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Introduction
A Public Health Inspector (PHI) is a front-line health worker who is responsible for communicable disease surveillance, school health, environment and occupational health, food safety, etc.1 Today, Sri Lanka has 1710 members island-wide in the capacity of PHIs and Supervisory Public Health Inspectors (SPHIs), who are considered the main enforcement arm of the prevention team.2 Being in direct contact with the community by visiting the residents at their locations, each PHI is allocated about 10 000–15 000 persons of the population residing in the specific, demarcated area identified as the ‘PHI’s area’. Through frequent visits, the PHI provides required care for the populations in the areas with regard to environmental, occupational health and food safety. Based on the collected data during those visits, it is required to update the monthly report (PHI Monthly Report Part 1 and 11–Health 631 form). These reports provide a wide range of ‘raw data’ about housing and sanitation, water supply, food safety and hygiene, occupational health, school health, control of communicable diseases, environmental pollution, volunteer programmes, health education, welfare centres for displaced persons, legal action, list of training programmes attended, list of seminars and workshops attended in respective areas. A copy of the monthly report needs to be forwarded to the relevant MOH (Medical Officer of Health), Regional Director of Health Service (RDHS), Provincial Director of Health Service (PDHS), and finally, it will reach the central level, Directorate Environmental, Occupational, Health and Food Safety (EOHFS). However, it should be highlighted that this process does not happen properly as stated above and has been so for more than 20 years.
Furthermore, in this process, currently, the data collection is done manually by the respective PHI assigned to the relevant area. Any supplementary use cannot be made of such data, as advanced analysis is impossible. Information or data collected concerning environmental, occupational health and food safety have not been considered for any further review or analysis beyond the RDHS level for a very long period. Also, this outdated monthly report format has resulted in incomplete and untimely reports at the national level, with inferior and inaccurate data. These drawbacks have drastically impacted the usage of such valuable data in making important policy decisions in the country’s health sector and also building up an archive or a database of easily accessible critical data, which is valuable to all other sectors as well.
The designing and development of an electronic-based system is expected to fill this vacuum and enhance the quality aspect of the information gathered, reduce the workload and increase the job satisfaction of public health workers. Overall, the launch of such a system would immensely benefit the country’s key stakeholders in various ways, which will augur well for a progressive nation to move forward as envisaged in achieving its Sustainable Development Goals.3 In both developed and developing nations, open-source software solutions have removed the barriers to the development of health information management systems.4–6 Open-source software has proven its benefits for use in health information systems.7 8 The District Health Information Software 2 (DHIS2) is an open-source software platform initially developed by the Health Information Systems Programme at the University of Oslo and is currently being used in over seventy countries around the world.9 In general, DHIS2 can be described as a ‘tool for collection, validation, analysis and presentation of aggregate statistical data, tailored (but not limited) to integrated health information management activities’ (in other words; simply for reporting, analysis and dissemination of data for all health programmes).10 Being a user-friendly and web-based software package, the DHIS2 platform can be customised and it is a generic tool with a flexible user interface. The implementation of the DHIS2 in Sri Lanka involves the customisation of this open-source software to meet the country’s specific requirements.11 The tailored features encompass diverse aspects such as defining indicators, refining data entry procedures, employing web-based pivot tables, graphically visualising data, integrating geographical information systems, ensuring data quality, managing user access, incorporating messaging and devising mobile DHIS2 solutions. Despite promising initiatives stemming from comprehensive studies, the overall implementation progress in the country has been sluggish, attributed to various factors. Nonetheless, evidence from undertaken projects highlights the potential for widespread DHIS2 integration in Sri Lanka.11
This study aims to digitalise the ‘PHI Monthly Report’ using DHIS2, pilot the system and assess its usability. The research focuses on addressing existing inefficiencies in data collection, enhancing reporting accuracy and improving the accessibility of critical health information to inform better decision-making in environmental, occupational health and food safety management.
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