Session 6: Report and Presentation of Health Related
Information Using Computer Packages

Total Session Time: 120 minutes

Prerequisites
• None

Learning Tasks
By the end of this session students are expected to be able to:
• Define report
• Explain principles of good report writing
• Describe methodology of report writing

Resources Needed
• Flip charts, marker pens, and masking tape
• Black/white board and chalk/whiteboard markers
• Computer and LCD projector

SESSION OVERVIEW
 Step         Time        Activity/Method Content

   1       05 minutes        Presentation     Introduction, Learning Objectives
                              Buzzing
   2       10 minutes                         Definition of Report
                            Presentation
   3       45 minutes       Presentation      Basic Principles of Good Report Writing
                            Presentation
   4       45 minutes       Small group       Methodological of Report Writing
                              activity
   5       05 minutes       Presentation      Key Points

   6       05 minutes       Presentation      Evaluation

   7       05 minutes       Presentation      Assignment




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SESSION CONTENTS

STEP 1: Presentation of Session Title and Learning Tasks (05 minutes)

READ or ASK students to read the learning tasks

ASK students if they have any questions before continuing.

STEP 2: Definition of Report (10 minutes)


Activity: Buzzing (05 minutes)

ASK students to pair up and buzz on the following question for 2 minutes:
  • What is a report?

ALLOW few pairs to respond and let other pairs to add on points not mentioned

WRITE their response on the flip chart/board

CLARIFY and SUMMARISE by using the content below

•   Report
    o The report is a practical document that describes deals or analyses a situation such
       that the reader can take specific actions about the situation.
    o The report as a whole asks if there is a problem.
    o The conclusion draws the various elements of this question together, typically
       acknowledging that there is a problem and breaking it down into its component
       parts.
    o The recommendations suggest the range of options available to solve the problem.

•   Types of report
    o Factual report: gathering information that explain or define a situation
    o Instructional report: gathering information that explain a problem and offer a
       range of solutions
    o Persuasive report: gathering information that explain a problem and recommend a
       solution.




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STEP 3: Basic Principles of Good Report Writing (45 minutes)

• Accuracy
   o Report factual information, for example ―I saw.‖
   o Report information gained from the physical senses, for example, sight, smell,
     taste, auditory, and touch.
   o Be aware of feelings that may destroy objective descriptions. Strong feelings can
     cause the writer to seek evidence to support her feelings and reject evidence that
     does not support them.
   o Make distinctions between fact and hearsay, fact and opinion, and fact and
     conclusions.
   o Be clear about the meaning of words; avoid jargon.
   o Clarify all abbreviations, such as SOB for shortness of breath.
   o Proofread the report and rewrite as needed.

• Completeness
   o Completeness is achieved by reporting all the facts discovered during the course
     of an investigation or data collection.
   o Information that appears irrelevant to the investigator may be relevant to the
     reviewer.
   o In most cases, the only information the reader will have will be the information in
     the report.
   o Partially stated facts can be misleading and misinterpreted.
   o Explain why certain information is lacking or incomplete.
   o Provide a detailed explanation of the possible source of additional information
     and undeveloped leads.

• Conciseness
   o Avoid unrelated, extraneous, incidental, and nonessential information and detail.
   o Pay attention to grammar.
   o Avoid adjectives, wit, sarcasm, flowery expressions, and repetition. A report is
     not a literary or creative writing exercise.
   o Use singleness of thought and purpose. A good report will give the reader a clear
     idea or picture of the investigation or the information collected.
   o Use headings, paragraphing, sentence structure, indentations, underlining, and
     capitalization to emphasize and give weight and/or visibility to information the
     investigator deems more important.

• Impartiality/Objectivity



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   o The investigator is a fact finder. Report the material and evidentiary facts without
     addition or subtraction.
   o Do not conceal or withhold information.
   o Do not assume.
   o Do not conclude.
   o Maintain an unbiased and open mind about the case.
   o Avoid formulating preconceived ideas about the guilt of the accused.
   o Avoid becoming emotionally involved in the process of seeking information.

• Clarity and Report Formatting
  o Arrange the contents of the report in discrete sections to facilitate the reader’s
     review and understanding of the report.
  o Write in chronological order.
  o Avoid ambiguous sentences and vague statements.
  o Additional parts of the complete report may include the title page, information on
     undeveloped leads, investigator’s conclusions, witness list, and exhibit/evidence
     list.

STEP 4: Methodological of Report Writing (45 Minutes)
• Typical report structure:
                                      Title page
                                          ▼
                                       Contents
                                          ▼
                                     Introduction
                                          ▼
                                  Acknowledgement
                                          ▼
                                  Executive Summary
                                          ▼
                                     Methodology
                                          ▼
                                       Findings
                                          ▼
                                      Conclusion
                                          ▼
                                   Recommendations
                                          ▼
                                     Bibliography
                                          ▼

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                                       Appendices
                                           ▼
                                        Glossary

• Point to consider during report writing:
   o Read journals for your subject.
   o Remember that each finding should have a conclusion.
   o Think about what a report does.
   o Check department style and use that.
   o Clarify your aims before you start.
   o Consider who the reader is.
   o Gather information to explain or define a situation.
   o Swap with a friend; proof-read each other’s reports.
   o Consider what you will need to tell your reader to get them there.
   o Proof-read from end to beginning; this disrupts expectations.



STEP 5: Key Points (5 minutes)
• Report is a practical document that describe the situation which the reader can take
  action
• Accuracy, completeness, conciseness, objectivity, clarity and formatting are the basic
  principles of report writing
• Report should be written by follow the methods of report writing

STEP 6: Evaluation (5minutes)
•   What is report?
•   What are the types of report?
•   What are the principles of report writing?
•   What are the components of report?




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STEP 7: Take Home Assignment (5minutes)
Activity: Take Home Assignment

TELL the student to answer the following question:
• Use the information recorded in the HMIS Monthly Tracer Medicine Register and
  writes a simple report to CHMT of your district of choice.

DIVIDE students into small manageable groups.

ALLOW group to work for three days and submit the task after scheduled time.

CONDUCT general discussion by asking groups to present one of these questions for not
        less than 5 minutes.

SUMMARIZE the activity using training guidelines.




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References
Embrey, M. A. (2013). MDS-3: Managing access to medicines and health technologies.
  Sterling, VA: Kumarian Press.

MoHSW, Strengthening Health Information System, Government printers, Dar es
 Salaam

United Republic of Tanzania Ministry of Health and Social Welfare, Strategy for
  Development and Implementation of an Integrated Logistics System for Essential
  Health Commodities: Government printers, Dar es Salaam

USAID | DELIVER PROJECT, Task Order 1. 2011. Tanzania: 2020 Supply Chain
     Modeling—Forecasting Demand from 2020–2024. Arlington, Va

International Council on Archives (1999), Managing Public Sector Records,
   Understanding computers an over view for records and archives: International
   Records Management Trust London

Mort S. (1995). Professional Report Writing. Gower Publisher Ltd. Bristol

UK. (2018). Report Writing-Quick Guide. Student Learning Advisory Service.
  University of Kent. Accessed date: 10.09.2018. Available at: www.kent.ac.uk
  https://career.guru99.com/wp-content/uploads/2014/10/max_formula_1.png




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Session 7: Computer Applications for Data Backup,
Information Searching and Learning

Total Session Time: 120 minutes

Prerequisites
•   None

Learning Tasks
By the end of this session, students are expected to be able to:
• Define data back up
• Describe importance of backing up data
• Explain causes of data loss
• Define computer virus
• Classify different type of computer viruses
• Describe the importance of computer antiviruses
• Demonstrate techniques in searching information on the internet

Resources Needed
•   Flip charts, marker pens, and masking tape
•   Black/white board and chalk/whiteboard markers
•   Computer and LCD projector
•   Internet




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SESSION OVERVIEW
 Step        Time       Activity/Method Step titles

   1      05 minutes       Presentation    Introduction, Learning Objectives
                          Presentation,
   2      10 minutes                       Definition of Data Backup
                           Brainstorm
                          Presentation
   3      15 minutes                       Importance of Backing up Data

                           Presentation
   4      20 minutes                       Causes of Data Loss

                           Presentation
   5      05 minutes                       Definition of Computer Virus

   6      25 minutes       Presentation    Types of Computer Viruses

   7      15 minutes       Presentation    Importance of Computer Antivirus
          15 minutes       Presentation    Techniques of Searching Information on the
   8
                                           Internet
   9      05 minutes       Presentation    Key Points

  10      05 minutes       Presentation    Evaluation

  11      05 minutes       Presentation    Assignment


SESSION CONTENT

STEP 1: Presentation of Session Title and Learning Tasks (5 minutes)

READ or ASK students to read the learning tasks

ASK students if they have any questions before continuing

STEP 2: Definition of Data Backup (10 minutes)

Activity: Brainstorm (05 minutes)

ASK student ―what is data back up?‖

ALLOW few students to respond.



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WRITE their responses on the board/flip chart.

SUMMARISE using the content below.



Data backup
• A data backup is the result of copying or archiving files and folders for the purpose of
  being able to restore them in case of data loss.
• Data backup have two distinct reasons:
  o To recover data after its loss, by data deletion or corruption.
     ▪ Data loss can be a common experience of computer users
  o To recover data from an earlier time, according to a user-defined data
     retention policy typically configured within a backup application for how long
     copies of data are required.

Data backup storage media

• Magnetic tape has long been the most commonly used medium for bulk data storage,
  backup, archiving, and interchange.
• Hard disk: Hard disks have been improving for many years, making them more
  competitive with magnetic tape as a bulk storage medium.
• Optical storage: Recordable CDs, DVDs, and Blu-ray Discs are commonly used with
  personal computers to store data.
• SSD/Solid state storage: flash memory, thumb drives, USB flash
  drives, CompactFlash, SmartMedia, Memory Stick, Secure Digital cards are very
  convenient for backing up low data volumes.
• Cloud backup: Backing up via the Internet to a remote location can protect against
  events such as fires, floods, or earthquakes which could destroy locally-stored backups.
• On-line backup storage is the most accessible type of data storage, which can begin
  restore in milliseconds of time.
• Near-line storage is less accessible and less expensive than on-line storage, but still
  useful for backup data storage.
• Off-line storage requires some direct human action to provide access to the storage
  media: for example inserting a tape into a tape drive or plugging in a cable.
  o Off-site data protection: To protect against a disaster or other site-specific problem,
     many people choose to send backup media to an off-site vault.
  o The vault can be as simple as a system administrator's home office or as
     sophisticated as a disaster-hardened, temperature-controlled, high-security bunker
     with facilities for backup media storage.


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• Backup site: Some organizations have their own data recovery centers that are
  equipped for data storage.


STEP 3: Importance of Backing up Data (15 minutes)

• The Human Eraser
  o Computers can do a lot of damage in a very short period of time.
  o The fastest erasers known consist of a fast computer combined with an unprepared
    or tired brain.
  o Backup systems can save hours, days or months of trying to reconstruct valuable
    data.
  o Before any important system change, such as adding hardware or software, it is
    important to remember to backup all data before installation of the new system.

• Hard disk failure
  o MTBFs (Mean Times Between Failure) have improved dramatically in the past
    several years for all peripherals.
    ▪ This refers to data capacity and the amount of data that can be lost if the disk fails.
    ▪ The problem is, nobody knows when a failure will occur.
  o According to the Murphy's Law, the loss will occur at the worst possible time.
  o Backup systems give immediate and automatic protection from unpredictable disk
    failures.

• Virus protection and spyware protection
  o Some unscrupulous individuals continue to write viruses that innocently hide in
    shareware programs and all throughout the Internet.
  o These programs have the capability to copy themselves and load into the system
    along with the software that we downloaded from the internet.
  o Once loaded, they proceed to wreak havoc the system, causing errors, lockups and
    loss of data.
  o A reliable backup system can restore data lost through virus infection when used in
    conjunction with good virus detection software and an earlier backup.

• Free up disk space
  o It is not easy to stop the steady growth of application software and related data in the
    system.
  o The only way of resolve this problem is to offload some of the less-used files from
    the hard disk to a secondary storage medium like tape or DVDs.
  o Removing those inactive files can open up the hard disk for new programs or
    growing data files.

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 o Inexpensive DVD or tape cartridges are a sure way to archive the programs and data
   while still keeping them accessible when needed.
 o It can enable to put off buying a larger disk.

• Events beyond the human control
  o Both natural and manmade disasters inject a disconcerting variability into any
    application that requires large amounts of data storage.
    ▪ These include fire, floods, lightning and outright theft.
  o After such an occurrence:
    ▪ Business will failed to survive.
    ▪ Regenerating vital billing or customer information would be very difficult from
      paper records, if not impossible.
  o Backup systems protect data against such calamity.
    ▪ It was advised to do an extra backup weekly and store the backup either in a
      fireproof safe or at an offsite location.
    ▪ If the system goes, the data stays
    ▪ It may mean the difference between business as usual and bankruptcy.

• Large file transfers
  o Transferring large volumes of data can be time-consuming.
  o Tape backup drives in particular have the capacity for very high data transfer rates
    making them ideal for moving large quantities of data between systems.
  o Tapes are also compact, inexpensive and have a long shelf life.
    ▪ The data are archived and accessible for years to come.
    ▪ With a tape backup system a system user can conveniently send a tape cartridge
      across the country, through the mail or across the office in a shirt pocket.

STEP 4: Causes of Data Loss (20 Minutes)
• Deleting files accidentally
  o The top risk of losing data is deleting files or parts of texts without having any
    backups available.
  o Updating files or deleting them is very common activities and we do them almost
    every day.
  o No wonder if we accidentally delete wrong files or overwrite the parts we did not
    intend.
  o We often lose data simply because we do not have proper workflow procedures and
    backup strategies.
  o More efficient procedures for saving our work and making backups regularly will
    definitely save a lot of time for us.



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• Viruses and damaging malware
  o There are numerous new viruses which attack computers every day.
  o Being connected to worldwide network has many advantages; however, it opens
    computers to many serious risks.
  o Damages may differ greatly but the majority of viruses affects operational software,
    misuses Internet connection and damages stored data.
  o There are many different types of viruses and, often, data loss is just a side effect of
    some larger damage done to operational system.
  o The most dangerous are the attacks targeted to steal and damage business data.
    ▪ Imagine the value of client databases, technical inventions, patient health
      information essential for treatment and medication or financial transactions'
      history of the health organization are destructed/ damaged with viruses.

• Mechanical damages of hard drive
  o Hard drives of computers are the most fragile parts of computers; they break down
    more often than any other device connected to computing.
  o There are so many moving parts inside of hard drives that it is no wonder they break
    down so easily.
  o Once the serious problem occurs in the hard drive, there is no way even a
    professional services provider can totally recover the important data in the drive.
  o Memory devices are also often damaged when computers are accidentally dropped.
  o Regular backups really help in case of hardware troubles.

• Power failures
  o There are two adversary effects of power failures.
    ▪ When you are halfway through writing a long article and you have not saved it
       yet, then in case of power going out you lose your data.
    ▪ Another, even deeper problem may arise when power failures affect operation
       systems or hardware of computers; shutting computer down suddenly without
       proper shutdown procedures may cause problems with rebooting operation system
       later, these operation system problems cause chain reaction and data might not be
       accessible any more.
  o Sudden changes in voltage may damage many different computer parts.
    ▪ Most problems can be solved by changing power supply unit but there are also a
       great possibility for damaging other hardware elements of computer, e.g. hard
       drives and other parts which are very sensitive to changes in voltage and strong
       magnetic fields.
  o Having automatic backups enables to recover from any accidents caused by power
    failures.



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• Theft of computer
  o It is a real tragedy to lose both computer and data at the same time.
  o There is always the danger of burglars breaking the offices and stealing electronic
    devices.
  o While traveling passengers leave the laptop in a bus/car, airport, conference centers,
    coffee shops or any other crowded place.
  o New computers cost some money, but very often the data saved to hard disks is even
    more expensive.
  o Even if there is no particular monetary value involved, personal memories, family
    pictures or other heirlooms are certainly important and very valuable to any person
    who use computer.
  o Losing computer may be less painful, if a computer user use proper data backup
    strategy and keep data in safe storage.
• Spilling coffee, and other water damages
  o Since laptop usage has been growing during past few years, the damages caused by
    spilling drinks on to the computers have become more often as well.
  o Average laptop does not have extra covers to protect internal parts from getting
    soaked.
  o Liquids cause short circuit of important electronic components and they are really
    hard to recover afterwards.
  o Hard drives are usually placed in protective case and may be still used after getting a
    little wet.
  o However, harder soaking makes hard drives inaccessible.
  o Another risk of the same category is dropping computer into water.
  o If the computer is completely immersed into water, it is really hard to fix anything
    afterwards.
  o Maybe visiting a repairman really quickly can save some parts of the computer
    appliances otherwise it will be a useless computer.
  o Also, if computer was not switched on at the moment of falling into water, the
    damage may be less severe.
  o Water accidents usually cause the loss of data saved to the hard drive.

• Fire accidents and explosions
  o Explosions happen rarely but fire most probably completely destroys both a
     computer and data saved on it.
  o Fire is also dangerous to the backups that are stored in the same house.
  o For example, having weekly backups stored on an external hard drive which is kept
     in same building does not help much if the building burns down.
  o In this case, both computer and backup drive will be destroyed and data will be
     completely lost.


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 o The safest practice against fire is to make regular backups and keep them in other
   (different) locations.


STEP 5: Computer Virus (5 Minutes)

• A virus refers to a man-made computer program or code that is loaded onto a user's
  computer without their knowledge and run without the user's approval.
• A computer virus attaches itself to a program or file enabling it to spread from one
  computer to another, leaving infections as it travels.
• Like a human virus, a computer virus can range in severity: some may cause only
  mildly annoying effects while others can damage the computer hardware, software and
  files.
• Almost all viruses are attached to an executable file, which means the virus may exist
  on the computer but it actually cannot infect the computer unless the user run or open
  the malicious program.
• It is important to note that a virus cannot be spread without a human action, such as
  running an infected program to keep it going.
• Because a virus is spread by human action, people will unknowingly continue the
  spread of a computer virus by sharing infecting files or sending emails with viruses
  as attachments in the email.

     NOTE: Virus attaches to an executable file that requires human action to spread.

STEP 6: Types of Computer Viruses (25 Minutes)
• These days there are so many different types of virus but the mostly popular viruses are
  Worms, Trojan Horse, and Blended threat.
• A malware is not a computer virus.
• A virus is usually hidden, and can do a number of things, as it relates to the health of
  the computer, a few examples are provided below:
  o Make a computer run slowly
  o Prevent computers from booting up
  o Damage parts of the system or amend how the system operates without the owner's
     knowledge
  o Be used to steal personal details
  o Move from machine to machine on a network
  o Attack other machines using machine as a host
  o Send out unauthorized messages




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Worm
• A worm is similar to a virus by design and is considered to be a sub-class of a virus.
• Worms spread from computer to computer, but unlike a virus, it has the capability to
  travel without any human action.
• A worm takes advantage of file or information transport features in the system, which is
  what allows it to travel unaided.
• The biggest danger with a worm is its capability to replicate itself in the system, rather
  than the computer to send out a single worm, it could send out hundreds or thousands of
  copies of itself, creating a huge devastating effect.
• One example is a worm sends a copy of itself to everyone listed in the sent e-mail
  address book.
  o Then, the worm replicates and sends itself out to everyone listed in each of the
     receiver's address book, and the manifest continues on down the line.

 o Due to the copying nature of a worm and its capability to travel across networks the
   end result in most cases is that the worm consumes too much system memory and
   network bandwidth, causing Web servers, network servers and individual computers
   to stop responding.
 o In recent worm attacks such as Blaster Worm, the worm has been designed to tunnel
   into the computer system and allow malicious users to control the computer
   remotely.

NOTE: Worm can replicate itself on system and does not require human action to
spread.


Trojan horse
• A Trojan Horse is full of as much trickery as the mythological Trojan Horse it was
  named after.
• The Trojan Horse, at first glance will appear to be useful software but will actually do
  damage once installed or run in the computer.
• Those on the receiving end of a Trojan Horse are usually tricked into opening them
  because they appear to be receiving legitimate software or files from a legitimate
  source.
• When a Trojan is activated in the computer, the results can vary.
• Some Trojans are designed to be more annoying than malicious, like changing
  the desktop, adding silly active desktop icons or they can cause serious damage by
  deleting files and destroying information in the system.




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• Trojans are also known to create a backdoor in the computer that gives malicious users
  access to the system, possibly allowing confidential or personal information to be
  compromised.
• Unlike viruses and worms, Trojans do not reproduce by infecting other files; they self-
  replicate.

NOTE: Trojan Horse appears useful but damages system, and it requires human action
to run, but do not self-replicate.

Blended Threat
• Added into the mix, we also have what is called a blended threat.
• A blended threat is a more sophisticated attack that bundles some of the worst aspects
  of viruses, worms, Trojan horses and malicious code into one single threat.
• Blended threats can use server and Internet vulnerabilities to initiate, then transmit and
  also spread an attack.

• Characteristics of blended threats are:
  o It causes harm to the infected system or network
  o It propagates using multiple methods
  o The attack can come from multiple points
  o The threats also exploit vulnerabilities
• A blended thread, the attack would normally serve to transport multiple attacks in one
  payload.
  For example:
  o It wouldn't just launch a DoS attack.
  o It installs a backdoor and maybe even damage a local system in one shot.
  o It is designed to use multiple modes of transport.
• While a worm may travel and spread through e-mail, a single blended threat could use
  multiple routes including e-mail, Internet Relay Chat (IRC) and file-sharing sharing
  networks.
• Rather than a specific attack on predetermined .exe files, a blended thread could do
  multiple malicious acts, like modify the .exe files, HTML files and registry keys at the
  same time
• It can cause damage within several areas of the network at one time.
• Blended threats are considered to be the worst risk to security since the inception of
  viruses, as most blended threats also require no human intervention to propagate.
Malware
• Technically, this is not classed as a virus.
• It is software used to spy on computer user's activities and collect personal information.
• More commonly is known as "spyware".

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STEP 7: Importance of Computer Antiviruses (15 Minutes)
Antivirus Software
Antivirus Software is data security utility which is installed in a computer system/PC
with a purpose of protection from viruses, spyware, malware, rootkits, Trojans, phishing
attacks, spam attack and other online cyber threats.
• Antivirus software is the "policeman" at the gate of a computer system.
• It protects the computer from incoming threats and seeks out, destroys and warns of
  possible threats to the system.
• New viruses are coming out all the time; it is the job of the antivirus software to keep
  up with the latest threats.
• This is achieved by daily updates of the antivirus database definitions, which counteract
  the latest threats to provide constant protection.


The benefits of using antivirus software in the computer system

• Protection from Viruses and Spyware
  o Antivirus has the primary job of detecting any sought of viruses, spyware, malware
    and other unknown threats and removing the same before they can do any harm to
    the data present in a computer system.

• Protection from Phishing Attacks
  o Phishing is termed as an unauthorized attempt by any third person or hacker to
    access the data present in the system, with the intention of stealing the same or infect
    the data so that it can’t be usable to the user.

• Provides Robust Web Protection
  o With the increased use of the internet, various online cyber threats are affecting the
    data security of the computer.
  o Antivirus software takes control of the web activities limiting unauthorized access of
    any online threat.

• Provides quick scan of removable device
  o Antivirus Software provides the advantage of quick scanning of any removable
    device connect to the computer system and scans it for any unknown threats.
  o The external drives are opened automatically after complete scanning of the
    removable devices and removing any unknown threats present in it.

• Two-Way Firewall

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 o Antivirus Software provides two-way firewall protection which puts a check in
   every incoming and outgoing data/mail through the internet and blocks the same if it
   finds something suspicious during transmission.

• Block Ads and Spam Website
  o At present, most of the viruses and spam attacks are executed from the pop-up ads
    and other spam website whose original intention is to steal confidential information
    from user’s computer which could result in big financial losses.

• Provides Password Protection
  o Some significant antivirus software provides the feature of password protection
    which protects them from getting stolen by any third person or hackers.

• Speed up the computer system
  o Nowadays, antivirus software developed in such a way that they don’t hamper the
    system performance.
  o Rather they come with built in modules which automatically deleted unwanted files
    and folders from the computer system, thus increasing its performance speed.

STEP 8: Techniques of Searching Information on the Internet (15
Minutes)
• A web search engine is a software system that is designed to search for information on
  the World Wide Web.
• The most popular search engines in the world are the following: Google, Bing, yahoo,
  Baidu, Ask.com, and AOL.com.
• The four top medical information search engine websites are: WebMD, PubMed,
  Healthline and HealthFinder
 Procedures of searching information on the internet
• Google is the most popular search engine in the world.
• But while so many people use it, few actually get formal instructions on how to search
  with Google.
• Below are steps on how to search on Google.

Step 1: Go to Google (But Which Google?)

• To search Google, user should have to go to Google.
• The user should have knowledge of various ways to reach the site.
• In fact, that there are even different Google web sites.




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Figure 10: Google Search




• Go directly to Google.com by typing in http://google.com into the web browser; that
  will take the user to the main Google web site, which is designed to serve the world in
  general.
• The user can prefer to go to the version of Google designed for the own country.
• The user can find a list of country-specific versions of Google shown on this page.
Step 2: Go To Google via a Toolbar
• A faster way to use Google is to enter a search into the search box that’s built into most
  popular browsers.




• With the Google’s Chrome browser, type the search content right into the same box
• Enter search term in the omnibox, for example a ―car‖.

                                   Figure 11: Omnibox




Step 3: Enter Search Terms

• Using a toolbar, as you type, you may see words begin to appear below the toolbar’s
  search box.
• These are suggestions that Google thinks may match what you’re interested in.
• Google calls this ―Google Suggest‖ or ―Autocomplete.‖

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• You can ignore the suggestions, but if one seems useful, select it to save some typing.

Figure 12: Search box




Step 4: Review Search Results
• After searched, the page will have a full of results.
• Some of these will be matching pages from across the web.
• Some of these will be matching content from those subject-specific versions of Google.




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Figure 13: Search results




Step 5: Preview Answers
• As you review results, you’ll wonder if some of the listed sites are the best answer to
  what you’re looking for.
• Google provides a way to quickly check on this.
• It’s called Google Instant Previews.
• Next to the web page listings, you’ll see a magnifying glass symbol appear:




    • Click on this, and you’ll make a preview of the page for that listing appear:




                                             96

Step 6: Refine the Google Search
• Google doesn’t know exactly what you want, when you enter a search, so the results
  you get are its best guess.
• There are ways you can help it make better guesses.
• For one, Google provides a variety of ways to refine your searches, to narrow them
  down.
• For examples: search for DVD players:




STEP 9: Key Points (05 minutes)
•   A data backup is the process of copying and archiving files for the purpose of
    restored them in case of data loss.
•   Deleting file, computer virus, physical computer damage, power failure, theft, natural
    and manmade disaster are the causes of data loss.
•   Worms, Trojan Horse and Blended threat are the most popular viruses in the world.
•   The antivirus software is a data security installed in a computer system.

STEP 10: Evaluation (05 minutes)
•   What is the difference between virus and antivirus?
•   What are the merits of using computer antivirus?
•   What are the factors caused data loss in the computer system?




                                            97

STEP 11: Take HomeAssignment (05 minutes)
Activity: Take Home Assignment

TELL the student to answer the following question:
     • What is data backup?
     • What are the reasons for data backup?
     • Mention types of computer virus and anti-virus.
     • Enlist causes for data loss

DIVIDE students into small manageable groups.

ALLOW group to work for three days and submit the task after scheduled time.

CONDUCT general discussion by asking groups to present one of these questions for not
        less than 5 minutes.

SUMMARIZE the activity using training guidelines.




                                         98

References
Embrey, M. A. (2013). MDS-3: Managing access to medicines and health technologies.
  Sterling, VA: Kumarian Press.

MoHSW, Strengthening Health Information System, Government printers, Dar es
 Salaam

International Council on Archives (1999), Managing Public Sector Records,
   Understanding computers an over view for records and archives: International
   Records Management Trust London

Abdelhak M. (2014). Health Information: Management of Strategic Resources. 5th Ed.
  Elsevier Health Science Publisher.

Axelsson S. (2006). Understanding Intrusion Detection through Visualization. Springer
  Science & Business Media Publisher. Berlin/Heidelberg, Germany.

Aycock J. (2006). Computer Viruses and Malware. Springer International Publisher.
  USA.

Couglas J.D. (2003). The Backup Book: Disaster Recovery from Desktop Data Center.
  3rd Ed. Network Frontiers, LLC. US.

Davis A. (2014). Health Information Technology. 3rd Ed. Elsevier Health Science
  Publisher. USA.

Miller M. (2009). The Complete Idiot`s Guide to Search Engine Optimization. Alpha
  Books Publisher. US.




                                         99

Session 9: Components of Health Management
Information System
Total Session Time: 120 minutes

Prerequisites
• None

Learning Tasks

By the end of this session, students are expected to be able to:
• Define health management information system (HMIS)
• List components of the health management information system
• Explain the importance of health management information system
• List key performance indicators of health management information system

Resources Needed
• Flipcharts, marker pens, masking tape
• Black/whiteboard and chalk/white board markers
• Computer and LCD projector


SESSION OVERVIEW
Step            Time     Activity/Method          Steps Title

                           Presentation,         Presentation of Session Title and Learning
          05 minutes
 1                                               Tasks

                           Brainstorm            Definition of health management information
 2        10 minutes
                           Presentation          system

                                                 Components of WHO health information
 3        30 minutes       Presentation
                                                 system
                                                 Importance of health management
 4        30 minutes       Presentation
                                                 information system
                          Presentation           Performance indicators of health
 5
          30 minutes    Group Discussion         management information system

 6        05 minutes       Presentation          Key Points



                                           108

    7          05 minutes         Presentation         Evaluation

    8          05 minutes         Presentation         Assignment


SESSION CONTENT

STEP 1: Presentation of Session Title and Learning Tasks (5
minutes)

READ the Learning Tasks to students

ASK students if they have any question before proceeding

STEP 2: Definitions of Health Management Information System
(10 Minutes)

Activity: Brainstorm (02 minutes)

ASK student what is ―health management information system?‖

ALLOW few students to respond.

WRITE their responses on the board/flip chart.

SUMMARISE using the content below.

•       Health Management Information System (HMIS) is a data collection system
        specifically designed to support planning, management, and decision making in
        health facilities and organizations.
•       An information system (IS) is an organized system with interrelated components
        used for the collection, organization, storage and communication of information.
•       Health information management (HIM) deals largely with patient or individual
        health-related data.
•       Health information systems (HIS) capture, store, manage, or transmit information
        related to the health of individuals or the activities of an organization that work within
        the health sector
•       Health planners and decision-makers need different kinds of information including:



                                                 109

    o Health determinants: socioeconomic factors, environmental factors, behavioral
       factors, genetic factors and the contextual environments within which the health
       system operates.
    o Inputs to the health system and related processes: policy and organization,
       health infrastructure, facilities and equipment, costs, human and financial
       resources and health information systems.
    o The performance or outputs of the health system: availability, accessibility,
       quality and use of health information and services, responsiveness of the system to
       user needs, and financial risk protection.
    o Health outcomes: mortality, morbidity, disease outbreaks, health status, disability
       and wellbeing.
    o Health inequities: determinants, coverage of use of services, and health outcomes,
       and including key stratifies such as sex, socioeconomic status, ethnic group and
       geographical location.
•   A good health information system brings together all relevant partners to ensure that
    users of health information have access to reliable, authoritative, usable,
    understandable and comparative data.

STEP 3: Components of Health Management Information System
(30 Minutes)

•   There is clear value in defining what constitutes a health information system and how
    its components interact with one another to produce better information for better
    decisions and better health.
•   HMIS is build-up with six components and these components are further grouped into
    three elements which are: inputs, processes, and outputs.
•   Inputs refer to resources.
•   Processes touch on how indicators and data sources are selected and data are collected
    and managed.
•   Outputs deal with the production, dissemination, and use of information.

The six components of a health information system
• Inputs
   o Health information system resources. These consist of the legislative, regulatory,
        and planning frameworks required to ensure a fully functioning health information
        system, and the resources that are prerequisites for such a system to be functional.
        ▪ Such resources involve personnel, financing, logistics support, information and
           communications technology (ICT), and coordinating mechanisms within and
           among the six components.
• Processes

                                             110

    o   Indicators. A core set of indicators and related targets for the three domains of
        health information is the basis for a plan and strategy for a health information
        system.
        ▪ Indicators need to encompass determinants of health; health system inputs,
           outputs, and outcomes; and health status.

    o   Data sources can be divided into two main categories:
        ▪ Population-based approaches: censuses, civil registration, and population
           surveys
        ▪ Institution-based data: individual records, service records, and resource
           records.
    o Data management. This covers all aspects of data handling: collection, storage,
        quality-assurance, flow, processing, compilation, and analysis.
•   Outputs
    o Information products. Data must be transformed into information that will
        become the basis for evidence and knowledge to shape health action.
    o Dissemination and use. The value of health information can be enhanced by
        making it readily accessible to decision makers (giving due attention to
        behavioural and organizational constraints) and by providing incentives for
        information use.

STEP 4: The Importance of Health Management Information
System (30 minutes)
•   Monitoring Performance
    o Any project or programme in the health sectors has goals to be met within a
      specific period of time.
    o In order to monitor if the goal is being reached, or has been reached, information is
      required.
    o Similarly, the Ministry of Health including vertical programme needs information
      to monitor improvement of health care delivery.
    o In order to obtain this information, there is need of having a health information
      system, which will ensure that information is obtained in the manner required by
      the planners and mangers.

•   Planning
    o In order to utilize limited resources adequately one needs to plan.
    o How can one know that project A needs more funding than project B, it is only
       through an adequate health information system that can be able to determine this.
    o Allocation of human and non-human resources in health sector needs data.



                                            111

    o Formulation of health policies in health sector needs accurate and adequate data
      from health facilities and communities.

•   Coordinating
    o In order to coordinate activities carried out by various national health programmes
      and Non-Governmental organization, there is a need of having a Health
      Information System.
    o Through HIS, the Ministry of health can be able to determine if the programmes
      and Non- Governmental Organization `s are performing their roles as expected.

STEP 5: The Performance Indicators of Health Management
Information System (30 minutes)
•   Indicators of country health information system performance can be categorized into
    two types:
    o Indicators related to data generation using core sources and methods: health
        surveys, civil registration, census, facility reporting, and health system resource
        tracking.
        ▪ These reflect country capacity to collect relevant data at appropriate intervals
            and use the most appropriate data sources.
        ▪ Benchmarks include periodicity, timeliness, and contents of data collection
            tools and availability of data on key indicators.
    o Indicators related to country capacities for synthesis, analysis and validation of
         data.
        ▪ These measure key dimensions of the institutional frameworks needed to
            ensure data quality, including independence, transparency and access.
        ▪ Benchmarks include the availability of independent coordination mechanisms
            and the availability of micro-data and metadata.

STEP 6: Key Points (5 minutes)
• The data collection system designed to support planning, management, and decision
  making in health facilities and organizations is called HMIS.
• A health information system resources, indicators, data sources, data management,
  information products, use and dissemination of health information are six components
  of HMIS.
• Monitoring performance, planning and coordination are the main importance of HMIS
  in the health sector industry.

STEP 7: Evaluation (5 minutes)
• What is Information System (IS)?
• What is a Health Information System (HIS)?

                                            112

• What is Health Information Management (HIM)?
• What is a Health Management Information System (HMIS)


STEP 7: Take Home Assignment (5 minutes)
 Activity: Take Home Assignment

 DIVIDE students into small manageable groups.

 ASK the students to work on the following assignment

 •      List key performance indicators of HMIS

 ALLOW group to work for two days and submit the task after scheduled
 time.

 CONDUCT general discussion by asking groups to present one of these
         questions for not less than 5 minutes.

 SUMMARIZE the activity using training guidelines.




                                        113

References

Davis A. (2014). Health Information Technology. 3rd Ed. Elsevier Health Science
  Publisher. USA.

Balgrosky A. J. (2014). Essentials of Health Information Systems and Technology. Jones
  & Bartlett Publishers.

Huffman, R.A.A. Edna, K. (1994). Health Information Management. Berwyn Illinois
  Company USA

Merida, L. Johns. (2007). Health Information Management Technology. 2nd ed . AHIMA
  Chicago, Illinois.

Wager A.K. (2013). Health Care Information Systems: A Practical Approach for Health
 Care Management. 3rd Ed. Wiley Brand Publishers, US.

WHO. (2008). Assessing the National Health Information System: An Assessment tool-
 Vesrion 4.00. Switzerland.

Winter A. (2011). Health Information Systems. Springer Publisher. New York City.

Wodon A. (2011). Health Information System. 2nd Ed. Editions L`Harmattan Publisher.
 Paris, France.

Embrey, M. A. (2013). MDS-3: Managing access to medicines and health technologies.
  Sterling, VA: Kumarian Press.




                                         114

Session 12: Management of Pharmaceutical
Information in Vertical Program

Total Session Time: 60 minutes

Prerequisites
• None

Learning Tasks
By the end of this session, students are expected to be able to:
• Define the term vertical programme
• Mention vertical programme existing in the country
• Explain the importance of pharmaceutical information management in vertical
    programmes

Resources Needed
• Flipcharts, marker pens, masking tape
• Black/whiteboard and chalk/white board markers
• Computer and LCD Projector

SESSION OVERVIEW
Step            Time     Activity/Method          Steps Title

                           Presentation,         Presentation of Session Title and Learning
          05 minutes
 1                                               Tasks
                           Presentation/
 2        10 minutes        Brainstorm           Definition of Vertical Programme


 3        10 minutes       Presentation          Vertical Programmes Existing in the Country

                                                 Importance of Pharmaceutical Information
 4        25 minutes       Presentation
                                                 Management in Vertical Programmes

 5        05 minutes       Presentation          Key Points

 6        05 minutes       Presentation          Evaluation




                                           139

SESSION CONTENT

STEP 1: Presentation of Session Title and Learning Tasks (5
minutes)

READ the Learning Tasks to students

ASK students if they have any question before proceeding

STEP 2: Definitions of Vertical Programme (10 Minutes)

Activity: Brainstorm (02 minutes)

ASK student what is ―vertical programme‖?

ALLOW few students to respond.

WRITE their responses on the board/flip chart.

SUMMARISE using the content below.

Vertical programme
• A vertical programme is a programme which targets one particular disease.
• A vertical program might focus on malaria from the bottom where members of
  community leave and go on up to the level where planners, evaluators and decision
  makers making decision of a particular case.
• Vertical programme deals with removing the places where mosquitoes breed,
  protecting the houses where the people live, educating people about how to avoid
  malaria, establishing clinics where malaria can be diagnosed and treated, and finally,
  finding medications to cure the disease, and so on.
• It is one system all focused on the same disease.
• It's vertical because it goes from the ground; where people who have the disease leave,
  up to the level where the doctors and scientists try to develop new cures.
• A horizontal program might focus on all tropical diseases, or in fact all diseases.
• A horizontal approach might consist of equipping a clinic to treat every kind of disease
  and health problem in the region.




                                           140

STEP 3: The Vertical Programmes Existing in the Country (10
Minutes)
Tanzania vertical health programmes:
• Reproductive Health Program
• National Aids Control Program
• National Immunization Program
• National TB / Leprosy Program


STEP 4: The Importance of Pharmaceutical Information
Management in Vertical Programmes (25 minutes)
•  The pharmaceutical management information system (PMIS) integrates
   pharmaceutical data collection, processing, and presentation of information that helps
   staff at all levels of country`s health system to make evidence-based decisions and
   manage pharmaceutical services.
• Any firm in the pharmaceutical industry requires efficient and effective management
   information systems (MIS) to support managerial functions.
• In 1996 and for the purpose of improve the efficiency of Health sector, the
   government integrated MSD logistics functions operations with all Vertical Programs.
• The integrated functions were:-
   o Coordination of procurement, Storage and Distribution of program medicines,
       Medical Supplies and Laboratory Reagents.
   o Managing receipts of all Medicines, Medical Supplies and Laboratory Reagents
       supplied by different programs and development Partners (Global Fund, UNICEF,
       World Health Organization and USAID).
   o Give timely report to the programs on stock status to programs and development.
• The importance of PMIS in vertical programmes:
  o The integration strengthened Vertical Programs services likewise lowered the
       operations costs of programs and resulted into increase the availability of VP
       Medicines, Medical Supplies and Laboratory Reagents to the health facilities.
  o A good PMIS provides the necessary information to make sound decisions in the
       pharmaceutical sector.
  o Effective pharmaceutical management requires policymakers, program managers,
       and health care providers to monitor information related to patient adherence,
       drug resistance, availability of medicines and laboratory supplies, patient safety,
       post-market intelligence, product registration, product quality, financing and
       program management, among other issues.
  o Coordinating the elements of a pharmaceutical supply system requires
       relevant, accurate, and timely information.



                                           141

  o    Increased funding for HIV/AIDS, tuberculosis, and immunization programs has
       contributed to the need for accurate and timely information on a variety of
       parameters that affect the ability to conduct accurate quantification, procurement
       planning, budgeting, resource mobilization and program management.


STEP 5: Key Points (5 minutes)
• Vertical health programme deals with specific health issues like Malaria cases
• Cost and effective distribution and availability of medication was improved after the
  integration of pharmaceutical management information system and vertical
  programmes

STEP 6: Evaluation (5 minutes)
• What is a vertical health programs?
• What is the main vertical health programmes found in Tanzania?




                                           142

References

MSD. (2018). Vertical programs services. Accessed: 08.09.2018. Available from:
 www.msd.go.tz

WHO. (2005). Vertical-horizontal synergy of health workforce. Netherlands. Available
 from: www.who.int/bulletin/volumes/83/4/editorial10405/en

Embrey, M. A. (2013). MDS-3: Managing access to medicines and health technologies.
  Sterling, VA: Kumarian Press.

Abdelhak M. (2014). Health Information: Management of Strategic Resources. 5th Ed.
  Elsevier Health Science Publisher.

Axelsson S. (2006). Understanding Intrusion Detection through Visualization. Springer
  Science & Business Media Publisher. Berlin/Heidelberg, Germany.

Davis A. (2014). Health Information Technology. 3rd Ed. Elsevier Health Science
  Publisher. USA.




                                         143

Session 13: Networking Programmes in Dissemination
of Pharmaceutical Information
Total Session Time: 60 minutes

Prerequisites
• None

Learning Tasks
By the end of this session, students are expected to be able to:
• Explain the importance of networking in dissemination of pharmaceutical information
• Explain the networking programmes used in dissemination of pharmaceutical
    information
• Disseminate pharmaceutical information (PRACTICAL)

Resources Needed
• Flipcharts, marker pens, masking tape
• Black/whiteboard and chalk/white board markers
• Computer and LCD projector

SESSION OVERVIEW
Step            Time     Activity/Method          Steps Title

                           Presentation,         Presentation of Session Title and Learning
          05 minutes
 1                                               Tasks
                           Presentation/
                                                 Utilization of Networking Programs in
 2        10 minutes        Brainstorm
                                                 Disseminating Pharmaceutical Information

                                                 Networking Programs used in Disseminating
 3        30 minutes       Presentation
                                                 Pharmaceutical Information

 4        05 minutes       Presentation          Key Points

 5        05 minutes       Presentation          Evaluation

 6        05 minutes       Presentation          Assignment




                                           144

SESSION CONTENT
STEP 1: Presentation of Session Title and Learning Tasks (5
minutes)

READ the Learning Tasks to students

ASK students if they have any question before proceeding

STEP 2: Utilization of Networking Programs in Disseminating
Pharmaceutical Information (10 Minutes)

Activity: Brainstorm (02 minutes)

ASK student what is a ―Networking‖?

ALLOW few students to respond.

WRITE their responses on the board/flip chart.

SUMMARISE using the content below.

Networking
• A network, in computing, is a group of two or more devices that can communicate.
• A network is comprised of a number of different computer systems connected by
   physical and/or wireless connections.
• The scale can range from a single PC sharing out basic peripherals to massive data
   centers located around the World, to the Internet itself.
• All networks allow computers and/or individuals to share information and resources.
• Computer networks serve a number of purposes, some of which include:

    o   Communications such as email, instant messaging, chat rooms, etc.
    o   Shared hardware such as printers and input devices
    o   Shared data and information through the use of shared storage devices
    o   Shared software, which is achieved by running applications on remote computers

Importance of networking technology in pharmaceutical health information system

•   Using computer networking technology in pharmacy is very useful for the
    pharmaceutical profession.


                                          145

•   The following are the benefits of pharmaceutical networking technology in healthcare
    industry:
    o It improves the pharmacists work, especially in acquisition of consumable and non-
        consumable medical materials, deliveries of pharmaceutical materials, stock and
        inventory control.
    o It gives them more time to help the customers in the service area.
    o It reduces client waiting time, pharmaceutical expenditure and the manpower
        requirement for any kind of pharmaceutical work.
    o It facilitates sharing of information with other service area within the health facility
•   Networking computers helps to run business operations efficiently
    o They make it easier to handle the business tasks such as recording drugs, requesting
        consumable and non-consumable medical items, tracking and paying drugs and
        medication bills from insurance company, client/patients and other service user.
    o It helps to improve patient safety, provide quality of care, monitoring efficacy and
        safety of medicine in use.
    o It gives updates of prices and other pharmaceutical product information online.
    o It is used in online and e-prescribing of medication.

STEP 3: The Networking Programs Used in Disseminating
Pharmaceutical Information (30 Minutes)
•   There are several different types of computer networks used in information
    communication.
•   Computer networks can be characterized by their size as well as their purpose.
•   Networks based on size are:
    o Personal area network (PAN): a computer network organized around an
       individual person within a single building like small office.
    o Local area network (LAN): used for single sites where people need to share
       resources among themselves but not with the rest of the outside world.
    o Metropolitan area network (MAN): a computer network across an entire city,
       college campus or small region.
    o Wide area network (WAN): occupies a very large area, such as an entire country
       or the entire world.
•   Networks based on their main purpose are:
    o Storage area network (SAN): a high-speed sub network of shared storage
       devices.
    o Enterprise private network (EPN): a computer network built by a business to
       interconnect its various company sites (such as production sites, offices and
       shops) in order to share computer resources.
    o Virtual private network (VPN)
       ▪ An encrypted connection over the Internet from a device to a network.


                                             146

       ▪ The encrypted connection helps ensure that sensitive data is safely transmitted.
       ▪ It prevents unauthorized people from eavesdropping on the traffic and allows
           the user to conduct work remotely.
•   Health Level Seven (HL7) allows computer systems to send and receive
    pharmaceutical information to each other in secure way.
    o Pharmacies, physician office, health care sites and facilities can exchange
       pharmaceutical information through this information exchange standards.
•   The following are Health information systems (HIS) used to disseminating/ sharing
    pharmaceutical information through networking system:
    o Pharmacy information system
    o Computerized Physician Order Entry (CPOE) system
•   Pharmacy information system (PIS)
    o The PIS is system that supports the distribution and management of drugs,
       identifying the type of intervention, determining the amount of inventory,
       reporting and managing of costs, and improving the accessibility of information.
    o The PIS helps clinical decision-making by alerting users about clinically
       important drug-drug interactions, drug allergies, and drug doses; it also evaluates
       patterns of drug use as well as other possible side effects of drugs.
    o The PIS may operate as a separate and individual system or as part of a hospital
       information system (HIS), paired with the Computerized Physician Order Entry
       (CPOE) system.
•   Computer physician order entry (CPOE) system
    o CPOE is the process of a medical professional entering medication orders or
       other physician instructions electronically instead of on paper charts.
    o A primary benefit of CPOE is that it can help reduce errors related to poor
       handwriting or transcription of medication orders.
    o CPOE systems allow providers electronically to specify medication orders as well
       as laboratory, admission, radiology, referral, and procedure orders.
    o CPOE systems and Clinical Decision Support (CDS) system can improve
       medication safety and quality of care and reduce costs of care.
•   HL 7 and system interoperability facilitates data sharing/ dissemination from
    pharmacies, physician office, health facilities to users which is the ministry of health.
•   The system that is used to disseminate pharmaceutical information to ministry of
    health is DHIS 2 Software.




                                             147

STEP 4: Key Points (5 minutes)
• Networking software helps in sharing pharmaceutical information within and outside
  of the hospital setup.
• PIS and CPOE systems are pharmaceutical systems used to sharing information.
• HL 7 and interoperability facilitates data sharing from the source to users through
  networking system.

STEP 5: Evaluation (5 minutes)
• What is networking?
• What is the difference between CPOE and PIS?
• What is interoperability?

STEP 6: Take Home Assignment (5 minutes)

Activity: Take Home Assignment

TELL the student to answer the following question:
   • Disseminate a rare drug side effect that has just occurred to a patient
     after consuming ALLU to your other staff connected to a Local Area
     Network (make sure student understand the background of
     establishing a LAN)
DIVIDE students into small manageable groups.

ALLOW group to work for t 1 day and submit the task after scheduled
time.

CONDUCT each group to present how they handled the activity for not
        less than 5 minutes.

SUMMARIZE the activity using training guidelines.




                                           148

References
MoHSW, Strengthening Health Information System, Government printers, Dar es
 Salaam

International Council on Archives (1999), Managing Public Sector Records,
   Understanding computers an over view for records and archives: International
   Records Management Trust London

Abdelhak M. (2014). Health Information: Management of Strategic Resources. 5th Ed.
  Elsevier Health Science Publisher.

Aycock J. (2006). Computer Viruses and Malware. Springer International Publisher.
  USA.

Couglas J.D. (2003). The Backup Book: Disaster Recovery from Desktop Data Center.
  3rd Ed. Network Frontiers, LLC. US.

Davis A. (2014). Health Information Technology. 3rd Ed. Elsevier Health Science
  Publisher. USA.

Miller M. (2009). The Complete Idiot`s Guide to Search Engine Optimization. Alpha
  Books Publisher. US.

Bagad S. V, Dhotre A. I. (2009). Computer Networks. Technical Publications. Brown R.
  T. (2006). Handbook of Institutional Pharmacy Practice. 4th Ed. University of
  Mississippi. USA.

Dixon E. Brian, Zafar A. (2009). Inpatient Computerized Provider Order Entry (CPOE).
  ARRQ National Resources Center for Health Information Technology. USA

Mitchell S. H, Veltri M. A, Kim G. R. (2009). Dispensing: pharmacy information
  systems. Pediatric informatics. New York (NY): Springer.

Shortliffe E. H, Cimino J. J. (2006). Biomedical informatics: computer applications in
  health care and biomedicine. 3rd ed. New York (NY): Springer.

Wager K.A, Lee F.W, Glaser J. P. (2009). Managing health care information systems: a
 practical approach for health care executives. 2nd ed. San Francisco (CA): Jossey-
 Bass.

Wolper L. F. (2004). Health care administration: planning, implementing, and
 managing organized delivery systems. 4th ed. Boston (MA): Jones & Bartlett
 Publishers.




                                         149

Session 1: Organization of Health Related Data Using
Computer Packages

Total Session Time: 120 minutes

Prerequisites
• None

Learning Tasks
By the end of this session students are expected to be able to:
• Explain concepts of electronic data storage and arrangement
• Demonstrate electronic filing and application of security to electronic data
• Explain the methods of summarizing data

Resources Needed
• Flip charts, marker pens, and masking tape
• Black/white board and chalk/whiteboard markers
• Computer and LCD projector
• Antivirus disc
• Peripheral storage devices
• Worksheet 1.1: The difficulties in patient registration process




                                            1

SESSION OVERVIEW
Step        Time        Activity/Method          Step Title

    1    05 minutes          Presentation        Introduction, Learning Tasks
                            Brain storming
    2    05 minutes                              Definition of Data Storage
                             Presentation
                            Brain storming
    3    25 minutes                              Electronic Data Storage and Management
                             Presentation
                                                 Electronic Filing and Application of
    4    35 minutes          Presentation
                                                 Security to Electronic Data
    5    35 minutes          Presentation        Methods of Summarizing Data
    6    05 minutes          Presentation        Key points
    7    05 minutes          Presentation        Evaluation

    8    05 minutes          Presentation        Assignment


SESSION CONTENTS

STEP 1: Presentation of Session Title and Learning Tasks (05 minutes)

READ or ASK students to read the learning tasks

ASK students if they have any questions before continuing

STEP 2: Definition of Data Storage (05 minutes)


Activity: Brain storming (2 minutes)

Ask students to brainstorm on the following question:

•   What is data storage?

ALLOW a few students to respond

WRITE their responses on the flip chart/ board

CLARIFY and SUMMARISE by using the content below


                                             2

•   Data storage
    o Data storage is the recording (storing) of information (data) in a storage medium.
    o Handwriting, phonographic recording, magnetic tape, and optical discs are all
       examples of storage media.


STEP 3: Electronic Data Storage and Management (30 minutes)

Activity: Brain storming (2 minutes)

Ask students to brainstorm on the following question:
• What is electronic data storage?
• What are the media and equipment used for electronic data storage?

ALLOW a few students to respond

WRITE their responses on the flip chart/ board

CLARIFY and SUMMARISE by using the content below

•   Electronic data storage is the means of storing soft data information in given format
    like Music, Video, Document or Pictures in a device which could be a flash disk or
    rather a hard disk drive
•   Electronic data storage requires electrical power to store and retrieve data.
•   Data stored in a digital machine-readable medium is sometimes called digital data.
•   Computer data storage is one of the core functions of a general purpose computer.
•   Electronic documents can be stored in much less space than paper documents.
•   Barcodes and magnetic ink character recognition (MICR) are two ways of
    recording machine-readable data on paper.
•   Three common types data storage are: hard drive, USB flash drive and memory card.

•   Hard drive (HD)
    o The term "hard drive" is actually short for "hard disk drive."
    o The term "hard disk" refers to the actual disks inside the drive.
    o The hard drive is a non-volatile memory hardware device that permanently stores
       and retrieves data on a computer.
       ▪ Non-volatile memory is a term used to describe any memory or storage that is
         saved regardless if the power to the computer is on or off.


                                            3

      ▪ The best example of non-volatile memory and storage is a computer hard
        drive, flash memory, and ROM.
    o A hard drive is a secondary storage device that consists of one or more platters to
      which data is written using a magnetic head, all inside of an air-sealed casing.
    o A typical hard drive is only slightly larger than a human hand and can hold over
      100 GB of data.

•   USB flash drive
    o A USB flash drive is a device used for data storage that includes a flash memory
      and an integrated Universal Serial Bus (USB) interface.
    o Most USB flash drives are removable and rewritable.
    o Physically, they are small, durable and reliable.
    o The larger their storage space, the faster they tend to operate.
    o USB flash drives are mechanically very robust because there are no moving parts.
    o They derive the power to operate from the device to which they are connected
      (typically a computer) via the USB port.
    o A USB flash drive may also be known as a flash drive or USB drive.

•   Memory card
    o A memory card is a type of storage device that is used for storing media and data
        files.
    o It provides a permanent and non-volatile medium to store data and files from the
        attached device.
    o Memory cards are commonly used in small, portable devices, such as cameras and
        phones.
    o The most common type of data that’s being stored on a memory card include
        videos, pictures, audio and other types of file formats.
    o Some of the most popular forms of memory cards are:
        ▪ Secure Digital (SD) card
        ▪ CompactFlash (CF) card
        ▪ Smart Media
        ▪ Memory Stick
        ▪ Multi Media Card (MMC)
•   In the healthcare system, data are store in the electronic systems, and these systems
    are called electronic health records (EHR) and electronic medical records (EMR)

•   Electronic Health Records
    o An electronic health record (EHR) is a digital version of a patient’s paper chart.




                                              4

    o It contains a patient’s medical history, diagnoses, medications, treatment plans,
      immunization dates, allergies, radiology images, and laboratory and test results in
      electronic format.
    o It is health information that is created and managed by authorized providers in a
      digital format capable of being shared with other providers across more than one
      health care organization.

•   Electronic Medical Records
    o Electronic medical records (EMRs) are a digital version of the paper based
       charts/form in the clinician’s office.
    o EMR contain medical information used by clinicians mostly for diagnosis and
       treatment..
    o An EMR contains the medical and treatment history of the patients in one practice.
    o Information in EMRs cannot easily be shared out of the medical practice.
    o The patient’s record can easily be printed out and shared with other members of the
       care team.

STEP 4: Filing and Application of Security to Data (35 minutes)

•   Retrieval
    o Paper Based System
       ▪ During normal business hours requests for thinned or discharged health records
         should be coordinated through the HIM staff.
       ▪ It is recommended that a process be in place to track the locations and holders
         of the health record.
       ▪ This can be accomplished through a record check out system.
       ▪ A reasonable length of time should be identified for which a record can be
         checked out.

    o Hybrid or Electronic System
      ▪ Appropriate access levels should be given based on the needs of the staff
        member to perform their job.
      ▪ Completed records upon discharge would be locked and only available as read-
        only.
      ▪ There should be a limited number of staff members with printing capabilities.

    o After Hours Retrieval – Paper Based System
      ▪ Every facility should have a process in place for after hour retrieval of records
        in case of an emergency.



                                              5

       ▪ Because evening and night shift staff may have to complete deficient discharge
         records or have access to an overflow record, the supervisor should have keys to
         access the department and be trained in retrieval, the sign-out process, and other
         security measures.
       ▪ Department procedures should track who has keys to the department and
         documentation of their training on filing and retrieval procedures.

    o After Hours Retrieval – Hybrid or Electronic System
      ▪ If using a hybrid or electronic health record consider if parts of the electronic
        health record need to be printed during the duration of the stay or upon
        discharge.
      ▪ This will depend on how the health record is defined within the organization
        and electronic storage capabilities.

•   Filing
    o Paper based system
        ▪ Filing of all documents that should be part of the complete health records are
          added to the discharge record, preferably prior to completion.
        ▪ As with the addition of any document to the record, care should be taken to
          verify the resident name prior to inserting the document in the record.

    o Hybrid system
      ▪ The facility policies and procedures should determine which parts of the record
        will be paper based and which parts are stored in a data repository.
      ▪ This policy should also determine whether or not additional documents should
        be added as paper based documents or scanned into the data repository.
      ▪ If documents are added to the electronic portion of the record after this has been
        completed, these should be added as addendums.

    o Electronic record
      ▪ The facility policies and procedures should allow for the capture of additional
        material for the electronic record through a system of scanning to the file.
      ▪ If the record has been determined to be complete and additional paperwork is
        discovered, these documents should be added as addendums.
      ▪ The electronic system should be able to separate the active from the inactive
        record within the data base

•   Ways of improve electronic patient data security
    o Do a security risk assessment



                                             6

   ▪ Information security risk assessment is an on-going process of discovering,
     correcting and preventing security problems.
   ▪ The risk assessment is an integral part of a risk management process designed to
     provide appropriate levels of security for information systems.
   ▪ Security risk assessments must be performed annually to meet the criteria of the
     meaningful use of an HER

o Encrypt data
  ▪ Encryption is the process of encoding a message or information in such a way
    that only authorized parties can access it and those who are not authorized
    cannot.
  ▪ Patient data should be encrypted whenever possible
  ▪ Antivirus programs and firewalls to defend the privacy and security of data
    should be installed in the system
  ▪ Use password to protect data from being accessed with unauthorized persons

o Control system access
  ▪ Access control is a key component of patient data security.
  ▪ There are two main types of access control: physical and logical.
  ▪ Physical access control limits access to buildings, rooms and physical IT assets
    where patient data are stored.
  ▪ Logical access limits connections to computer networks, system files and health
    data.

o Authenticate users
  ▪ Authentication is the process of recognizing a user’s identity.
  ▪ Authentication process can be described in two distinct phases: identification
    and actual authentication.
  ▪ Identification phase provides a user identity to the security system and this
    identity is provided in the form of a user ID.
  ▪ An actual user can be mapped to other abstract user object in the system, and
    therefore be granted rights and permissions to the user and user must give
    evidence to prove his identity to the system.
  ▪ The process of determining claimed user identity by checking user-provided
    evidence is called authentication and the evidence which is provided by the user
    during process of authentication is called a credential.

o Use and scan audit logs
  ▪ An audit log is a document that records an event in an information (IT)
    technology system.


                                       7

       ▪ It is a security-relevant chronological record, set of records, destination and
         source of records that provide documentary evidence of the sequence of
         activities that have affected at any time a specific operation, procedure, or event.
       ▪ It documents what resources were accessed; audit log entries usually include
         destination and source addresses, timestamp and user login information.
       ▪ EHRs have audit logs that record which user did what in the EHR and when.
       ▪ Most of hospitals that practices EHR were using their audit logs or another
         feature designed to prevent people from tampering with the logs to erase the
         signs of an intruder.
       ▪ EHR practices need software that automatically scans their audit logs to detect
         anomalies that might indicate a cyber-attack, such as an unfamiliar user or a
         known user logging on at an unusual time of the day.

    o Back up data off site
      ▪ An offsite backup is a backup process or facility that stores backup data or
        applications external to the organization or core IT environment.
      ▪ It is similar to a standard backup process, but uses a facility or storage media
        that is not physically located within the organization's core infrastructure.
      ▪ The institution that practices EHR should have off site backup, both for security
        purposes and also for the case of natural disasters.

STEP 5: Methods of Summarizing Data (35 minutes)
•   Table, Graph and charts are commonly used in presenting and summarizing data
•   Table (Tabulation)
    o The process of placing classified data into tabular form is known as tabulation
    o A table is a symmetric arrangement of statistical data in rows and columns
    o Rows are horizontal arrangements whereas columns are vertical arrangements




                                             8

     Table 1: Number of patients admitted at Mount Meru hospital in the year 2011
                                                 NUMBER OF PATIENTS
                   AGE
     Below 35                                             1,280

     35-55                                                                                                   1,160

     Above 55                                                                                                300

     Total                                                                                                   2,740


•   Line graph
    o A line graph is a graphical tool used to present and compare two variables.
    o One variable is represented at X axis and other at Y axis.
    o The points given are plotted and are joined together by straight lines.

                                     Figure 1: Annual sales of a particular organization




•   Simple Bar chart
    o A simple bar chart is used to represents data involving only one variable classified
       on spatial, quantitative or temporal basis
                      Figure 2: Hospital Patients by unit
                                                         Hospital Patients by Unit
                                        5000


                                        4000
                 patients per year
                    Number of




                                        3000


                                        2000


                                        1000


                                           0
                                                           Emergency




                                                                                       Maternity




                                                                                                   Surgery
                                               Cardiac




                                                                           Intensive
                                                Care




                                                                             Care




                                                                       9

•   Multiple bar chart
    o A two or more sets of inter-related data are represented.
    o Multiple bar diagram facilities comparison between more than one phenomena.

     Figure 3: The number of Male and Female Cataract at Mwembetogwa ward

                                                           THE NUMBER OF MALE & FEMALE CATARACT
                                                       SCREENING AT MWEMBETOGWA WARD FROM 1991-1995


                                                       14000
                                                       12000
                                                       10000
                   NO. Clients




                                                        8000                                                                Male
                                                        6000                                                                Female
                                                        4000
                                                        2000
                                                               0
                                                                      1991    1992      1993       1994     1995
                                                                                      Years



•   Component bar chart
    o Sub-divided or component bar chart is used to represent data in which the total
      magnitude is divided into different or components

     Figure 4: The Diabetic Tablets produced from 1991-1994
                                                             THE DIABETIC TABLETS IN 100 gms/BOX PRODUCED FROM 1991-
                                                                                        1994

                                                       120


                                                       100
                                 Quantity in 100 gms




                                                        80
                                                                                                                Glimepiride
                                                                                                                Glyburide
                                                        60
                                                                                                                Glipizide
                                                                                                                Chlorpromide
                                                        40


                                                        20


                                                         0
                                                                   1991      1992           1993     1994
                                                                                    Years



•   Percentage component bar chart
    o Sub-divided bar chart may be drawn on percentage basis
    o This type of chart is useful to make comparison in components holding the
       difference of total constant




                                                                                    10

                Figure 5: Inpatient cases at Medical ward-MNH 1991-1994
                                             INPATIENT CASES IN HUNDRED AT MEDICAL WARD-MNH
                                                               FROM 1991-1994

                                             100%
                                             90%




                      Number of Cases in %
                                             80%
                                             70%
                                             60%                                                     MTA
                                             50%                                                     HIV/AIDS
                                             40%                                                     Malaria
                                             30%
                                             20%
                                             10%
                                              0%
                                                    1991      1992           1993         1994
                                                                     Years


•   Pie chart
    o Pie chart is named so, due to its similarity with pie and its slices.
    o Pie chart is a circular chart which is divided into sectors.
    o Each sector corresponds to different values of a data.
    o In pie charts, the percentage of each number is calculated and then obtained
        percentages are plotted at pie chart.
                              Figure 6: Hospital Patients by Unit
                                                              Hospital Patients by Unit
                                                                                    Cardiac
                                                                                     Care
                                                                                     12%




                                                                              Emergenc
                                                             Surgery             y
                                                              53%               25%

                                                                                         Intensive
                                                                                           Care
                                                                               Maternity    4%
                                                                                 6%



•   Histogram
    o A bar graph that displays the data from a frequency distribution
    o Horizontal Scale (x-axis) is labeled using CLASS BOUNDARIES or
       MIDPOINTS
    o Vertical Scale (y-axis) is labeled using frequency
    o Bars are contiguous (No gaps)




                                                               11

                              Figure 7: Time to complete blood transfusion
                                                     Time to Complete Blood Transfusion

                                  30

                               Fr 25
                               eq
                               ue 20
                               nc
                               y  15                                                                  Frequenc y

                                  10

                                     5

                                     0

                                         235.5    260.5     285.5   310.5    335.5   360.5

                                                                Minutes




•   Frequency polygon
    o It presented by using Line graph rather than a bar graph.
    o It uses class midpoints rather than class boundaries on x-axis
                Figure 8: Frequency polygon for Blood pressure data

                                             Frequency Polygon for B.P.

                                18

                                16

                                14

                                12
                  Frequency




                                10

                                 8

                                 6

                                 4

                                 2

                                 0
                                  92.5    106.5     120.5      134.5     148.5    162.5      176.5   190.5   204.5   218.5

                                                                       Systolic Pressure




•   Ogive
    o Line graph (rather than a bar graph)
    o Uses class boundaries on x-axis
    o Uses cumulative frequencies (total as you go) rather than individual class
       frequencies
    o Used to visually represent how many values are below a specified upper class
       boundary




                                                                    12

                                             Figure 9: Blood Pressure of fifty subjects

                                                           Blood Pressures of 50 Subjects

                                               60




                     Cummulative Frequency
                                               50

                                               40

                                               30

                                               20

                                               10

                                                0
                                                 99.5     127.5        155.5          183.5   211.5

                                                                  Systolic Pressure




STEP 6: Key Points (05 minutes)
•   Data are stored through recording in the storage media.
•   Hybrid electronic system is a filing technique that combined electronic records and
    paper-based records in data storage practices.
•   Data should be protected to avoid stolen of data by unauthorized person.
•   Diagram, graphs and number are the main techniques of summarizing health data.

STEP 7: Evaluation (05 minutes)
• What is electronic data storage?
• What is data security?
• What kind of data presented by using graph?
• What kind of data presented by using diagram?




                                                                  13

STEP 8: Assignment (05 minutes)

Activity: Group assignment

TELL the student to answer the following question:
• Describe the three main security measures that you can use to mitigate data
  management process at pharmacy information system.

DIVIDE students into small manageable groups.

ALLOW group to work for three days and submit the task after scheduled time.

CONDUCT general discussion by asking groups to present one of these questions for not
        less than 5 minutes.

SUMMARIZE the activity using training guidelines.




                                         14

References
Embrey, M. A. (2013). MDS-3: Managing access to medicines and health technologies.
  Sterling, VA: Kumarian Press.

MoHSW, Strengthening Health Information System, Government printers, Dar es Salaam

United Republic of Tanzania Ministry of Health and Social Welfare, Strategy for
   Development and Implementation of an Integrated Logistics System for Essential
   Health Commodities: Government printers, Dar es Salaam

USAID | DELIVER PROJECT, Task Order 1. 2011. Tanzania: 2020 Supply Chain
     Modeling—Forecasting Demand from 2020–2024. Arlington, Va.

International Council on Archives (1999), Managing Public Sector Records,
    Understanding computers an over view for records and archives: International
    Records Management Trust London

Gartee R. (2011). Electronic Health Records + MEDCIN CD: Understanding and Using
   Computerizing Medical Records. 2nd Ed. Pearson. USA

Gerda Koch. (2000). Basic allied health statistics and analysis. 2nd Ed. Thomson Delmar
   learning. USA.

Gupta, P. (2000). Mathematical Statistics. New Delhi Publisher, India

Gupta, P. (2006). Statistical Methods. New Delhi Publisher, India

J. Jothikumar. (2005). Statistics: Higher secondary-First year. 1st Ed. Tamilnadu
    Textbook Corporation. Chennai.

Pietka E et al. (2016). Information Technology in Medicine. 1st Ed. Springer International
    Publishing. USA.

Thanki S. (2018). Medical Imaging and Its Security in Telemedicine Applications. 1st Ed.
   Springer International Publisher. USA.




                                            15

             Worksheet 1.1: The difficulties in patient registration
             process



Worksheet 1.1: The importance of digitalizing pharmaceutical data

Instructions: This is a take home exercise that should be done by all students
individually.

Finished work should be collected and handed over to the tutor. Time for collection will
be discussed and agreed in class.



Instructions: Answer the question below

Explain the importance of digitalizing pharmaceutical data in the healthcare industry.




                                            16

Session 3: Creation of Table from Health Data Using
Spreadsheet

Total Session Time: 120 minutes

Prerequisites
• None

Learning Tasks
By the end of this session students are expected to be able to:
• Explain Microsoft Excel formula
• Use Microsoft Excel formulas to analyse data in a table
• Explain Microsoft excel function (function wizard)

Resources Needed
• Flip charts, marker pens, and masking tape
• Black/white board and chalk/whiteboard markers
• Computer and LCD projector

SESSION OVERVIEW
 Step         Time        Activity/Method Content

   1       05 minutes        Presentation     Introduction, Learning Objectives
                           Presentation/
   2       05 minutes                         Formulas for Microsoft Excel
                           Demonstration
                           Presentation/      Analysis of data using Microsoft excel
   3       45 minutes
                           Demonstration      formulas
                           Presentation/
   4       45 minutes                         Microsoft excel functions (Function wizard)
                           Demonstration
   5       05 minutes       Presentation      Key Points

   6       05 minutes       Presentation      Evaluation

   7       05 minutes       Presentation      Assignment




                                             29

SESSION CONTENTS

STEP 1: Presentation of Session Title and Learning Tasks (05 minutes)

READ or ASK students to read the learning tasks

ASK students if they have any questions before continuing.

STEP 2: The Formulas for Microsoft Excel (05 minutes)

Microsoft Excel Formulas

• A formula is an expression made up of cell addresses and arithmetic operators.
• Formulas can also be made up of discrete values i.e. =6*3.
• Excel evaluates the formula to a value.
• An example of a formula looks as follows.

                             =A2 * D2 / 2

WHERE,

• "=" tells Excel that this is a formula, and it should evaluate it.
• "A2" * D2" makes reference to cell addresses A2 and D2 then multiplies the values
  found in these cell addresses.
• "/" is the division arithmetic operator
• "2" is a discrete value




                                            30

STEP 3: The Analysis of Data Using Microsoft Excel Formulas (50
minutes)

Application of Microsoft Formula in analysis of data in the table

•   Use the following data to practice Ms Excel formulas

         Table 2: Home supplies budget
        S/N ITEM           QTY PRICE               SUBTOTAL Is it Affordable?
        1     Mangoes         9      600
        2     Oranges         3     1200
        3     Tomatoes        1     2500
        4     Cooking Oil     5     6500
        5     Tonic Water    13     3900

        Table 3: House building project schedule
        S/N ITEM                START DATE END DATE                   DURATION
                                                                      (DAYS)
        1      Survey land             04/02/2015       07/02/2015
        2      Lay foundation          10/02/2015       15/02/2015
        3      Roofing                 27/02/2015       03/03/2015
        4      Painting                09/03/2015       21/03/2015

Procedures for inserting formulas

•   Use home budget to calculate the subtotal.

    o   Create a new workbook in Excel
    o   Enter the data shown in the home supplies budget above.

•   Write the formula that calculates the subtotal

    o   Set the focus to cell E4
    o   Enter the following formula.

                        =C4*D4

WHERE,

•   "C4*D4" uses the arithmetic operator multiplication (*) to multiply the value of the
    cell address C4 and D4.

                                              31

•   The worksheet should look as follows.




• Press enter key
• The following result will appear on the worksheet




•   Auto select cell address and apply the same formula to other rows.




                                            32

•   Mistakes to avoid when working with formulas in Excel

    o Remember the rules of Brackets of Division, Multiplication, Addition, and
      Subtraction (BODMAS).

        ▪ This means expressions are brackets are evaluated first.
        ▪ For arithmetic operators, the division is evaluated first followed by
          multiplication then addition and subtraction is the last one to be evaluated.
        ▪ Using this rule, we can rewrite the above formula as = (A2 * D2) / 2.
        ▪ This will ensure that A2 and D2 are first evaluated then divided by two.

    o Formulas usually work with numeric data

        ▪ Take advantage of data validation to specify the type of data that should be
          accepted by a cell, such as numbers only.

    o To work with the correct cell, addresses referenced in the formulas; press F2 on the
      keyboard.

        ▪ This will highlight the cell addresses used in the formula.

                                             33

    o When working with many rows use serial numbers for all the rows and have a
      record count at the bottom of the sheet.

        ▪ Compare the serial number count with the record total to ensure formulas are
          included to all rows.

The common used excel formulas
• SUM formula: =SUM (C2,C3,C4,C5)
   o In excel, SUM formula is used to calculate the total number.
   o For instance here we had calculated the total number of computer items sold by
      using formula =SUM (C2,C3,C4,C5) at the end we get the total 20, 500, as
      shown in next formula.
   o In formula, inside bracket we have to mention the column or row number which
      we want to add.
                          Formula =SUM (C2,C3,C4,C5)




                            Results executed SUM = 20,500




•   Average Formula: = Average (C2,C3,C4,C5)
    o In excel, the average formula, is used to retrieve the average for any number.
    o Like we have calculated the average sales of computer across the country.
    o Highlights the formula, i.e., = Average (C2,C3,C4,C5) that we have applied for
       our data.




                                           34

•   SUMIF formula = SUMIF (A2:A7,“Items wanted”, D2:D7)
    o The Sum IF gives the total number of any items for selected ranges.
    o For instance here we want to calculate only the total sales amount for software
      items, to do that we will apply the formula as =SUMIF (A2:A7, “software”,
      D2:D7).
    o Here A2 and A7 defines the range for software and same way we can find sales
      amount for hardware. (A2:A7, “hardware”, D2:D7).

                      Software




                      Hardware




                                           35

    o The total sale amount of hard-ware and soft-ware in the table are as follows:




•   COUNTIF Formula: COUNTIF(D2:D7, “Function”)
    o COUNTIF function offers wide application.
    o Here we have taken a simple example of COUNTIF function, where our motive is
      to find the total number of cells whose value is greater than 3000.
    o Apply the formula =COUNTIF(D2:D7,”>3000”).




    o The total number of cells that has value greater than 3000.




                                           36

•   Concatenate Function: =CONCATENATE(C4,Text, D4, Text,…)
    o Concatenate function is used in excel to connect different segment or text to
       display as a single sentence.
    o For example, here we want to display text as ―NewYork has the highest sale of
       12000 dollars‖
    o For that we will use the formula =CONCATENATE(C4,‖has the highest sale
       of‖,D4,dollar‖).




    o The formula can execute the following results




                                          37

•   INT Formula: INT (this number)
    o Int formula is used to remove integer from the number like we have demonstrated
       over here in below example.




•   MAX Formula: =MAX(D2:D7)
    o This excel formula will retain the cells that have the highest value in the column.
    o For example, here we want to know the highest value for computer items, and it
      retains the value 12000.
    o We can execute the same formula to get a minimum value
      ▪ In the formula we have to replace MAX with MIN.




    o The highest value in the column


                                            38

•   Factorial Formula= FACT(number)
    o Factorial formula will return the factorial of the number.
    o To know the factorial number for 3, we use this formula.
    o We can use this formula to know the probability for any number
    o Here we will have factor 3=3x2x1.

                                              3!




                                   Results of 3!= 6




•   VLookup Formula = VLookup (value, range, and get me value in the column, is
    my list sorted)
    o VLookup formula is used when we know the detail of any object or person and,
       retain other formation based on that detail.



                                         39

    o For example here we have an example of the keyboard, where we know the retail
      price of the keyboard but we don’t know how much total sale it made in
      California by selling keyboard.
    o To know that we will use =VLookup(20,D2:D7,2,False).
    o This formula will give us the total sale amount based on the retail price.
    o While applying this formula we have to ensure that whatever we are placing as
      ref, must be unique, for example looking for any particular employee with its ID
      number it should not be allotted to others otherwise it will show an error.




                                    D7 and not E7

    o When formula is executed, the total sale amount shown is 2500




•   IF function formula: IF (E2>2000, correct/Incorrect)
    o Here we have used IF function

                                          40

   o This function is used when we want to refer whether the following condition met
     is correct or incorrect.
   o Here we have used ―good‖ as any sales made greater than 2000 should be
     remarked as good.
   o Likewise, we can set this as ―bad‖, ―correct‖ or ―incorrect‖.




   o Below table shows when we applied our formula it highlighted cell as ―good‖.




   https://career.guru99.com/wp-content/uploads/2014/10/if_function_formula_1.png

STEP 4: The Microsoft Excel Functions (Function Wizard) (45 minutes)

Ms Excel Function (Function Wizard)
• A function is a predefined formula.
• Functions allow to use descriptive names and automatically apply formulas for data
   analysis.
• Examples of functions include:
   o SUM for summation of a range of numbers

                                         41

     o AVERAGE for calculating the average of a given range of numbers
     o COUNT for counting the number of items in a given range

The importance of functions
• Functions increase user productivity when working with excel.
   o Let's say we would like to get the grand total for the above home supplies budget.
   o To make it simpler, we can use a formula to get the grand total.
   o Using a formula, we would have to reference the cells E4 through to E8 one by
      one.


     o We would have to use the following formula.

                               = E4 + E5 + E6 + E7 + E8

     o With a function, we would write the above formula as:

                               =SUM (E4:E8)

     o As we can see from the above function used to get the sum of a range of cells, it is
       much more efficient to use a function to get the sum than using the formula which
       will have to reference a lot of cells.

Common functions
S/N    FUNCTION         CATEGORY         DESCRIPTION              USAGE


01     SUM              Math & Trig      Adds all the values in   =SUM(E4:E8)
                                         a range of cells


02     MIN              Statistical      Finds the minimum        =MIN(E4:E8)
                                         value in a range of
                                         cells


03     MAX              Statistical      Finds the maximum        =MAX(E4:E8)
                                         value in a range of
                                         cells




                                             42

04    AVERAGE       Statistical   Calculates the average   =AVERAGE(E4:E8)
                                  value in a range of
                                  cells


05    COUNT         Statistical   Counts the number of     =COUNTS(E4:E8)
                                  cells in a range of
                                  cells


06    LEN           Text          Returns the number of    =LEN(B7)
                                  characters in a string
                                  text


07    SUMIF         Math & Trig   Adds all the values in   =SUMIF(D4:D8,">=
                                  a range of cells that    1000",C4:C8)
                                  meet a specified
                                  criteria


08    AVERAGEIF     Statistical   Calculates the average   =AVERAGEIF(F4:F
                                  value in a range of      8,"Yes",E4:E8)
                                  cells that meet the
                                  specified criteria


09    DAYS          Date & Time   Returns the number of    =DAYS(D4,C4)
                                  days between two
                                  dates


10    NOW           Date & Time   Returns the current      =NOW()
                                  system date and time



Numeric functions
S/N   FUNCTION      CATEGORY      DESCRIPTION                USAGE




                                      43

1     ISNUMBER    Information   Returns true if the          =ISNUMBER(A3)
                                supplied value is numeric
                                and false if it is not
                                numeric


2     RAND        Math & Trig   Generates a random           =RAND()
                                number between 0 and 1


3     ROUND       Math & Trig   Rounds off a decimal         =ROUND(3.14455,2)
                                value to the specified
                                number of decimal points


4     MEDIAN      Statistical   Returns the number in the    =MEDIAN(3,4,5,2,5)
                                middle of the set of given
                                numbers


5     PI          Math & Trig   Returns the value if Pi      =PI()


6     POWER       Math & Trig   Returns the result of a      =POWER(2,4)
                                number raised to a power


7     MOD         Math & Trig   Returns the remainder        =MOD(10,3)
                                when you divide two
                                numbers


8     ROMAN       Math & Trig   Converts a number to         =ROMAN(1984)
                                roman numerals



Date Time Functions
S/N   FUNCTION    CATEGORY      DESCRIPTION                  USAGE




                                    44

1    DATE           Date & Time     Returns the number that   =DATE(2015,2,4)
                                    represents the date in
                                    excel code


2    DAYS           Date & Time     Find the number of days   =DAYS(D6,C6)
                                    between two dates


3    MONTH          Date & Time     Returns the month from    =MONTH("4/2/2015")
                                    a date value


4    MINUTE         Date & Time     Returns the minutes       =MINUTE("12:31")
                                    from a time value


5    YEAR           Date & Time     Returns the year from a   =YEAR("04/02/2015")
                                    date value


VLOOKUP function
• The VLOOKUP function is used to perform a vertical look up in the left most column
  and return a value in the same row from a column that you specify.
• The home supplies budget has a serial number column that uniquely identifies each
  item in the budget.
• Suppose we have the item serial number, and we would like to know the item
  description, we can use the VLOOKUP function.
• Here is how the VLOOKUP function would be used.




                                         45

                     =VLOOKUP (C12, A4:B8, 2, FALSE)

WHERE,

•   "=VLOOKUP" calls the vertical lookup function
•   "C12" specifies the value to be looked up in the left most column
•   "A4:B8" specifies the table array with the data
•   "2" specifies the column number with the row value to be returned by the
    VLOOKUP function
•   "FALSE," tells the VLOOKUP function that we are looking for an exact match of
    the supplied look up value




                                         46

Computation of Mean using Excel functions
• First, open a new spreadsheet.
• Click on a blank cell where you will paste a function to calculate the mean, median or
  mode.
• Using the series fill function, enter the series of integer values 1 to 10 in cells A6 to
  A15.
•   Next click on the function wizard button.
•   From the drop down list Or select a category,
    select Statistical.
•   Click on Average to highlight it, then on OK.
•   Using the mouse, highlight the cells containing the
    data range just entered or you can select data by
    first clicking the collapse icons.




                                            47

                                                          These are the collapse icons and are used in
                                                        selecting ranges in many Excel dialogues.



                                                          Excel previews the result of applying the function
                                                        here.




•   Click OK.
•   The value of the mean will now appear in the blank cell you selected in step 2.

Computation of Median and Mode in the Excel functions
• To calculate the median or mode, follow the same procedure but highlight MEDIAN
  or MODE in step 4.
• Alternately you can enter the formulae directly into spreadsheet cells as shown below.
• All the statistical functions are accessed in the same way and have a similar interface.

Using formulae in cells to calculate descriptive statistical measures in Excel

Mode
• The syntax for this computation is:
                                     =Mode (Range)
Median
• The syntax for this computation is:
                                     =Median (Range)
Mean
• There is a built in Excel function that returns the mean as its value
                                     = Average (Range)

Using formulae in cells to calculate Measures of Dispersion in the excel

Range
• The range of a sample is the largest score minus the smallest score.
• This can be calculated using the Excel Formula
                                    = (Max(A1:A10)-(Min(A1:A10)
Variance
• The variance in a population is calculated as follows.
• We won’t build this equation ourselves in Excel during this session.

                                            48

•   The population variance:

                                         x − x 
                                                      2

                                    S 
                                      2

                                                N

•   The sample variance:

                                         x − x 
                                                      2

                                    S 
                                      2

                                             N −1


•   This formula depends upon first calculating X and N which we have already seen
    above.
•   The Excel function to calculate the variance for a population is:
                                      = varp(range)

•   The Excel function for calculating a sample is:
                                      = var(range)

•   You can access both from the function wizard or use them by typing formulae in
    cells.

Standard Deviation Excel functions
• The Standard Deviation is the square root of the deviance.
• You can calculate it with the formula:
                                    =sqrt(var(range))


•   Or you can calculate it by using the appropriate functions:
                                       = stdev(range) or stdevp(range)

Computation of Frequency in Excel
• The Excel useful statistical function is Frequency.
• Given a set a data and a set of intervals, Frequency counts how many of the values in
  the data occur within each interval.
• The data is called a data array and the interval set is called a bins array.
• The format for the FREQUENCY function is:
  o FREQUENCY(DATA,BINS)
      ▪ FREQUENCY is an array
         function.



                                           49

       ▪ This means that the function returns a set of values rather than just one value.
       ▪ To enter an array function, the range that the array is to occupy must first be
         selected and the function must be entered by pressing Shift+Ctrl+Enter
         instead of just Enter or using the mouse.

•   The following worksheet contains the examination results for 14 students.
•   The numbers in the column headed Score Below is the bins array.
•   Before keying in the function, you must select the range of the array for the result.
•   In this case it will be F8:F17.




•   With this range selected, the following function is keyed into the Formula bar:
                                =FREQUENCY(C4:C17,E8:E17)
•   Press Shift+Ctrl+Enter.
•   The array is now filled with data.
•   This data shows that no student scored below 30, 1 student scored between 30 and 39,
    3 between 40 and 49, 1 between 50 and 59, 3 between 60 and 69, 1 between 70 and
    79, 3 between 80 and 89, and 2 scored between 90 and 100.
•   If any of the results are changed, the data in the No. In Range column will be
    updated automatically.


STEP 5: Key Points (05 minutes)
•   Excel allows manipulating the data using formulas and functions.
•   Functions are generally more productive compared to writing formulas.
•   Functions are also more accurate compared to formulas because the margin of making
    mistakes is very minimal.

                                             50

STEP 6: Evaluation (5 minutes)
• What order of operations used to evaluate formulas in Excel?
• What are the useful functions in Excel?
• What is the pivot table?


STEP 7: Assignmen (5 minutes)
Activity: Group assignment

ACTIVITY:

TELL the student to answer the following question:
• Explain the IF functions as applied in Microsoft Excel.
• Explain the benefit of using formula in Excel sheet.

DIVIDE students into small manageable groups.

ALLOW group to work for three days and submit the task after scheduled time.

CONDUCT general discussion by asking groups to present one of these questions for not
        less than 5 minutes.

SUMMARIZE the activity using training guidelines.




                                           51

References

International Council on Archives (1999), Managing Public Sector Records,
    Understanding computers an over view for records and archives: International
    Records Management Trust London

Gartee R. (2011). Electronic Health Records + MEDCIN CD: Understanding and Using
   Computerizing Medical Records. 2nd Ed. Pearson. USA

Gerda Koch. (2000). Basic allied health statistics and analysis. 2nd Ed. Thomson Delmar
   learning. USA.

Gupta, P. (2000). Mathematical Statistics. New Delhi Publisher, India

Gupta, P. (2006). Statistical Methods. New Delhi Publisher, India

J. Jothikumar. (2005). Statistics: Higher secondary-First year. 1st Ed. Tamilnadu
    Textbook Corporation. Chennai.

Pietka E et al. (2016). Information Technology in Medicine. 1st Ed. Springer International
    Publishing. USA.

Held B, Richrdson T, Moriaty B. (2016). Microsoft Excel Functions and Formulas.
   Mercury Learning & Information.

Held B. (2010). Microsoft Excel Functions & Formulas. Wordware Publishing, Inc.

LeCorps R. (2002). Microsoft Excel Fundamentals: A Practical Workbook for Small
   Business. RGL Learning & Publishing.

Shekhar V. V. (2000). Microsoft Excel 2000. Unistar Books Publishers.




                                            52

             Worksheet 3.1: The measures of central tendency and
             dispersion Excel formula and functions



Worksheet 1.1: The importance of digitalizing pharmaceutical data

Instructions: This is a take home exercise that should be done by all students
individually.

Finished work should be collected in hardcopy and softcopy format and handed over to
the tutor. Time for collection will be discussed and agreed in class.



Instructions: Answer the question below

Consumable and non-consumable medical items at Kasulu district hospital 2008 annual
report.

CONSUMABLE MEDICAL ITEMS
2178 2716 1652 3182 2178 1672                    2101   2716   1761   2716   1007   2716

NON-CONSUMABLE MEDICAL ITEMS
2012 1613 1201 2010 978 1613 871                        911    1001   1613   1512   1613

REQUIRED:
A. Use formula to compute the following in the spreadsheet:
   • Mode for non-consumable
   • Median for consumable
    • Standard deviation for non-consumable
    • Mean for consumable

B. Use Excel functions to compute the following:
   • Mode for non-consumable
   • Median for consumable
    • Standard deviation for non-consumable
    • Mean for consumable



                                            53

Session 4: Creation of Chart from Health Data Using
Spreadsheet

Total Session Time: 120 minutes

Prerequisites
• None

Learning Tasks
By the end of this session students are expected to be able to:
• Define a chart as applied in Ms Excel
• Explain types of Ms Excel charts
• Create a chart using Ms Excel principles
• Format data using condition formatting

Resources Needed
• Flip charts, marker pens, and masking tape
• Black/white board and chalk/whiteboard marker
• Computer and LCD projector
• Worksheet 3.1: The Microsoft Excel charts

SESSION OVERVIEW
 Step         Time        Activity/Method Content

   1       05 minutes        Presentation     Introduction, Learning Objectives

   2       05 minutes       Presentation      Definition of chart as applied in Ms excel
                           Presentation/
   3       15 minutes                         Types of Microsoft Excel charts
                           Demonstration
                           Presentation/      Procedures of creating a chart using
   4       40 minutes
                           Demonstration      Microsoft Excel
                           Presentation/      Procedures of using condition formatting in
   5       40 minutes
                           Demonstration      Microsoft Excel
   6       05 minutes       Presentation      Key Points

   7       05 minutes       Presentation      Evaluation

   8       05 minutes       Presentation      Assignment


                                             54

SESSION CONTENTS

STEP 1: Presentation of Session Title and Learning Tasks (5 minutes)

READ or ASK students to read the learning tasks

ASK students if they have any questions before continuing.



STEP 2: The Definition of Chart as applied in Microsoft Excel (5
minutes)

Chart
• A chart is a visual representative of data in both columns and rows.
• Charts are usually used to analyse trends and patterns in data sets.
• For example, the district hospital pharmacist have been recorded the malaria drugs
  inventory figures in Excel for the past three years; using charts, the pharmacist can
  easily tell which year had the most consumption of Malaria drugs and which year had
  the least.
• Charts are used to compare set targets against actual achievements.
• Use the following data for chart practice.

             Table 4: Sales of Computer Appliances at AB Computer Shop

        Item                      2012          2013         2014        2015
        Desktop Computer           20            12           13          12
        Laptops                    34            45           40          39
        Monitors                   12            10           17          15
        Printers                   78            13           90          14

STEP 3: The Types of Microsoft Excel Charts (15 minutes)
Types of charts
• Different scenarios require different types of charts.
• Excel provides a number of chart types
• The type of chart depends on the type of data that used during chart design.
• To help simplify things for the users, Excel has an option that analyses data and
   makes a recommendation of the chart type used.




                                           55

The following table shows some of the most commonly used charts


S/N   CHART     WHEN                              EXAMPLE
      TYPE      SHOULD
                USE IT?


1     Pie       When user
      Chart     want to
                quantify
                items and
                show them
                as
                percentages.


2     Bar       When user
      Chart     want to
                compare
                values
                across a few
                categories.
                The values
                run
                horizontally



3     Colum     When user
      chart     want to
                compare
                values
                across a few
                categories.
                The values
                run
                vertically




                                       56

4     Line        When user
      chart       want to
                  visualize
                  trends over
                  a period of
                  time i.e.
                  months,
                  days, years,
                  etc.




5     Combo       When user
      Chart       want to
                  highlight
                  different
                  types of
                  information




The importance of charts
• It allows visualizing data graphically.
• It's easier to analyse trends and patterns in the charts
• Easy to interpret compared to data in cells

STEP 4: The Procedures of Creating a Chart Using Microsoft Excel (40
minutes)
Procedures for creating charts in Excel
• Open Excel
• Enter the data from the sample data table above (Table 4)
• The workbook should now look as follows




                                             57

•   To get the desired chart the user should follow the following steps




•   Select the data you want to represent in graph
•   Click on INSERT tab from the ribbon
•   Click on the Column chart drop down button
•   Select the chart type you want
•   The user can able to see the following chart




                                             58

•   When you select the chart, the ribbon activates the following tabs:




•   Try to apply the different chart styles, and other options presented in your chart.

STEP 5: The Procedures of Using Conditional Format in Microsoft
Excel (40 minutes)

Conditional Formatting

• Conditional formatting refers to formatting that is only applied when the specified
  condition is true.
• Let's say we want to easily fetch the sales figures greater than 30; we can use
  conditional formatting to highlight all the sales figures that are greater than 30.




                                            59

Procedures for conditional Formatting

•   Highlight all the sales figures as shown below




•   Click on Conditional Formatting drop-down menu on the HOME tab




•   The user get the following dialogue window when click on ―Greater Than‖




                                            60

•   The final result should look as follows




Procedures for removing conditional formatting
• Click on conditional formatting button
• Select clear rules
• Select clear rules from the entire sheet

STEP 6: Key Points (5 minutes)
•   Charts are a powerful way of graphically visualizing of statistical data.
•   Excel has many types of charts that we can use depending on user needs.
•   Conditional formatting is also another power formatting feature of Excel that helps us
    easily see the data that meets a specified condition

STEP 7: Evaluation (5 minutes)
• What Ms Excel chart?
• What is a conditional formatting?




                                              61

STEP 8: Assignment (5 minutes)

Activity: Group assignment

TELL the student to answer the following question:
• Explain the three report formats that are available in Microsoft Excel.

DIVIDE students into small manageable groups.

ALLOW group to work for three days and submit the task after scheduled time.

CONDUCT general discussion by asking groups to present one of these questions for not
        less than 5 minutes.

SUMMARIZE the activity using training guidelines.




                                            62

References

MoHSW, Strengthening Health Information System, Government printers, Dar es Salaam

International Council on Archives (1999), Managing Public Sector Records,
    Understanding computers an over view for records and archives: International
    Records Management Trust London

Gartee R. (2011). Electronic Health Records + MEDCIN CD: Understanding and Using
   Computerizing Medical Records. 2nd Ed. Pearson. USA

Gupta, P. (2000). Mathematical Statistics. New Delhi Publisher, India

Gupta, P. (2006). Statistical Methods. New Delhi Publisher, India

J. Jothikumar. (2005). Statistics: Higher secondary-First year. 1st Ed. Tamilnadu
    Textbook Corporation. Chennai.

Held B, Richrdson T, Moriaty B. (2016). Microsoft Excel Functions and Formulas.
   Mercury Learning & Information.

Held B. (2010). Microsoft Excel Functions & Formulas. Wordware Publishing, Inc.

LeCorps R. (2002). Microsoft Excel Fundamentals: A Practical Workbook for Small
   Business. RGL Learning & Publishing.

Shekhar V. V. (2000). Microsoft Excel 2000. Unistar Books Publishers.




                                           63

             Worksheet 3.1: The Microsoft Excel charts



Worksheet 4.1: The utilization of Ms Excel package in creating a chart

Instructions: This is a take home exercise that should be done by all students
individually.

Finished work should be collected in hardcopy and softcopy format and handed over to
the tutor. Time for collection will be discussed and agreed in class.



Attempt to this Activity

                         The Income and Expenditure Report




Required:

• Making two graphs from this information

Graph 1: Pie Chart

• This graph will show the total amount of money spent on each category over a six
  month period.

• To do this, you must total the amount spent on each item in column I.
• Do not include the average in your equation.

                                            64

• Next, highlight the expenses (house payment, gasoline, etc).
• Hold down the CTRL key and highlight your new totals.
• Create a pie chart.
• Go to data labels and show the percentages.
• Cut and paste all the information you need and the graph to a new sheet.
Graph 2: Bar Chart
• This will be a bar chart for income and expenses.
• Below your total column, type Income in A12. Enter the income for each month. They
  are as follows:
       January:       2,000
       February:      2,100
       March:         2,000
       April:         1,900
       May:           2,500
       June:          2,200

• Create a bar chart that looks like the one below.
• Include the chart you make and the date for the chart on the page you print.
• This page should include the two data sets and the two charts.
• Print preview to make sure it all prints on one page.


                                    Income & Expenses


          June

          May

         April
                                                                                 Income
         March                                                                   Expenses

      February

       January

             $-        $500.00   $1,000.00   $1,500.00   $2,000.00   $2,500.00




                                             65

Session 5: Creation of Histogram from Health Data
Using Spreadsheet

Total Session Time: 120 minutes

Prerequisites
• None

Learning Tasks
By the end of this session students are expected to be able to:
• Define Histogram
• Explain Histogram data used in Ms Excel
• Create Histogram using Ms Excel

Resources Needed
• Flip charts, marker pens, and masking tape
• Black/white board and chalk/whiteboard markers
• Computer and LCD projector
• Worksheet 3.1: The Microsoft Excel histogram


SESSION OVERVIEW
 Step         Time        Activity/Method Content

   1       05 minutes        Presentation     Introduction, Learning Objectives
                            Presentation/
   2       10 minutes                         Definition of Histogram
                              Buzzing
   3       30 minutes       Presentation      Histogram Data Used in Ms Excel
                           Presentation/
   4       60 minutes                         Creation of Histogram Using Ms Excel
                           Demonstration
   5       05 minutes       Presentation      Key Points

   6       05 minutes       Presentation      Evaluation

   7       05 minutes       Presentation      Assignment




                                             66

SESSION CONTENTS

STEP 1: Presentation of Session Title and Learning Tasks (5 minutes)

READ or ASK students to read the learning tasks

ASK students if they have any questions before continuing.

STEP 2: Definition of Histogram (10 minutes)


Activity: Buzzing (5 minutes)

ASK students to pair up and buzz on the following question for 2 minutes:
  • What is histogram?

ALLOW few pairs to respond and let other pairs to add on points not mentioned

WRITE their response on the flip chart/board

CLARIFY and SUMMARISE by using the content below

•   A histogram is a column chart that shows frequency data.
•   A histogram is "a representation of a frequency distribution by means of rectangles
    whose widths represent class intervals and whose areas are proportional to the
    corresponding frequencies."

STEP 3: The Histogram Data Used in Microsoft Excel (30 minutes)
•   To create a histogram in Excel, the designer should provide two types of data:
    o The data that required to analyze
    o The bin numbers that represent the intervals by which it measures the frequency.
•   The user must organize the data in two columns on the worksheet.
    o These columns must contain the following data:
        ▪ Input data: This is the data that used to analyze by using the Histogram tool.
        ▪ Bin numbers: These numbers represent the intervals that the Histogram tool is
           used for measuring the input data in the data analysis.
•   When user uses the Histogram tool, Excel counts the number of data points in each
    data bin.


                                            67

•   A data point is included in a particular bin if the number is greater than the lowest
    bound and equal to or less than the greatest bound for the data bin.
•   If the user omits the bin range, Excel creates a set of evenly distributed bins between
    the minimum and maximum values of the input data.
•   The output of the histogram analysis is displayed on a new worksheet or in a new
    workbook and shows a histogram table and a column chart that reflects the data in the
    histogram table.

STEP 4: The Procedures for Creating Histogram in Microsoft Excel (60
minutes)

Creating Histogram using Ms Excel

•   First, enter the bin numbers (upper levels) in the range C3:C7.




•   On the Data tab, in the Analysis group, click Data Analysis.




NOTE: If you can't find the Data Analysis button; click here to load the Analysis
ToolPak add-in.


                                            68

•   Select Histogram and click OK.




•   Select the range A2:A19.
•   Click in the Bin Range box and select the range C3:C7.
•   Click the Output Range option button, click in the Output Range box and select cell
    F3.
•   Check Chart Output.




•   Click OK.




                                           69

•   Click the legend on the right side and press Delete.
•   Properly label your bins.
•   To remove the space between the bars, right click a bar, click Format Data Series and
    change the Gap Width to 0%.
•    To add borders, right click a bar, click Format Data Series, click the Fill & Line icon,
    click Border and select a colour.
•   Result:




                                             70

STEP 5: Key Points (5 minutes)
• The omission of bin range in the Ms Excel creates a set of evenly distributed bins
  between the minimum and maximum values of the input data that results to
  histogram.
• The output of the histogram analysis is displayed on a new worksheet or in a new
  workbook and shows a histogram table and a column chart that reflects the data in the
  histogram table

STEP 6: Evaluation (5 minutes)
• What is histogram?
• What is a bin in Excel?
• What is frequency distribution in Excel?

STEP 7: Assignment (5 minutes)
Activity: Group assignment

TELL the student to answer the following question:
     • Explain the merits and demerits of using Histogram in healthcare data
        presentation.
     • Explain the different between Ms Excel 2013 and 2016 in creation of
        Histogram.

DIVIDE students into small manageable groups.

ALLOW group to work for three days and submit the task after scheduled time.

CONDUCT general discussion by asking groups to present one of these questions for not
        less than 5 minutes.

SUMMARIZE the activity using training guidelines.




                                             71

References
MoHSW, Strengthening Health Information System, Government printers, Dar es
 Salaam

International Council on Archives (1999), Managing Public Sector Records,
   Understanding computers an over view for records and archives: International
   Records Management Trust London

Gartee R. (2011). Electronic Health Records + MEDCIN CD: Understanding and Using
  Computerizing Medical Records. 2nd Ed. Pearson. USA

Gerda Koch. (2000). Basic allied health statistics and analysis. 2nd Ed. Thomson Delmar
  learning. USA.

Gupta, P. (2000). Mathematical Statistics. New Delhi Publisher, India

Gupta, P. (2006). Statistical Methods. New Delhi Publisher, India

J. Jothikumar. (2005). Statistics: Higher secondary-First year. 1st Ed. Tamilnadu
    Textbook Corporation. Chennai.

Thanki S. (2018). Medical Imaging and Its Security in Telemedicine Applications. 1st
  Ed. Springer International Publisher. USA.

Held B, Richrdson T, Moriaty B. (2016). Microsoft Excel Functions and Formulas.
  Mercury Learning & Information.

Held B. (2010). Microsoft Excel Functions & Formulas. Wordware Publishing, Inc.

LeCorps R. (2002). Microsoft Excel Fundamentals: A Practical Workbook for Small
  Business. RGL Learning & Publishing.

Shekhar V. V. (2000). Microsoft Excel 2000. Unistar Books Publishers.




                                           72

              Worksheet 3.1: The Microsoft Excel histogram



Worksheet 4.1: The utilization of Ms Excel package in creating a histogram

Instructions: This is a take home exercise that should be done by all students
individually.

Finished work should be collected in hardcopy and softcopy format and handed over to
the tutor. Time for collection will be discussed and agreed in class.




Instructions: Answer the question below

TASK 1

Data: 1,2,2,3,3,3,3,4,4,5,6

Use these data to create the following Histogram:




                                            73

TASK 2
Consider the set {3, 11, 12, 19, 22, 23, 24, 25, 27, 29, 35, 36, 37, 45, 49} and use Shodor
histogram activity to create the following:


                                Data Range Frequency
                                0-10             1
                                10-20            3
                                20-30            6
                                30-40            4
                                40-50            2



Then, create the following:




                                            74

Session 8: Utilization of Computer Packages in
Ordering, Invoicing, Dispensing, Selling and Inventory
Management
Total Session Time: 120 minutes

Prerequisites
• None

Learning Tasks
By the end of this session, students are expected to be able to:
• List common inventory management applications
• Demonstrate procedures for electronic ordering
• Demonstrate procedures for electronic invoicing
• Demonstrate procedures for electronic dispensing
• Demonstrate procedures for electronic selling
• Carry out inventory management functions using computer (PRACTICAL)

Resources Needed
• Flipcharts, marker pens, masking tape
• Black/whiteboard and chalk/white board marker
• Computer and LCD projector




                                       100

SESSION OVERVIEW
Step      Time      Activity/Method         Steps Title

                     Presentation,         Introduction of Session Title and Learning
       05 minutes
 1                                         Tasks

                     Brainstorm            Definition of an Electronic Inventory
 2     10 minutes
                     Presentation          Management Software/Application

                                           List Common Inventory Management
 3     30 minutes    Presentation
                                           Applications
                                           Demonstrate Procedures for Electronic
 4     30 minutes    Presentation
                                           Ordering and Invoicing
                     Presentation
                                           Demonstrate Procedures for Electronic
 5     30 minutes      (Group
                                           Dispensing and Selling
                     Discussion)

 6     05 minutes    Presentation      Key Points


 7     05 minutes    Presentation      Evaluation


 8     05 minutes    Presentation      Assignment




                                     101

SESSION CONTENTS

STEP 1: Introduction of Session Title and Learning Tasks (5 minutes)
READ or ASK students to read the learning tasks

ASK students if they have any questions before continuing.

STEP 2: Definition of an Electronic Inventory Management
Software/Application (5minutes)

Activity: Brainstorm (05 minutes)

ASK student ―what is Electronic Inventory Management?‖

ALLOW few students to respond.

WRITE their responses on the board/flip chart.

SUMMARISE using the content below.

•    Electronic Inventory Management Software/Application
    o It is software installed on the computer systems that enables a firm (in this case a
        pharmacy) to keep a check on the inventory levels by performing the automatic
        counting of inventories, recording withdrawals and revising the stock balance.

STEP 3: List Common Inventory Management Applications (10 minutes)

•    What are examples of inventory management software
    o Electronic Logistic Management Information System (eLMIS)
               Is a revolutionary and cost-effective system of health data management
               that ensures greater commodity security and better health outcomes for
               people in a given locality like say Tanzania.
    o District Health Information Software 2 (DHIS2)
               is a free and open source health management data platform used by
               multiple organizations, and governments worldwide. Since DHIS2's
               release in 2006, NGOs and national governments in 60 countries have
               deployed DHIS2 for health-related projects, including patient health
               monitoring, improving disease surveillance and pinpointing outbreaks, and
               speeding up health data access.

                                             102

o Zoho Inventory
   Popular inventory management solution for small and large companies, used to
   automate their order and inventory management, and to keep track of delivery in
   order to make smarter business decisions. It also includes a powerful analytic and
   reporting kit, and out-of-the-box features such as inventory replenishment for
   avoiding stock-outs.
o Cin7
   A complete, automated point-of-sales package and inventory management suite
   created to cater to the needs different business sizes and industries. Completely
   cloud-based, this platform offers top-of-the-line features that let you sell and
   distribute your products more quickly and efficiently.
o TradeGecko
   A top-listed inventory specialists’ choice for cloud based and automated delivery
   of asset management services. Ideal for multi-channel and multiregional
   wholesalers and distributors who find it handy to manage sales, supply chains,
   and customer relationships from a single location.
o Brightpearl
   Another recommended multi-channel retail management system that is a solid
   TradeGecko alternative and helps businesses handle orders, inventory, customer
   data, accounting and reporting. It offers an advanced sales management kit, and
   integrates with all popular marketplaces and payment gateways.
o SellerCloud
   An eCommerce and inventory management solution used to manage the full
   scope of multi-channel selling. From inventory and warehouse management,
   publishing listing to marketplaces, to order processing and shipping, as well as
   accounting integration, this Zoho Inventory alternative does all the work needed.
o Logiwa
   A cloud-based warehouse management software that caters specifically to small
   and medium-sized businesses in the retail and e-commerce industries, giving them
   a user-friendly platform that comes with all the core capabilities and features to
   address their complex needs and requirements.




                                       103

STEP 4: Demonstrate Procedures for Electronic Ordering and
Invoicing (30minutes)

Electronic Ordering Captured from eLMIS
• The first step is to login




•  Enter role of Buyer supply chain planner
  o Click order management menu , from the order management menu click create
     order
  o Click inside the ship to my site box and type the first few characters of your site.
     The system will automatically match the ship to sites, selected and list of that site
     will appear in the box below. Then select your site from the list.
  o Using the procedure described in step2, select vendor, ship from, vendor site
  o Using the date button and the time button, select the req. delivery date and
     req.ship date
• Add lines




    o Click adds line to add lines to the purchase order.
    o Chose product group


                                            104

    o Click on product group button, select product group and click search. Select your
      product then click ok.
    o Click save option or submit option.
    o Click on approve for order and for confirmation order will go to a new status.

Electronic Invoicing

•    e-Invoicing
    o This is an act of electronically exchanging of the invoice document between
        supplier and a buyer in an integrated electronic format.

•   Allowed formats of an e-Invoice
   o Structured invoice data issued in Electronic Data Interchange (EDL) or XML
       formats
   o Structured Invoice data Issued using standard Internet based web forms
Note: true definition of an electronic invoice is that it should contain data from the
supplier in a format that can be entered (integrated) into the buyers Account Payable (AP)
system without requiring any data input from buyers AP administrator.

STEP 5: Demonstrate Procedures for Electronic Dispensing and Selling
(30minutes)

•   Electronic Dispensing
    o A good example is that of an Electronic Dispensing Tool (EDL) for which is a
       software program that helps pharmacy staff efficiently manage both patients and
       their antiretroviral.
    o it contains fields in which you fill relevant data that is used to monitor patient
       adherence, trace dispensing history, show therapy regimen and status changes also
       appointment keeping, inventory management, and early indicators of HIV
       medicine resistance to antiretroviral.
    o After a patient is identified it takes less time to attend to them.
•   Electronic Selling
    o Also referred to as e-commerce is the buying and selling of goods and services
       over an electronic network, primarily the internet.
    o Types of transactions that occur
       ▪ Business to business (B2B)
       ▪ Consumer to consumer (C2C)
       ▪ Business to Consumer (B2C)
       ▪ Consumer to Business (C2B)


                                           105

STEP 6: Key Points (5 minutes)
• Computer application software’s are employed to conduct various activities that are
  carried out in a pharmaceutical environment.
• Activities like ordering, selling, sending invoice, dispensing as well as making
  payments can be achieved through the use of search software.
• Examples of software’s/applications that can be used in ordering, selling, sending
  invoice and dispensing are (e-LMIS, Logiwa, Seller Cloud and TradeGecko.

STEP 7: Evaluation (5 minutes)
• What is Electronic ordering/selling/dispensing/invoicing?
• What are the examples for applications used in inventory management?
• What are the benefits for an Electronic Dispensing Tool?
• What are the legit format types of an electronic Invoice?

STEP 8: Take Home Assignment (5 minutes)
Activity: Group assignment

TELL the student to answer the following question:
• Explain Electronic Inventory Management.
• Explain on DHIS2 and eLMIS as software applications used in inventory
  management.
• What is electronic ordering, selling and dispensing?

DIVIDE students into small manageable groups.

ALLOW group to work for three days and submit the task after scheduled time.

CONDUCT general discussion by asking groups to present one of these questions for not
        less than 5 minutes.

SUMMARIZE the activity using training guidelines.




                                         106

References

Embrey, M. A. (2013). MDS-3: Managing access to medicines and health technologies.
  Sterling, VA: Kumarian Press.

United Republic of Tanzania Ministry of Health and Social Welfare, Strategy for
  Development and Implementation of an Integrated Logistics System for Essential
  Health Commodities: Government printers, Dar es Salaam

International Council on Archives (1999), Managing Public Sector Records,
   Understanding computers an over view for records and archives: International
   Records Management Trust London

What is Inventory Management Software? Analysis of Features, Types, Benefits and
 Pricing. (n.d.). Retrieved September 25, 2018, from
 https://financesonline.com/inventory-management-software-analysis-features-types-
 benefits-pricing/

GNU. (2016). DHIS 2 User Manual. DHIS2 Documentation Team. Free Software
  Foundation. Available at: www.gnu.org . accessed : 11.09.2018

MOHCDGEC. (2016). National Guideline for Health Data Quality Assessment. Dar es
 salaam. Tanzania

WHO. (2008). Health Information System. Geneva. Available at:
 www.healthmetricsnetwork.org . Accessed: 11.09.2008




                                         107

Session 10: Utilization of HMIS (MTUHA) Database in
Capturing and Managing Pharmaceutical Data
Total Session Time: 120 minutes

Prerequisites
• None

Learning Tasks
By the end of this session, students are expected to be able to:
• Define HMIS/MTUHA Database
• List commonly used HMIS/MTUHA tools
• Capture and process data using (HMIS) MTUHA database software (PRACTICAL)-
    DHIS 2 Software
• Generate reports from HMIS/MTUHA database (PRACTICAL)- DHIS 2 Software

Resources Needed
• Flipcharts, marker pens, masking tape
• Black/whiteboard and chalk/white board markers
• Online DHIS2
• HMIS Registers

     SESSION OVERVIEW
Step            Time    Activity/Method         Steps Title

                          Presentation         Presentation of Session Title and Learning
          05 minutes
 1                                             Tasks

                          Brainstorm
 2        05 minutes                           Definition of HMIS (MTUHA)
                          Presentation

 3        15 minutes      Presentation         HMIS (MTUHA) Tools

                                               Capture and process data using HMIS
 4        45 minutes      Presentation
                                               (MTUHA) database software
                          Presentation         Generation of report from HMIS (MTUHA)
 5
          35 minutes    Group Discussion       database software

 6        05 minutes      Presentation         Key Points



                                         115

    7          05 minutes        Presentation         Evaluation

    8          05 minutes        Presentation         Assignment




SESSION CONTENT
STEP 1: Presentation of Session Title and Learning Tasks (5
minutes)

READ the Learning Tasks to students

ASK students if they have any question before proceeding

STEP 2: Definitions of HMIS/MTUHA (5 Minutes)

Activity: Brainstorm (02 minutes)

ASK student what is ―HMIS‖ and ―MTUHA‖?

ALLOW few students to respond.

WRITE their responses on the board/flip chart.

SUMMARISE using the content below.

•       HMIS Database is a system designed to collect facility based health and health related
        data, compile, store and retrieve for data analysis to produce report which in turn
        inform service providers, health managers, decision markers/policy makers and the
        public to make informed decision on health planning, monitoring and evaluation and
        provision of services at all levels of health care delivery.
•       HMIS in Swahili is called MTUHA which stands for ―Mfumo wa Taarifa za
        Uendeshaji wa Huduma za Afya‖.

STEP 3: The HMIS/MTUHA Tools (15 Minutes)
•       HMIS uses three main tools in collection, analysis, storage, management, and
        reporting of data:
        o Books/registers
        o Tally sheet forms


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    o Monthly report forms

•   HMIS books are subdivided into five (5) main groups:
    o HMIS Guideline
    o Data Collection Books
    o Tally Sheet Forms
    o Monthly Report Forms
    o Annual Report Book

•   HMIS/MTUHA registers/ books:
    o Book 1: HMIS Guidelines
    o Book 2: Health Facility information Book
    o Book 3: Community book
    o Book 4: Ledger book
    o Book 5: Out-patient register
    o Book 6: Antenatal care register
    o Book 7: Child register
    o Book 8: Family planning register
    o Book 9: Diarrhoea treatment corner
    o Book 10: Facility annual Report book
    o Book 11: Dental and oral health register
    o Book 12: Labour & Delivery book
    o Book 13: Postnatal Register
    o Book 14: In-patient Department Register
    o Book 15: Human Resource Register
    o Book 16: Eye Register

•   HMIS Guideline
    o This is Book No. 1. It is used as an instruction manual and reference to other
      books/registers, i.e., Books No. 2–16.
    o Each facility should have at least one copy.
    o The HMIS Programme will ascertain that each division in each health service
      delivery facility obtains at least one copy.

•   Data collection books/registers
    o These books are used to collect data on different aspects of health (Books No. 2,
       3, 4, 5, 6, 7, 8, 9, 11, 12, 13, 14, 15 and 16).
    o New books and registers have been added to this list.
    ▪ They include the malaria laboratory investigations register, dispensing register,
       monthly tracer medicine register and death notification form/register.


                                           117

•   HMIS/MTUHA Departmental registers used to collect data at hospital level:
    o Laboratory register
    o Physiotherapy register
    o Mortuary register

•   Currently HMIS/MTUHA has added other registers which are yet to be numbered,
    these are:
        o Malaria laboratory investigation register
        o Dispensing register
        o Monthly Tracer medicine register
        o Death notification form/register

•   Tally sheet forms
        o These forms are used to track data for analysis.
        o This is then used in report writing.
        o Each HMIS register/book should have a tally sheet which will be used jointly
            with some register/book for collecting data
    • Monthly report forms
      o The HMIS uses monthly report forms to collect data each month.
      o These forms are in duplicate: one copy is sent to the district while the other is
        kept at the health facility

    • Annual report book
      o The HMIS annual book is used to summarize data from the Facility health
        information register (book 2) and community register (book 3)

STEP 4: Capture and Process Data Using HMIS (MTUHA)
Database Software (45 minutes)

DHIS 2 Software
•   DHIS2 provides a powerful set of tools for data collection, validation, reporting and
    analysis, but the contents of the database.
    o               For example:-
       ▪ What to collect,
       ▪ Who should collect it
       ▪ On what format; it depends on the context of use
•   The Tanzania HMIS/MTUHA database software is called DHIS 2
•   DHIS 2 is platform independent



                                             118

•  DHIS 2 can run on both on-line (with the internet) and offline (without the internet)
   modes.
• Input: DHIS provides user-friendly interface to enter data. Data entry forms mimic
   the paper tools.
• Processes: DHIS automatically computes sums, indicators and checks validity of the
   data.
• Output: Provide different tools for reporting – both for routine reports and analysis,
   also user can create and save their reports
Accessing DHIS 2 Software for data entry process
• Each user need the following to access DHIS2
   o Device e.g. laptop
   o Internet access
   o Internet browser e.g. Google chrome, Firefox
   o URL: https://dhis.moh.go.tz/
   o DHIS2 account (username and password)

Figure 11: Components of DHIS 2 Software




DHIS 2 User Account
• Required details
  o Full name
  o Active email address
  o Phone (optional)
  o Duty Post

Types of DHIS 2 Applications Menus
• Service Applications: They are used to collect data, validate, analyse and report
   processed information
• Maintenance Applications: They're used for system maintenance such as revision of
   paper tools, indicators, changes in organization units, improving system performance
   and other operations

Applications Navigation Menu
• All Apps are in one Menu


                                           119

   Figure 12: Application Navigation Menu




Navigations
• There are two types of Application Menu

   Figure 13: Application Menu

             Left vertical menu                     Middle Menu




Vertical programs integrated into DHIS 2
 • National Malaria Control Program (NMCP)
 • National TB and Leprosy Control Program (NTLP)
 • National AIDS Control Program (NACP)
 • Administration & HR Management Department

National TB and Leprosy Control Program (NTLP) forms integrated into DHIS 2

                                       120

•  Quarterly Summary Forms
  o LEP 07 Case Notification Report
  o LEP 09 Results of Treatment
  o TB 07 Case Notification Report
  o TB 09 Results of Treatment
• Annual Summary Forms
  o LEP 10 Report on Presentation of Disabilities

National AIDS Control Program (NACP) forms integrated into DHIS 2
 • Quarterly Summary Forms
   o Cohort Reporting Form
   o HIV Care-ART Reporting Form
 • Monthly Summary Forms
   o HIV Care and Treatment (HCT)
   o Home Based Care (HUWANYU)
   o Male Circumcision Services
   o Sexually Transmitted Infections (STI)

National Malaria Control Program (NMCP) forms integrated into DHIS 2
• Monthly Summary Forms
   o National Malaria Control Program Form 001
       ▪ Laboratory
       ▪ Logistics Data for Malaria Commodities
   o OPD & IPD forms
       ▪ Malaria Blood slide Positive
       ▪ Malaria mRDT Positive
       ▪ Clinical (No Tests)
       ▪ In pregnancy
   o ANC forms
       ▪ Malaria Treated Net
       ▪ Malaria positive
       ▪ IPT1 and IPT2

Administration and Human Resources Management Department forms integrated
into DHIS 2
• Human Resources Register

DHIS 2 Applications
• Aggregate Data Entry
• Events Capture Data Entry

                                       121

• Reports
• Data Visualizer
• GIS / Maps
• Pivot Tables
• Messaging & Interpretation
• Administrative Features
   o Organization unit management
   o Data element & Indicator Management
   o Dataset Management
   o Users and Roles Management
   o Data administration
   o Settings

Figure 14: DHIS 2 Apps




                                     122

Figure 15: Logging Out




DHIS 2 Organization units: Data Access and Reporting
 • First level (Highest): MoHSW
   o Data access at the central level
   o Central point for DHIS2 users and settings administration
   o Data reporting for the whole country

 • Second level: Regions
   o Data access at regional level
   o Data reporting for the whole region
 • Third level: Councils/Districts
   o Data entry point
   o Data access
   o Data report
 • Fourth level: Facilities
   o Data entry point
   o Data report




                                           123

Figure 16: Ministry of Health Organization Units
       Organization units                       DHIS 2 Data Access




                 MoHSW




    Region 1               Region 2




   Council 1       Council 2      Council 3



                                               Dispensary
    Facility 1     Hospital1      Facility 2
                                                   1




Data elements
 • Explains what we collect and analyse
    o For example, "Malaria new cases", "Total Population", "1st ANC visits",
       "Measles doses given―; Idadi ya Wajawazito Waliotegemewa wa umri chini ya
       miaka 20 (ANC form)
 • Sometimes referred to as Indicators in other contexts
    o In DHIS 2 data elements and indicators are not the same
 • It describes the raw data, e.g. the counts and not the coverage
 • It can be further disaggregated using categories, e.g. "Measles doses given" + <1y /
    >1y.
 • Routine Data Element: is data that is collected at regular intervals through
    mechanisms designed to meet predictable information needs: Such as Total OPD
    cases / total delivery in a month.
 • Semi-permanent Data Element: is data that changes at after relatively longer
    intervals of time (say annually) as compared with routine health data. For example,
    data on population in a district.

Data element: Groups/ Categories
 • Data element groups: Some data element are group into different categories to
    make it easy to generate selected reports
    o Disaggregation (dimensions to data values)
    o Deciding the detail on how data values are collected and stored

                                                     124

      ▪ For example, "Malaria new cases" + <5y + Male
    o A data element can be linked to one category combination
    o A data value is linked to a category option combination

Figure 17: DHIS 2 Data element and data element group




  Data
  element
  group




  Data
  element




Data element: Access and Reporting
 • Each data element is linked to a data collection form
 • User access all data elements for the forms linked to the facilities he/she is privileged
    to view

Figure 18: The link between DHIS 2 Data element and Data collection form




                                            125

DHIS 2 Data Set
 • Data set is a collection of data elements into a logical data collection tool
 • In DHIS2 it acts as a transformation of the paper based forms into digital forms

Figure 19: DHIS 2 Data Set




Data Set: DHIS 2 Data Entry Procedures
• Each facility is assigned data set related to services it offers
• HMIS country coordinators coordinate allocation of forms (data sets) into DHIS2
• Apps > Data entry


                                           126

•   Select ―WHERE‖ organization unit
•   Select form (data set) to fill data

STEP 5: Generation of Reports from HMIS (MTUHA) Database
Software (35 minutes)

Data Set: DHIS 2 Reporting
• Pivot table
   o Reporting rates: summaries of percentages of facilities forms/data set data
      submission
   o Apps > Pivot table > Select form under reporting rates > define period (when) and
      organization units (where)

•   Reports
    o Data set report: summaries of data entered for the given form/data set and
       selected period
    o Apps > Reports > data set report > Data set > Define organization unit (where) >
       Define period (when)
    o Reporting rate summary: summaries of number of forms submitted and count
       of ones submitted on time for each data set

DHIS 2 Period Dimension
• Periods are organised by types/frequencies;
  o Monthly, Quarterly, Six-monthly, Yearly
  o Most data is collected monthly
  o IDSR weekly, HR quarterly, Population yearly
• Reports can be monthly or aggregated to
  o Bi-Monthly, Quarterly, Six-monthly, or Yearly (and cumulative throughout the
      year)
• Fixed periods
  o 2013, March 2014,
• Relative periods can be used to allow easy reuse of report layouts and charts
  o Last month, last quarter, this year etc.




                                          127

Figure 20: Period Selection




Figure 21: Period selection: Data Entry Procedure




DHIS 2 Software Indicators
• Indicator: a reflection of tracked data elements or situation in terms of a numeral
  count, ratio factions, percentages etc.
• Ratio/Fraction indicators:
• Used to express an indicator as a fraction of two sets of data elements




                                            128

Examples of Indicators
• Birth by skilled attendant
   o Type: Percentage (factor=100)
   o Numerator: ―Skilled birth attendants‖
   o Denominator: ‖Total Deliveries‖
• Measles coverage under 1 year
  o Type: Percentage (factor=100)
  o Numerator: ―Measles doses given <1 year‖
  o Denominator: ‖Population <1 year‖25/11/2014

STEP 6: Key Points (05 minutes)
• HMIS is the system designed to collect facility based data and health related data.
• The data collected through HMIS data collection tools is used by health managers for
  planning, evaluation and decision making.
• The Ministry of Health use DHIS 2 software to collect data and compile reports.

STEP 7: Evaluation (05 minutes)
• What is a Tanzania HMIS (MTUHA)?
• Which register is used as a HMIS guideline?
• Which register is used to summarize other HMIS data collection tools?
• What is DHIS 2?

STEP 8: Take Home Assignment (05 minutes)
 Activity: Take Home Assignment

 TELL the student to answer the following question:
    • Mention RCH (Reproductive and Child Health) indicators that are
      related to medicine and medical supplies, state the nominator and
      denominator.
    • State the MTUHA books that capture information/data related to
      health commodities.
 DIVIDE students into small manageable groups.

 ALLOW group to work for three days and submit the task after scheduled
 time.

 CONDUCT general discussion by asking groups to present one of these
         questions for not less than 5 minutes.


                                         129

SUMMARIZE the activity using training guidelines.




                                      130

References
Embrey, M. A. (2013). MDS-3: Managing access to medicines and health technologies.
  Sterling, VA: Kumarian Press.

MoHSW, Strengthening Health Information System, Government printers, Dar es
 Salaam

International Council on Archives (1999), Managing Public Sector Records,
   Understanding computers an over view for records and archives: International
   Records Management Trust London

Abdelhak M. (2014). Health Information: Management of Strategic Resources. 5th Ed.
  Elsevier Health Science Publisher.

Davis A. (2014). Health Information Technology. 3rd Ed. Elsevier Health Science
  Publisher. USA.

GNU. (2016). DHIS 2 User Manual. DHIS2 Documentation Team. Free Software
  Foundation. Available at: www.gnu.org . accessed : 11.09.2018

MoHCDGEC. (2016). National Guideline for Health Data Quality Assessment. Dar es
 salaam. Tanzania

WHO. (2008). Health Information System. Geneva. Available at:
 www.healthmetricsnetwork.org . Accessed: 11.09.2008




                                         131

Session 11: Analysis of Data Using HMIS/MTUHA
Database (PRACTICAL)
Total Session Time: 120 minutes

Prerequisites
• None

Learning Tasks
By the end of this session, students are expected to be able to:
• Establish trends of pharmaceutical services from HMIS/MTUHA database
• Identify pharmaceutical services problems from analysed data
• Prepare reports

Resources Needed
• Flipcharts, marker pens, masking tape
• Black/whiteboard and chalk/white board markers
• Computer and LCD projector
• Online DHIS2
• HMIS Registers

SESSION OVERVIEW
Step            Time    Activity/Method          Steps Title

                          Presentation,         Presentation of Session Title and Learning
          05 minutes
 1                                              Tasks
                          Presentation/     Establish Trends of Pharmaceutical Services
 2        25 minutes       Brainstorm       from HMIS (MTUHA) Database

                                            Identify Pharmaceutical Services Problems
 3        30 minutes      Presentation      from Analysed Data

                                            Prepare Reports
 4        50 minutes      Presentation

 6        05 minutes      Presentation          Key Points

 7        05 minutes      Presentation          Evaluation


                                          132

SESSION CONTENT

STEP 1: Presentation of Session Title and Learning Tasks (5
minutes)

READ the Learning Tasks to students

ASK students if they have any question before proceeding

STEP 2: Establish Trends of Pharmaceutical Services from
HMIS/MTUHA Database (25minutes)

The below are trends of Pharmaceutical Service while using inventory
program tools
HMIS, LMIS and DHIS
• Health management information systems (HMIS) collect, aggregate, and use service
   data from health facilities
• Logistics management information systems (LMIS) collect and use commodity
   supply data from health and storage facilities
• A HMIS collects and reports program information, such as incidence of
   disease, client/patient information, and health services rendered.
• HMIS data can be used to determine disease patterns or to track health services
   use, as well as to monitor and evaluate health service delivery.
• DHIS2 is the most widely used application in LMISs, and is optimized for data
   reporting.

LMIS
• A LMIS is a system that is used to collect, organizes, and present logistics data
  gathered from all levels of the health system.
• An LMIS enables logisticians to collect the data needed to make informed
  decisions that will ultimately improve product availability and patient
  treatment.
• One immediate decision that is made based on logistics data is the quantities of
  products that should be resupplied to health facilities.
• An LMIS provides data needed to operate a supply chain.
  o It collects data about health products such as quantities consumed, stock on
      hand, losses and adjustment.
  o It collects data from stores, dispensing records area.



                                           133

Features and functionality of LMIS in relation to pharmaceutical services
• Requisitions and Ordering
   o Create, authorize, approve report and requisitions, both regular, based on
      configured processing periods, and emergency.
   o Supports offline data capture on key screens.
   o Executes complex and configurable approval hierarchies.
   o Calculates order amounts based on average consumption and max policies.
   o Complex data validations to support quality data capture.
   o Generate orders for external fulfillment based on approved requisitions.

•   Setup and Customization
    o Manage system users, role assignments, programs, facilities, orderable and
       associations with bulk upload and administrative screens.
    o Configure the system to match your processing and reorder periods,
       policies and facility hierarchy.

•   Stock Management
    o Record transactions and view electronic stock cards (supports lot info)
    o Perform physical inventory & adjustments
    o Track ins/outs of stock – send and receive stock

DHIS 2
• it is used for Capturing, managing, and analysing of data
• Highly flexible and configurable platform with a wide variety of use cases
• Free and open source software
• Extensible through Web APIs and other applications

DHIS 2 Features
• GIS
• Pivot tables
• Charts
• Routine data
• Events
• Tracking




                                           134

                      Linking HMIS and LMIS in Tanzania
                              HMIS                     LMIS
System used                   DHIS 2                   eLMIS
Data collected                Services     (Patient,   Product used for that
                              cases)                   service
Where data comes              Services records         Stores and dispensing
from                                                   records area
Frequency of data             Monthly                  Quarterly
reporting from
facilities
Who enters data               District HMIS focal      District pharmacist
electronically in the         person
system



STEP 3: Identify Pharmaceutical Services Problems from Analysed
Data (30minutes)
•   HMIS forms in eLMIS




                                       135

STEP 4: Prepare Reports (50minutes)
•   LMIS data compared with service data in HMIS, the sample dashboard graph
    with sample data
•   National level dashboard
    o Consumption data has been pulled into DHIS2 and dashboards developed
       to compare cases of PPH and retained placenta and consumption of
       oxytocin, ergometrine, and misoprostal.




•   Council (district) level dashboard
    o Users can drill down into data of one council (district) to examine the
       consumption and services data




                                           136

STEP 5: Key Points (05 minutes)
•   To understand trends that occurs during data collection.
•   Analyse data for interpretation.
•   Generate reports from analysed data.

STEP 6: Evaluation (05 minutes)
•   What are the common trends for data collection?
•   What is data analysing?
•   What is the importance of data analysing?




                                           137

References
GNU. (2016). DHIS 2 User Manual. DHIS2 Documentation Team. Free Software
  Foundation. Available at: www.gnu.org . accessed : 11.09.2018

MOHCDGEC. (2016). National Guideline for Health Data Quality Assessment. Dar es
 salaam. Tanzania

 WHO. (2008). Health Information System. Geneva. Available at:
  www.healthmetricsnetwork.org . Accessed: 11.09.2008

MoHSW, Strengthening Health Information System, Government printers, Dar es
 Salaam

International Council on Archives (1999), Managing Public Sector Records,
   Understanding computers an over view for records and archives: International
   Records Management Trust London

Abdelhak M. (2014). Health Information: Management of Strategic Resources. 5th Ed.
  Elsevier Health Science Publisher.

Aycock J. (2006). Computer Viruses and Malware. Springer International Publisher.
  USA.

Couglas J.D. (2003). The Backup Book: Disaster Recovery from Desktop Data Center.
  3rd Ed. Network Frontiers, LLC. US.

Davis A. (2014). Health Information Technology. 3rd Ed. Elsevier Health Science
  Publisher. USA.




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