Tap on this button to enter the Household Registration form

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Registration of Household Information

Registration of Household Information

Registering Household Member

Registering Household Member

Registering Household Member

Register the following households!

Gebrewold Dejen Dagnachew

• Gote 1
• Registration date: 22-12-2009
• Household number: 001
• Phone: 0970018723
• Not at house
• 2km from HP
• CBHI Member
• Membership date: 22-12-2009

Alem Abebe Chala

• Gote 2
• Registration date: today!
• Household number: 001
• Phone: 0997987661
• At house
• 10km from HP
• Not CBHI Member

Registration of Household Member

2. Then tap on ‘Household Members’

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1. To register a new household member tap on a Household name in the Households list

3. This will take you to the list of members of this Household

Tap on this button to enter the Household Member Registration form

Register Household Members!

Household: Bereket Daniel Mersha (Gote 1)

Gebrewold Dejen Dagnachew

• Head of household
• Member id: 01
• 42 years old

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Genet Getachew Mengistu

• Wife to Gebrewold
• Member id: 02
• 38 years old
• Pregnant, has already completed ANC1

Hiwot Gebrewold Dejen

• Daughter to Gebrewold
• Member id: 03
• 20 years old

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Dagim Gebrewold Dejen

• Son to Gebrewold
• Member id: 04
• 1 Years old

Household: Alem Abebe Chala (Gote 2)

Alem Abebe Chala

• Head of household
• Member id: 01
• 50 years old

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Mahlet Tariku Gemechis

• Wife to Alem
• Member id: 02
• 35 years old
• Pregnant, has not completed ANC 1

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Betelehem Alem Abebe

• Wife to Alem
• Member id: 02
• 35 years old
• Postpartum woman

Ayida Alem Abebe

• Daughter to Alem
• Member id: 03
• 15 years old

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Mekdes Alem Abebe

• Daughter to Alem
• Member id: 04
• 18 years old

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Dawit Alem Abebe

• Son to Alem
• Member id: 04
• 12 hr

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Identifying Head of Household

When you start registering household members, the app will ask if you are registering the Head of Household.

Once a Head is identified, this question will disappear.

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By submitting the Register Household form, you register the Household but NOT the head of household’s individual membership.

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You must still register the Head of Household as a member of the household

The Head will be flagged in the Household Members list

Change Head of Household

HEWs can update the Head of Household if it changes.

1. After selecting the Household, open the ‘Edit Head of Household’ form. Confirm that you want to change the Head.

2. Choose the new Head from the list.

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New Head of Household must be a current household member and be 15 years or older.

3. Mark the reason for the Head change and submit.

Edit Household Information

An HEW can edit the following pieces of Household information:

• Registration Date
• Family Phone Number
• GPS Location
• Distance from Health Post
• Household Number

Let us update the information for the Alem Abebe Chala household:

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• Family Phone Number= 0912131415
• House number 002

Edit Member Information

HEWs can edit the following Member Information:

• Basic client information (captured in Member Registration)
• Health status (pregnancy)
• Next Appointment

Remove Member

HEWs should use this form when they need to remove a household that they registered in error or as a duplicate.

Filling this form will permanently remove the member file from the device. The member will no longer appear in any lists.

If needing to update member information, the HEW should use the Edit Member Information form.

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If needing to remove the member because of death, the HEW must note this death in the appropriate service delivery form or in the Death Registration form.

Death Registration

Member death can be recorded through:

• service delivery form (in event that death is directly due to medical condition or illness)
• death registration form (death is due to natural causes or accident)

Death Registration form will remove the member’s information from the device. The member name will no longer appear in any lists.

If the Head of Household dies, HEW will need to identify a new Head using the Edit Head of Household form.

Deaths recorded through this form AND through service delivery forms will be counted in death reporting. A death only needs to be registered once.

Demonstration Only

Change Head, Edit Household, Edit Member and Remove Member

Practice

Change Head:

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Alem Abebe Chala died and fill the registration form and change Head of the Household

Family Folder (pouch), Part 2

• Registration of status change on relocation for Household
• Registration of status change on relocation for Household member

Relocating Household

2. Then tap on ‘Relocate Household’ to access the relocation form

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3. Complete and submit the form!

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1. To relocate a household tap on the Household name in the Households list

Registration of status change for relocation of household membership

1. To relocate a household member tap on a Household name in the Households list

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2. Then tap on ‘Household Members’

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4. On the following screen tap on ‘Relocate Member’ to access the form

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3. Select the member you want to relocate by tapping on his/her name

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Registration of status change on relocation for Household member

Registration of status change on relocation for Household member

Demonstrate HH and Member Relocation

Relocate Ayida Alem Abebe

To Gote 1

Reason: Education

Practice:

Family Folder (pouch), Part 3

• Registration of household characteristics

Registration of household characteristics

HEWs use this form to capture information about a household:

• Latrine availability
• Waste disposal availability
• Drinking water source type & treatment
• LLITN management
• Kitchen amenities

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Registration of household characteristics

1. To register/edit a household’s characteristics tap on the desired household name in the Households list

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2. Then tap on ‘Household Properties’ to enter the form

3. Complete the form and review before submitting!

Registering Household characteristics

Registration of household characteristics

Complete the Household Properties form for 2 households!

Be sure to alternate the answers to see how the form changes.

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Registration of Household HEP package implementation and model graduation status verification of household

1. To register/edit a household’s HEP packages implementation status tap on the desired household name in the Households list
2. Then tap on ‘HEP implementation and Graduation’ to enter the form

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Registration of Household HEP package implementation and model graduation status verification of household

Registration of Household HEP package implementation and model graduation status verification of household

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Registration of Household HEP package implementation and model graduation status verification of household

A household needs to practice all the packages applicable to them in order to be eligible to become a model household.

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In other words: the answers to all the packages have to be either ‘Yes’ or ‘Not Applicable’ (not ‘No’ or no answer)

Model graduation example

Demonstrate HEP packages data recording and updates and confirm model HHs

Practice

Household: Alem Abebe Chala

HEP Packages Eligible: 18

HEP Packages Applicable: 16

HEP Packages Practice: 16

The household should be confirmed and model household.

Family Folder (pouch), Part 4

• Registration of Women Development Team profile
• Registration of 1 to 5 network profile

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1-to-5 and 1-to-30 management

In order to create a 1-to-5 or a 1-to-30 group you need to have a possible group head in your Client list / Household members: a female of age at least 18.

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In order to create a 1-to-5 group you must first create a 1-to-30 group that you can link it to.

Registration of Women Development Team profile (1-to-30 group)

Registration of Women Development Team profile (1-to-30 group)

Registration of Women Development Team profile (1-to-30 group)

Registration of 1 to 5 network profile

Registration of 1 to 5 network profile

Registration of 1 to 5 network profile

Demonstrate and Practice - HDA 1 to 5 and 1to 30�

Family Folder (pouch), Part 5

• Registration of WDA HEP package competency based training
• Registration of Household HEP package implementation and model graduation status verification of household

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Registration of WDA HEP package competency based training

1. Tap on ‘One to thirty Management’ to see the list of one-to-thirty groups
2. Tap on the desired one-to-thirty group
3. Tap on WDA Training to access the form

Registration of WDA HEP package competency based training

Registration of WDA HEP package competency based training

Registration of WDA HEP package competency based training

RMNCH

�Pregnancy Continuum of Care�

Actors on pregnancy continuum of care at the community/woreda level?

• Caregivers
• Beneficiaries
• Medical/technical support
• Decision makers

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eCHIS has been designed and implemented based on the context of pregnancy continuum of care(COC)

RMNCH Service Delivery Areas

Pregnant & Post-Partum

Nutrition

Family Planning Visit

TT Vaccinations

Child Vaccinations

Sick Children

RMNCH Service Delivery areas

Each Service Delivery module has a filtered list of registered household members who are eligible to receive those services.

All Client List Management

Icon Guide

Visit Priority

Visit Type (examples)

Visit Location

Visit Priorities

>= 7 days late from appointment date

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3-6 days late from appointment date

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2 days from appointment date back (Due date) and forth

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>= 3 days forth (future)

PREGNANCY & POST-PARTUM in eCHIS

ANC

Pregnancy Outcome

PNC

RMNCH - Pregnancy & Post-Partum, Part 1

• Identification of Pregnant Woman
• Pre-follow up of information registration
• Alternative Workflows
• Action Cards

Identification of Pregnant Woman

A woman can be marked as pregnant in 2 different places in the eCHIS app:

1. Register a New Member or Client form

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2. Edit Member Info form

HEW must ask if the woman has already completed ANC 1.

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If she has not completed ANC 1 visit yet, the woman must be referred to the Health Center.

Identification of Pregnant Woman�(using New Member Registration form)

Refer to Health Center for ANC 1

HEW must ask if the woman has already completed ANC 1.

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If the woman HAS completed ANC 1, a referral to the Health Center is not necessary.

Identification of Pregnant Woman�(using New Member Registration form)

ANC 1 already completed

Identification of Pregnant Woman�(using Edit Member Info form)

HEW can also update the pregnancy status of a client, from not pregnant to pregnant, in the Edit Member form.

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Register a Member

Mahlet Tariku Gemechis

• Household: Alem Abebe Chala
• Relationship: Relative to Alem
• Age: 25 years old
• Pregnant
• Has not completed ANC 1

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Sync With Server!

Logging in to Health Center Referral Application

Username: hc_afar

Password: 321

Who are Health Center Referral Application users?

Health Center workers who deliver the following RMNCH services:

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• Pre & Post-Natal care
• Family Planning
• Child Vaccinations
• TT Vaccinations
• Malnutrition
• PLW & IMNCI referrals

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Who are Health Center Referral Application users?

Health Center workers who deliver the following RMNCH services:

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• Pre & Post-Natal care
• Extrac ANC Medications
• PLW Emergency referral cases
• EDD Calculator

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Logging into �HC Referral application

Women due for ANC 1

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Contains a list of pregnant women who were registered at a Health Post and have not yet completed ANC 1

Document Pregnancy Outcome

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Contains a list of pregnant women who are expected to deliver. To be updated when there is a birth outcome. Information sent to HEWs for PNC visits.

PLW Emergency Referrals

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If a referral case has been created at the Health Post, the client and relevant referral information will appear in this folder. Can record self referral visits in this folder.

EDD Calculator

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Helps to calculate client LMP, EDD and Gestational Age

Extra ANC Medications

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Record extra Folic Acid or TT Vaccinations given outside of scheduled ANC 1 visit.

Late ANC and PNC Visits

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Lists of all visits that HEW is overdue to conduct

Pre-follow up information registration

Midwives can fill out the ANC 1 visit form for clients who are on the list AND clients who are not yet on the list.

Pregnant women may come directly to the Health Center for ANC 1 instead of visiting the HEW first!

Pre-follow up information registration

SMS to HEW!

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Fill out ANC 1 visit for Mahlet Tariku Gemechis�

SELECT YOUR # Mahlet

ANC 1 Completed: YES

ANC 1 Date: today

LMP: 05-01-2014

Folic Acid: YES, 30

TT1: Completed during ANC 1

HIV tested: YES

HIV positive: NO

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Have Integrated card?: YES

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ALL HEALTHY!

ANC 2 at: HEALTH POST

ANC 2 visit: due date

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Women due for ANC 1 – not on the list

SMS to HEW!

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Health Center Action Cards

HEW Action Cards

Only appears when there is new client information from Health Center - HEW must take ACTION on this information!

• ANC 1
• Pregnancy Outcome
• Referrals
• Extra ANC Medications

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What are ‘Linked’ and ‘Not Linked’ Action Cards?

[HEW] Health Center Action Cards – client linked

This folder will ONLY appear if there are new ANC 1, Birth Outcome, Referral or ANC Medication Action Cards from the Health Center that require HEW action.

Tsige Alemu Animut

Demonstrate

Create Health Center Action Cards – For Mahlet Tariku Gemechis

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MCHN - Pregnant & Post-Partum, Part 2

• Pregnancy ANC follow up information registration
• ANC 2, 3, 4
• Registering Birth Preparedness and complication readiness plan

Pregnancy ANC follow up information registration

Birth preparedness and complication readiness plan

The HEW can choose to deliver this counselling information to a pregnant woman during her ANC 2-4 visits. Some of the counselling messages are accompanied by images and audio messages that the HEW can share with the woman.

Demonstrate and Practice!�

Women due for ANC 2 Follow Up at the health post.

Client Name: Genet Getachew Mengistu

Household: Dejen Dagnachew

Pregnancy: Completed ANC 1

Current Visit: ANC 2 Follow up

Age: 30

Weight: 52

GA: 28 wks

IFA: 30

MUAC: Green

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RMNCH - Pregnant & Post-Partum, Part 2

Delivery Outcome and Immediate Care of the Newborn

• HEW & Health Center app functionality
• Mother & Child status

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Registering PNC Service Registration

• soft registration of child
• PNC 1, 2, 3, 4
• mother & child status

Delivery Outcome

Delivery Outcome and Immediate Care of the Newborn

Both the HEW and Health Center Referral Apps can register the outcome of a pregnancy!

WHY IS THIS?

It is not required for BOTH HEW and Health Center to register the delivery outcome in the application. As long as 1 user enters the information and triggers PNC immediately.

If the woman is the client list

Highlight Documenting Delivery Outcomes [Health Center Referral App]

Delivery outcome and immediate care of the newborn [HC Referral App]

Practice: If the woman is NOT on the list

Delivery outcome and immediate care of the newborn [HEW Application]

Demonstrate and Practice Document Pregnancy Outcome [HEW App]

Client: Betelehem Alem Abebe

Delivery Location: Home

Delivery Date: Yesterday

Time: 6:30 AM

Danger Sign: No

Delivery : SVD

Birth Type: Live Birth

Mother Still Alive: Yes

Number of Baby:1

Baby Still Alive: Yes

Weight of Baby: 3000 gm

Vaccines: Received

Fill the other questions and complete the form

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PNC Visits

PNC Service Registration

• PNC visits are normally conducted by the HEW in the community
• It is very important for the mother and new born that the first PNC visit happen within 48 hours after birth
• The PNC form in the eCHIS HEW application collects statuses of the mother and new born and, if applicable, registers the new born as a family member

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ALL BABIES UNDER 42 DAYS OLD MUST BE REGISTERED THROUGH THE PNC FORM – NOT MEMBER REGISTRATION!

PNC Service Registration

Tigist

Ali Ahmed

It has been 62 hours since Tigist Ali Ahmed delivered.

Is Tigist Ali Ahmed still alive?

PNC Service Registration

PNC Service Registration

PNC Service Registration

Are any of the following danger signs observed in tigist ali ahmed?

Tigist ali ahmed

60 seconds

PNC Service Registration – Breath Counter

Complete the PNC 1 visit for Tigist Betelehem!

• Visit is TODAY at Bethlehem home
• Bethlehem is alive and well
• No danger signs
• BP cuff and thermometer available
• Good BP
• Temperature 37.0
• 40 folic acid tablets given
• TTs up to date
• No referral

• 1 baby boy born
• Alive and well
• Tesfaye
• 360grams
• BCG given
• OPV0 given
• Vitamin K given
• No danger signs
• Referral not needed

PNC Service Registration

Review - PREGNANCY & POST-PARTUM in eCHIS

ANC

Pregnancy Outcome

PNC

FAMILY PLANNING

Who is eligible for Family Planning services?

• Pregnant or post-partum women
• All women ages 10-49

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If the client is already registered they will be in the Family Planning Visit Module and you do not need to register them again.

What Family Planning services are offered? Where?

AT THE HEALTH POST

• Counselling
• Medical eligibility
• Condoms
• Oral Contraceptives
• Depo

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AT THE HEALTH CENTER

• Counselling (only in HEW app)
• Medical eligibility (only in HEW app)
• Condoms
• Oral Contraceptives
• Depo
• Implants
• IUCD/PPIUCD
• Tubal Ligation
• Vasectomy of Partner

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Family Planning Overview

Family Planning Client List – HEW app

Access Family Planning clients through

All Client Files

OR

filtered Family Planning module

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Family Planning - Icons for Methods

Hiwot Ketema Lemma

Family Planning Case Detail – Client Info

On the case detail screen, there are tabs to show you different information about the client. These are

1. Client Info
2. Scheduled Visits
3. Family Planning
4. Malnutrition
5. Delivery Info
6. Family Planning
7. TT Vaccinations

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RMCNH - Family Planning, Part 1

• Family Planning Service Registration
• service delivery at Health Post
• follow ups
• referrals
• Family Planning Method Switch

Family Planning Service Registration, at Health Post

OR

Select your client from the case list and proceed with the Family Planning Visit

Family Planning Service Registration, at Health Post

Family Planning Service Registration, at Health Post

Family Planning Service Registration

(counselling)

Family Planning Service Registration

(methods)

Family Planning Service Registration

(methods)

Family Planning Service Registration

(condom distribution)

Demonstrate and Practice

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Client: Mekdes Alem Abebe

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Mekdes is a woman in reproductive age group, not pregnant and already registered in the app.

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Location: She is at the Health Post today and has requested implant family planning method

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HEWs: Trained and can administer implant

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Method In Stock : Available at the HP

Counsel and Appoint a client and complete the form

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HEW App Workflow

Submit the form

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Make sure to sync

Family Planning Review

Vaccinations

Who is eligible for Child Vaccinations?

• Any child under 1 year old
• Has not finished their vaccination series

What Child Vaccinations are administered?

• BCG
• Penta 1, 2, 3
• OPV 0, 1, 2, 3
• IPV
• Rota 1, 2
• PCV 1, 2, 3
• Measles

Where?

• Health Post – during Vaccination Days
• Health Center – during Vaccination days

Option to Update Client Information and Reason for Filling in Form

Immunization Information and Schedules

Key Messages and Vaccine Options

Vaccinations not administered: Record Reasons

Action to provide required Vaccines

Vaccines next visit date

Immunization Defaulter Tracer Service

The Child Vaccinations client list shows HEW the registered household members who are eligible to receive EPI services.

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Using this list, the HEW can easily keep track of upcoming and overdue vaccination visits.

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They can also use this list to plan for vaccination days, making sure they will have enough vials

Demonstrate and Practice!

Complete a Childhood Vaccination form for: Dawit Alem Abebe (2 months old)

History updates:

• BCG and OPV0 = 05-01-2023
• Penta 1, OPV1, Rota 1, PCV 1 = 06-16-2023
• Penta 2, OPV2, Rota 2, PCV 2 = 07-16-2023

Next Visit Vaccines: Penta 3, OPV3, PCV 3 and IPV

Next Visit Date: = 08-16-2023

TT Vaccinations

Who is eligible for TT services?

• Any female client (not pregnant, pregnant and post-partum)
• Ages 10-49
• Have not already received all TT vaccines

Registering TT Service

Where are TT services administered?

• Health Center
• Health Post

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The five doses of TT vaccine

• TT2 at least 4 weeks after TT1
• TT3 at least 6 months after TT2
• TT4 at least 1 year after TT3
• TT5 at least 1 year after TT4

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Registering TT Service

Complete a TT Vaccination form for: Betelehem Alem Abebe

History updates:

• TT1, 06-01-2023
• TT2, 07-01-2023

MUAC 25cm

Vaccines given today: none

Next visit: 01-01-2024

Record vaccinations given IN THE PAST:

SMS Reminders – Family Planning, Immunizations and Malnutrition

Sent to Client:

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• 2 days before Childhood Vaccination visit
• 2 days before TT Vaccination visit
• 2 days before Family Planning visit
• 2 days before Malnutrition visit

Brief Wrap up of RMNCH - EPI Service Delivery

eCHIS Module Releases 2

Sick Children

What services are offered for Sick Children

At the Health Post:

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• Decision support screen/treat
• Follow-up Scheduling
• Referrals to HC
• Counselling

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At the Health Center:

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• Receive referrals from HP
• View key patient information
• Follow-up Scheduling
• Provide referral feedback and illness updates to Health Post

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What clients are eligible to receive these services?

0 to 2 months - CBNC

2 months to 5 years- ICCM

Demonstrate and Practice

CBNC/0 to 2 Month:

Dawit Alem Abebe

ICCM/2 to 59 Months

Dagim Gebrewold Dejen

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Steps to find the Sick children module

Start Button

Steps to find the Sick children module---

Sick Children Client List

Find clients eligible for ICMNCI services through All Client Files

OR

filtered Sick Children module

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ICCM: HEW and HC App Functionality

• [0 - 2 month] (HEW app): Assess, classify and treat, counsel and follow up sick young infants from birth up to 2 months

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• [2 months - 5 years] (HEW app): Assess, classify and treat, counsel, and follow-up children from 2 months to 5 years of age

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• IMNCI (HC app): Assess, classify and treat, counsel, and follow-up sick children from birth to 5 years of age

Classification: Birth Asphyxia�

Check the Newborn for Birth Asphyxia

ICCM Module

IMMEDIATE NEWBORN CARE (INC) – Assess breath at Birth

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View, search, and identify clients from the list

ICCM Module

IMMEDIATE NEWBORN CARE (INC) – Assess breath at Birth

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View forms, and start to provide the service

ICCM Module

IMMEDIATE NEWBORN CARE (INC) – Breath Assessment at Birth

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Information to treat clients with respect and dignity & follow protocols

ICCM Module

IMMEDIATE NEWBORN CARE (INC) – Assess breath at Birth

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View pregnancy outcome related information and start to provide early PNC

ICCM Module

IMMEDIATE NEWBORN CARE (INC) –Assess Breath at Birth

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View pregnancy outcome related information and start to provide early PNC

ICCM Module

IMMEDIATE NEWBORN CARE (INC) - Breathing Assessment at Birth

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View pregnancy outcome related information and start to provide early PNC

ICCM Module

IMMEDIATE NEWBORN CARE (INC) - Assess Breathing at Birth

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Assess client danger sign and record information

ICCM Module

IMMEDIATE NEWBORN CARE (INC) - Assess breath at Birth

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Assess physical exam of a child and record the information

Complete the [0 - 2 month] Screening Visit form for

Dawit, Age 12 hr

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Visit happening now at Health Post

1. No danger signs
2. No difficulty feeding
3. No convulsions
4. No severe chest indrawing
5. Gasping or
6. Not breathing or
7. 30 breaths per minute
8. Temperature 37.0
9. No red umbilicus or draining pus
10. No skin pustules
11. Moves on his own
12. Skin on his face is yellow!
13. Palms and soles are yellow!
14. No diarrhea
15. Infant is only breastfed, 10 times in last 24 hours, positioning is good, well attached and child is suckling effectively
16. No edema
17. Weighs 5 kg for 55cm

Classification: Birth Asphyxia

• Referral recommended
• HEW creates a referral
• Pre-referral treatment counseling given
• Needs follow up

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Practice

[0 - 2 month] Screening visit:

Complete the [0 - 2 month] Screening Visit form for Nolawi

1. Visit happening now at Health Post
2. No danger signs
3. No difficulty feeding
4. Weighs 1.4 kg
5. Gestational age 30
6. No convulsions
7. No severe chest in drawing
8. No Gasping
9. No difficulty in breathing
10. 30 breaths per minute
11. Temperature 37.0
12. No red umbilicus or draining pus
13. No skin pustules
14. Moves on his own
15. Skin on his face is yellow!
16. Palms and soles are yellow!
17. No diarrhea
18. Infant is only breastfed, 10 times in last 24 hours, positioning is good, well attached and child is suckling effectively
19. No edema

Classification: Very preterm &or very low birth weight

• Referral recommended
• HEW creates a referral
• Pre-referral treatment counseling given
• Needs follow up

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Practice Session 2

IMNCI/ [0 - 2 month] Screening visit: Assess, classify and manage sick infant from birth up to 2 months

ASSESS THE NEWBORN FOR INFECTION

Complete the [0 - 2 month] Dawit Alem Abebe

1. Visit happening now at Health Post
2. No danger signs
3. No difficulty feeding
4. No convulsions
5. No severe chest in drawing
6. 61 breaths per minute
7. Temperature 37.0
8. No red umbilicus or draining pus
9. No skin pustules

1. Moves on his own
2. Skin on his face is yellow!
3. Palms and soles are yellow!
4. No diarrhea
5. Infant is only breastfed, 10 times in last 24 hours, positioning is good, well attached and child is suckling effectively
6. No edema
7. Weighs 5 kg for 55cm

Classification: Pneumonia

• Referral not recommended
• Provide counseling
• Medications required
• Needs follow up

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Practice !! [0 - 2 months] Screening visit:

Submit form and sync!

Submit form and sync!

����Nutrition Module

Who are eligible for Nutrition Service?

183

�Nutrition services given for under 5 children

• GMP for 0-23 months well children.
• Under 5 children screening for Acute malnutrition.
• Management of MAM, Uncomplicated SAM and complicated SAM.
• Vitamin A supplementation for children 6-59 months and
• Deworming for children 24-59 months.
• Nutrition counseling

184

�Nutrition services given for PLW

• PLW Screening for Acute Malnutrition.
• Management of Moderate Acute Malnutrition.
• Iron Folic Acid (IFA) Supplementation for pregnant women and Deworming for Pregnant women.
• Nutritional counselling.

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Summary of Nutrition service provided for Children.

185

Summary of Nutrition service provided for PLW.

186

Steps to find Child Nutrition Module.

187

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Steps to find PLW Nutrition Module.

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3

�Before we begin Let register this information.�

Abera Kassa

• Gote: 02, HH No:011
• Household Head
• Age: 28
• Member ID: 01

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Marta Dessaleng

• Spouse
• Age :26
• Member ID: 02
• Non pregnant

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Girma Abera

• Son to Abera
• Age:36 month
• Member ID:04

Bilen Abera

• Daughter
• Age:55 month
• Member ID: 03

Beza Abera

• Daughter to Abera
• Age: 4 month
• Member ID:05

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189

190

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The outcome of GMP by comparing weight for age.

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3

1. Normal weight for Age (WGA)

Let do GMP /nutrition screening/ for Beza Abera

• Beza is Already found in our child Nutrition List.
• Beza Daniel: weight 5.4
• Classification = Normal weight

191

Growth Monitoring for Beza Abera her wt is 5.4

192

Click on the Search Icon

Then Write the client name

Growth Monitoring for Beza Cont...

193

Today is the 1^st Measurement for Beza

By Clicking on it we will start taking weight for Beza.

This page is blank because today’s measurement is the first for Beza. So there no previous information about the nutritional status of Beza.

Growth Monitoring for Beza Cont...

194

Childs < 6 month are not eligible for MUAC Measurement

Result of Growth Monitoring.

195

Feeding and Social Issue Assessment.

196

Assessment

Assessment

We say ineffective feeding when the attachment ,positioning and suckling reflex is poor.

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Most of the time weight loss is Associated with ineffective feeding , if there is other RX or counsel according to the cause.

Counseling based on assessment findings.

197

GMP: Growth monitoring and promotion.

Counseling on BF & ITN.

198

Promotion

Promotion

Promotion

Adjusting of Appointment place and Date of follow-up.

199

Completing growth monitoring for beza.

200

Click on the Finish Button.

NB: even if Beza has another weight measurement within this month it is not counted toward HMIS indicator , only the first Measurement is counted to prevent double report.

By clicking on the Finish button we can complete the growth monitoring form for beza. then after syncing the form to the server we can do follow up for Beza by adjusting the date setting on our mobile.

2. Moderately Underweight

Let do nutrition screening for Eyob Daniel

• Eyob Daniel is Already found in our child Nutrition List.
• Eyob Daniel: weight 7.4
• Classification = Underweight

201

Equipment selection for measurement.

202

Since eyob age is greater than 6 month he is eligible for MUAC Measurement that is why it displays three equipment.

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Result of Growth Monitoring.

203

Growth Monitoring assess child Nutritional status by comparing weight of child against Age . So the outcome is interpreted based on WHO Growth standard weight for Age (WFA) Z score.

1. A child having >=-2 Z score is classified as Normal Weight
2. A child having >= -3 Z score but less than – 2 Z score is classified as Moderately Underweight.
3. A child having < -3 Z score is classified as Severely Underweight

Age Appropriate IYCF Counseling.

204

Promotion

Promotion

GMP: Growth monitoring and promotion.

Counseling on ITN and Vit A supplementation.

205

Promotion

Adjusting of Appointment place and Date of follow up.

206

Adjust date

GMP has monthly Follow up until the child reaches 2 years old.

So we can select the next follow up place and Appoint the care taker after one month by adjusting the date of appointment.

3. Severely Underweight

Let do nutrition screening for Eyob Daniel

• Eyob Daniel is Already found in our child Nutrition List.
• Eyob Daniel: weight 6.8
• Classification = Severely Underweight

207

Growth Monitoring and Promotion.

208

Growth Monitoring and Promotion.

209

Growth Monitoring assess child Nutritional status by comparing weight of child against Age . So the outcome is interpreted based on WHO Growth standard weight for Age (WFA) Z score.

1. A child having >=-2 Z score is classified as Normal Weight
2. A child having >= -3 Z score but less than – 2 Z score is classified as Moderately Underweight.
3. A child having < -3 Z score is classified as Severely Underweight

Growth Monitoring and Promotion.

210

Counsel the care taker on complementary feeding, Hygiene ,

Vitamin A supplementation.

Complete Growth Monitoring and sync the form.

211

212

Overview of under 5 nutrition screening.

Acute Malnutrition (AM) screening or Classification.

Criteria used for AM Screening or Classification?

1. MUAC
2. Edema
3. WFL/H: this classification is not used at HP.

So we only focus on MUAC & Edema Classification.

Expected outcome after Screening?

1. Normal = MUAC>12.5. edema= 0
2. Moderate Acute Malnutrition (MAM).= MUAC 11.5-12.5
3. Severe Acute Malnutrition (SAM).

MUAC = <11.5 and Any Grade of bilateral pitting edema.

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213

1. Normal or No Acute Malnutrition Case/Screening

Outline:

• we will see how to record a child with No Acute Malnutrition.
• We will see how to follow a child with No acute Malnutrition.

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Case 1; Practice

Name Girum Abera

MUAC = 12.7

Edema = 0

Normal or No Acute Malnutrition Case...

214

Click on the search icon

Write name of the child

Normal or No Acute Malnutrition Case...

215

Normal or No Acute Malnutrition Case...

216

Equipment selection:

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1. If you only want to do Screening, you can select MUAC tape.

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1. If you want to do both screening and GMP, you can select both MUAC tape and Weight scale.

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Normal or No Acute Malnutrition Case...

217

Complete AM screening and sync.

218

Follow up of No Acute Malnutrition Case...

219

Case 2

• Girma Abera
• MUAC 12.6 cm
• Edema 0
• His appointment is today.

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Follow up of No Acute Malnutrition Case...

220

Follow up of No Acute Malnutrition Case...

221

222

2. Moderate Acute Malnutrition Case/Screening

Outline:

• we will see how to record a child with Moderate Acute Malnutrition.
• We will see how to follow a child with Moderate acute Malnutrition

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Case 1; Practice

Name = Ephrem Guluma MUAC = 11.9

Edema = 0

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Moderate Acute Malnutrition Case...

223

Moderate Acute Malnutrition Case...

224

Moderate Acute Malnutrition Case...

225

Moderate Acute Malnutrition Case...

226

Moderate Acute Malnutrition Case...

227

Moderate Acute Malnutrition Case...

228

Moderate Acute Malnutrition Case...

229

Complete the form and sync.

230

Follow up of MAM cases.

231

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What are Entry and Exit Category of MAM case.

Follow up of MAM Cases (New Case)

232

Follow up of MAM Cases (New Case)

233

234

Follow up of MAM Cases (New Case)...

Follow up of MAM Cases (New Case)...

235

Follow up of MAM Cases (New Case)...

236

Follow up of MAM Cases (New Case)...

237

Follow up of MAM Cases (New Case)...

238

Follow up of MAM Cases (New Case)...

239

Complete Follow up form and sync.

240

241

Overview of Cured Case .

242

Overview of Relapse Case .

243

3. Overview of Severe Acute Malnutrition Case.

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Outline:

• we will see how to record a child with Severe Acute Malnutrition.
• We will see how to follow a child with Severe Acute Malnutrition.

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​

244

3. Severe Acute Malnutrition Case Case/Screening

Outline:

• we will see how to record a child with Moderate Acute Malnutrition.
• We will see how to follow a child with Moderate acute Malnutrition

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Case 1; Practice

Name = Sara Habtamu MUAC = 11.9

Edema = 0

Passed Appetite

No medical Cxn

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Record a child with SAM.

245

Record a child with SAM.

246

Record a child with SAM.

247

Record a child with SAM.

248

Record a child with SAM.

249

Record a child with SAM.

250

Record a child with SAM.

251

Record a child with SAM.

252

Record a child with SAM.

253

Record a child with SAM.

254

Record a child with SAM.

255

Record a child with SAM.

256

Record a child with SAM.

257

Complete the form and sync.

258

Follow up for SAM case.

259

Follow up for SAM case...

260

Follow up for SAM case...

261

Follow up for SAM case...

262

Follow up for SAM case...

263

Follow up for SAM case...

264

Follow up for SAM case...

265

Follow up for SAM case...

266

Follow up for SAM case...

267

Follow up for SAM case...

268

Follow up for SAM case...

269

Follow up for SAM case...

270

Follow up for SAM case...

271

Complete the form and sync.

272

273

Overview of Complicated SAM Case that needs Referral.

274

Complicated SAM Case that needs Referral...

Back referral to OTP

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Referral to SC

275

Complicated SAM Case that needs Referral...

Complicated SAM Case...

276

• Practice on the complicated SAM based on the cases

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277

Deworming and Vita A

278

Let Record Vitamin A and deworming supplementation given in the past.

Vitamin A and deworming supplementation given in the past.

279

Vitamin A and deworming supplementation was given in the past.

280

It makes red because the app doesn’t accept a service given before six month. But it accepts any service given within six month.

Vitamin A and deworming supplementation given in the past.

281

Competing Vitamin A and deworming Form.

282

283

Let Record Vitamin A and deworming given Today.

Record Vitamin A and deworming given Today.

284

Record Vitamin A and deworming given Today.

285

Record Vitamin A and deworming given Today.

286

Record Vitamin A and deworming given Today.

287

288

Overview of PLW Nutrition Module.

289

PLW Nutrition Module-

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1. How to record PLW with No Acute Malnutrition.

Record PLW with No Acute Malnutrition.

291

Record PLW with No Acute Malnutrition...

292

Record PLW with No Acute Malnutrition...

293

Record PLW with No Acute Malnutrition...

294

Complete the Form and Sync...

295

296

2. How to Record PLW with Moderate Acute Malnutrition.

Record PLW with Moderate Acute Malnutrition.

297

Record PLW with Moderate Acute Malnutrition...

298

Record PLW with Moderate Acute Malnutrition...

299

Record PLW with Moderate Acute Malnutrition...

300

Record PLW with Moderate Acute Malnutrition...

301

Record PLW with Moderate Acute Malnutrition...

302

Record PLW with Moderate Acute Malnutrition...

303

Record PLW with Moderate Acute Malnutrition...

304

Complete PLW Form and sync the form.

305

306

4. How to follow PLW with Moderate Acute Malnutrition.

Follow up for PLW with MAM.

307

Follow up for PLW with MAM.

308

Follow up for PLW with MAM.

309

Follow up for PLW with MAM.

310

Complete PLW Follow up form and sync the form.

311

����eCHIS TB Module

Overview of TB Services

Services Administered

• Screening
• Follow-up

Locations

Eligible Clients

• All clients are eligible

Health Post

Health Center

• Referral
• Counselling

313

HEW App

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Disease Module

TB Screening

Latent TB Infection Follow-up

Management of IP Interrupters

DS TB Intensive Phase Follow-up

DS TB Continuation Phase Follow-up

HC App

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Disease Referrals

Initial Diagnosis Result

Sputum/Clinical Examination

Referral

Action Card

System overview

TB Screening and diagnosis

HC TB Treatment Status

HC TB Interrupter Outcome

Workflow of the HEW app

Health Post

• TB screening and referral
• Action card management
• TB Treatment and Follow Up
• IP/CP Management of Interrupters

315

Workflow of the HC app (only for HC)

Health Center

• TB Diagnosis for clients referred from HP
• TB Sputum Examination ( end of 2^nd , 5^th and 6^th months)
• TB Clinical Visits ( end of 2^nd , 5^th and 6^th months)
• TB Treatment Status
• TB Interrupter Outcome
• TB screening for clients who make visits to HCs (Client not on the list)

316

TB Screening Visit using HEW app

317

Register the following clients for TB case

Head of Household

Addis Yidnekachew Behailu- Head

• Sex= Male Age= 42

Bethlehem Hailu Kebede

Wife

Female Age = 19

318

Head of Household

• Alem Behailu Memher - Head
• Sex= Female
• Age= 30

TB Screening Visit at HP

319

Client Files

Tapping on Client Files menu button will take you to the list of modules screen

Disease Module

320

Disease

Tapping on Disease menu button will take you to the list of households screen

Disease Module

321

Select the Client for TB Screening

Disease Module

322

Select the Client for TB Screening

Basic Screening Info

You are conducting the screening visit now

Screening is at HP

Client identified by HEW

323

Adult Vital Signs

324

This is not a contact

Screening of a TB case

The client has cough, Stained sputum, Chest pain

Client has a presumed

TB status

Child (< 1 Year) Vital Signs

325

This is not a contact

Screening of a TB case

The client has cough, Stained sputum, Chest pain

Client has fever and has presumed

TB status

Referral

326

Referral reason

Create referral

Finish the form

Sync HEW app

327

• Sync eCHIS HEW App

TB Screening Visit practice

328

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• Identify Addis Yidnek Behailu family
• Select/find Addis Yidenek Behailu ( age 32 –male)
• You are conducting the screening visit now
• Screening is at HP
• Client identified by HEW
• This is not a contact screening of a known TB Case
• The client has cough for two weeks and more, stained sputum and Chest Pain
• Create referral for the client

TB Screening Visit practice

329

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• Identify Alem Behailu Memher family
• Select/find Alem Behailu Memher,( Female, 30)
• You are conducting the screening visit now
• Screening is at HP
• Client identified by HEW
• This is not a contact screening of a known TB Case
• The client has stained sputum and Chest Pain
• Create referral for the client

TB Initial Diagnosis HC app(HC only)

330

TB Diagnosis Result-HC

331

• Bacteriologically Confirmed Pulmonary Cases
• Clinically Confirmed Pulmonary Cases
• Extra pulmonary Cases
• DR TB Diagnosis
• Latent TB Treatment

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Types of TB diagnosis Result

Sync eCHIS HC App

332

• Sync eCHIS HC App

TB Diagnosis

333

Outcome of Diagnosis

334

Lab Result

Pulmonary/

Extrapulmonary

Drug Susceptibility

....Cont

335

Bacteriologically confirmed Pulmonary TB

....Cont

336

Cont…

337

Medication based on

weight and age

Someone needs to

Follow up the client

Select Health Post

Sync HC app

338

• Sync eCHIS HC App

TB initial diagnosis practice (HC app user only)

339

• Open HC App and Sync the app
• Open Disease Referrals module
• Select the client Addis Yidenek Behailu ( age 32 –male)
• Tap the TB Initial Diagnosis Result Module
• Most recent visit date and HEW screening classification should be shown as a Summary
• Follow the form and enter MRN No, date of HC screening
• Outcome of TB Screening: TB Positive
• Drug Resistant or Drug Susceptible TB: Drug Susceptible
• TB Type: Pulmonary TB
• How was the Pulmonary type identified: Bacteriologically Confirmed
• Weight: 61

Cont’d.. ( Only HC app)

340

• DOT Supporter: HEW
• Enter the adherence supporter’s full name, Address
• Medications List:
• Medication Kit: RHZE (Adult Dose)
• Dose per day: 4
• Total treatment days: 60
• Refer to hospital : No
• Intensive Phase Appointment Location: Health Post
• Confirm next follow up date
• Sync the app

TB Intensive phase follow up Visit using HEW app

341

Sync HEW APP

342

• Sync eCHIS HEW App

Action card

343

Tapping on Start button takes you to the home screen

Approve Action Card

344

Select Client

From the list

Tap on the

Approve TB Action Card Menu

Confirm the

Action Card

TB Intensive phase follow up

345

• Go to Client file
• Go to Disease‘ Module
• Select the family of the Client
• Select the Client
• Go to the DS TB Intensive Phase Follow Up Module

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​

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Start the Intensive Phase

346

The TB intensive phase follow up is the same procedure for the

• Pulmonary or extra Pulmonary TB type and
• Bacteriological or clinically confirmed case

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Intensive Phase Follow up

347

Go to Disease Module->

Select Client ->

DS TB IP Follow Up

Confirm the start

Date of the IP

Previous screening info

Provide/Record Missed Dose

348

Medications

349

Record Multiple Missed Doses

350

Next Follow Up

351

Provide Multiple Doses

352

Repeat the process and provide medications for Four(4) days

(You can select future dates)

IP - End of Second Month

353

Notification screen will appear to inform the HEW about the completion of the Intensive Phase and refer the client to the HC for Sputum Test.

Create referral : Yes

Sync HEW apps

354

• Sync eCHIS HEW App

Intensive Phase follow up visit �practice – HEW app�

355

• Identify Addis Yidnek Behailu family
• Select/find Addis Yidenek Behailu ( age 32 –male)
• You are conducting the intensive phase follow up now
• The follow up is at HP
• Give multiple Dose

​

​

​

TB Sputum test at end of 2^nd month

(HC app only )

356

Sync eCHIS HC App

357

• Sync eCHIS HC App

Disease Referral-HC App

358

Sputum Exam Result will be displayed for Bacteriologically Confirmed TB cases

Sputum Exam Result

359

Cont...

360

cont’d

If the client’s Sputum Examination is Smear +ve at the end of the intensive phase, the health professionals at the HC will decide whether the client should continue the Intensive Phase or refer them to health facilities for further treatment