NAMTAC

Project Overview

The Namibia Technical Assistance Consortium (NAMTAC) implements a primarily Strategic Information CDC-sponsored project focusing on HIV. Working closely with CDC Namibia, the project goals include:

  • Design and implement innovative health information systems solutions in Namibia to improve public health in HIV 
  • Conduct HIV surveillance activities in Namibia
  • Support the Ministry of Health and Social Services (MOHSS) by strengthening their capacity to design and sustain HIS solutions

Areas of Support

Through NAMTAC, our team works across the following activities:

  • HIS Development — developed apps, electronic medical record and registry systems
  • Data Repositories — implemented national data warehouses, incorporating complex data processing techniques such as ETL (Extract, Transform, Load)
  • Server and Infrastructure Support — configuring virtual servers, application servers, database servers, and VPNs 
  • Surveillance — conducted r surveillance, Urine Tenofovir POC Evaluation, and the SHIRE study (Evaluations of the Social Harms and Benefits Associated with HIV Recency Testing and Partner Notification service)
  • DHIS2 Support — supported DHIS2 Tracker applications, server management, data extraction and analysis 
  • Strategic HIS support — collaborated with MOHSS and stakeholders to conceptualize and demonstrate innovative projects like unique patient identification, data exchange standards, offline solutions, and EMRs to support site-level data utilization

Accomplishments

Master Patient Index

  • Developed a national master patient index (MPI) based on SanteMPI to uniquely identify patients within the Namibian health system and assign them a unique, automatically generated short Health ID (e.g., BF4S32) with a check digit for each patient in the MPI
  • Deduplicates and links patient records to create a single, consolidated record for improved accuracy in public health surveillance
  • Developed an Android and Windows MPI App to enable facility-level registration of patients, patient search and Health ID printing within the MPI so that Health IDs can be integrated into all program data collection tools for consistent patient identification
  • Linked with the National Population Registry System (NPRS) to utilize Namibian identification numbers (for individuals above 16 years) and birth certificate numbers (for individuals below 16 years)
  • Enables facilities to generate and print a Health ID card for clients, with their Health ID printed on it
  • Being piloted, with plans to scale to the rest of Namibia from April 2025 onwards, the Health ID system will become the standard practice for all patients accessing healthcare at public health facilities

Impact: The Master Patient Index supports the use of a single health identifier across all programs in the health system. This enables deduplication and linkage of patient records while providing an easy method for patients to identify themselves at any facility.

National Data Warehouse

  • Designed, developed, and deployed a national data warehouse with a dimensional model,  incorporating data from Quantum EPMS (the Namibian HIV EMR), DHIS2 Core and DHIS2 Tracker. Wrote SQL-based analysis scripts to clean, combine and analyze complex program data, creating a unified analysis database
  • Collaborated with program leadership, field staff, CDC Namibia and other stakeholders to develop dashboards and reports encompassing various areas such as monitoring patients on ART, tracking ART initiation and monitoring patients' viral load status
  • Used PowerBI to create dashboards accessible to all members of the health system, allowing them to measure key indicators for the ART, TB and Malaria programs
  • Trained MOHSS staff on defining program needs and building/maintaining dashboards to support their activities and they are expected to expand the NDW data sources to incorporate all data from the health sector eventually
  • Impact: The National Data Warehouse will become a centralized hub for all programmatic health data, allowing decision makers to easily see, use and analyze data from various datasets nationwide.

PMTCT Tracker

  • Developed PTracker, an electronic medical record system to strengthen the PMTCT M&E system, currently based on OpenMRS 2.6, but will soon be upgraded to OpenMRS 3 with a new, user-friendly UI
  • Collects patient-level data and enables the Ministry to track the mother-baby pairs across health facilities, as pregnant mothers in Namibia attend antenatal visits at clinics and health centers, deliver at hospitals, and then return to clinics and health centers for post natal care
  • Developed a companion app based on ODK for offline scenarios, where data gets pushed to PTracker at certain intervals  
  • Incorporates a standards-based mediator, based on OpenHIM, to facilitate data exchange between ODK and PTracker 
  • Automatically submits aggregated data from PTracker to DHIS2 and the National Data Warehouse, allowing users to access the PTracker reports and visualizations without needing access to the EMR that contains personal identifiable information

Impact: The PTracker digitizes data for pregnant and breastfeeding women, including HIV-positive and negative mothers, as well as HIV-exposed infants. This empowers healthcare workers to ensure adequate care for HIV-exposed infants and maintain their HIV-negative status. PTracker is available in 84% of the health facilities that provide PMTCT services.

Additional Accomplishments

  • Developed a versatile health information exchange based on OpenHIM, which can be extended as needed to support any other interoperability scenario in the health sector
  • Supported MoHSS and GRN in configuring server infrastructure, including server virtualization, for all the aforementioned systems

Key Leadership

UCSF

  • Principal Investigator: George Rutherford, MD, MA
  • Project Director: Fitti Weissglas, MSc, MBA
  • Leadership Team: Rosaline Hendricks, Michelle Moghadassi, Ifeoma Ndozi-Okia, Asen Mwandemele