Implementing the urban community health information system in Ethiopia: Lessons from the pilot-tests in Addis Ababa, Bishoftu and Hawassa

Background: The Strengthening Ethiopia's Urban Health Program (SEUHP), supported by the United States Agency for International Development (USAID), initiated the pilot testing of the Urban Community Health Information System (UCHIS) in three sites (Addis Ababa, Bishoftu and Hawassa) to support the Ethiopian Federal Ministry Health (FMOH) in its efforts to standardize and expand the Health Management Information System (HMIS) to urban areas. This paper aimed to document the lessons learned and the challenges encountered in the implementation process of UCHIS. Methods: UCHIS implementation guidelines, service delivery cards, monitoring tools, registers, data quality assessment, and progress reports were reviewed. To further understand the UCHIS implementation process, five key informant interviews and four focus group discussions were held between March and April 2018. Results and Discussion: The pilot program identified improvements in data quality and use at the urban health extension professional (UHE-p) level for decision-making and for reporting to city/town health offices and health centers. The prioritization of households according to their economic status and health needs helped UHE-ps to target health services and perform activities optimally. The development and standardization of health service cards for various communicable and non-communicable diseases and maternal, neonatal, and child health services enabled UHE-ps to provide health services in a comprehensive manner. Conclusions: The initiation of UCHIS as a pilot test enabled the UHE-ps to collect high-quality data and report to city/town health offices and health centers. Additionally, UCHIS helped UHE-ps to comprehensively focus on the 15 health service packages and target the neediest sections of the population.