KenyaHMIS Training Curriculum

November 14, 2023

HIS Training curriculum provides a comprehensive training guide for all KenyaHMIS solution. The document offers key areas of focus for training of different HIS products. module and solutions. For potential trainer of trainers (ToTs), the curriculum is clustered into three broad sections i.e. Electronic Health (eHealth) , Mobile Health (mHealth) and Informational Products (i-Products).

HIS TRAINING CURRICULUM

SECTION A:

INTRODUCTION

KenyaHMIS project support the ministry of health and other stakeholders in the development, maintenance, and support of the health information systems. Capacity development and capacity building forms a critical part of this scope to guarantee continuous and meaningful use of the HIS solutions at various levels. This document provides a standard curriculum to guide training activities on the various sets of products.

Title of the proposed programme

The training program shall be called Electronic HIS Training Curriculum

Philosophy of the programme

Electronic HIS training program shall provide reference and basis for HIS related training activities. Effectiveness of system use is directly determined by users’ capacity. HIS systems value chain covers 3 levels; facility, sub-national and national levels, each with varying capacity requirement based on the use case at each level. Moreover, as systems evolve, users require constant training on various aspects.

Electronic HIS training program shall give prominence to standard system workflows with emphasis on clinical management processes supported at facility level.

There are four distinct training programs areas covered in this curriculum namely:

eHealth program
mHealth program
Data and Information program
Technical System Administration Program

Details of these programs are outlined in subsequent sections of this document.

Rationale of the Program

The training program is designed to demonstrate human – electronic systems interaction to improve healthcare services and patient outcomes. Capacity building is key to guarantee effective system use at various levels (i.e., Facility, Partner, County and National). The curriculum espouses the aims and objectives of the trainings and various value derived from every HIS solution.

Needs assessment.

User surveys indicate three areas of capacity concern for HIS end users.

Specific HIS skills. Need to equip healthcare workers with specific HIS skills necessary to perform their respective roles.

New HIS features. Train on new HIS features and functionality to ensure that they are able to utilize full potential of system.

Security and privacy training. Healthcare workers lack knowledge of security and privacy risks associated with using HIS.

Stakeholders Involvement

To achieve effective outcome of the trainings, there is important need to involve all the stakeholders within the HIS space. Currently, the project is embracing cascaded model for capacity building where the training targets the service delivery partners who are in turn empowered to carry out trainings within their organization and facility level users. At the national level, the project involves the Ministry of Health (MoH) through NASCOP in the training design and execution.

Justification of the need for the programme

Development and adoption of a standard HIS training curriculum is necessary to guarantee adequate planning, preparation, and standard delivery of skills to specific audience.

Goal of the programme

The overall goal of this curriculum is to equip the trainer with the necessary resources while administering a training on any of the HIS products. It is aimed at building the capacity of health workers to competently use the EMR system to improve the quality of health care provision at the facility level.

Expected learning objectives of the programme.

To provide a comprehensive guide on HIS products training

To equip the trainer with necessary materials and resources

To ensure quality delivery of trainings

Expected learning outcomes of the programme.

At the end of training for different users are expected to develop competencies in the following areas:

Describe the types of data and reports available in HIS.
Explain how HIS can help improve patient care in their specific role.
Demonstrate use of HIS to access patient records, update orders, and generate reports.
Identify the security and privacy risks associated with using HIS and explain how to mitigate these risks.
Demonstrate maintenance and administration skills of an HIS.

Mode of delivery of the programme

Presentation
Interactive lecture
Brainstorming
Group activity

Eligibility /Target Group for the proposed programme

The target group is anyone who is responsible for cascading training to other users, this may include:

Data clerks
Data managers
Health records information officers
Receptionists or support staff
Nurses
Clinicians
Program staff
Technical advisors
M&E officers, among others

Course Evaluation

Course evaluation is important to measure knowledge and skills of participants. It Can be used to:

Improve mentoring and participant learning.
Assess achievement of learning objectives

The assessment shall include.

Pre – Test
Post Test
Training evaluation /Feedback

COURSE DESCRIPTION

mHealth program
eHealth program
Data and Information program
Technical System Administration Program

2.1: eHealth Program

a) Code: Title of unit: eHealth Program: 40hrs

b) Course Purpose

The purpose of the course is to enable the health care provider acquire knowledge and skills on eHealth products, gain understanding on navigating through the solutions and the value they add to their daily activities.

c) Expected Learning Outcomes

At the end of the course the student shall be able to:

Understand eHealth solutions and the modules covered.
Understand the value proposition of each eHealth solution.
Develop skills to navigate through the various eHealth products.
Develop competency in the use and application of eHealth solutions in their daily activities.

d) Course Content

The topics to be delivered within this unit as outlined below.

No	Product/ Solution	Duration (time)	Key topics
1	Registration	10 minutes	Difference between creating a new patient and an existing user to patient. Verifying client’s existence in client registry using ID card or birth certificate for <18years Documenting patient demographics Documenting Patient locator information Posting to registry for clients not yet assigned a NUPI. Saving form once complete Editing of the form NUPI reports
2	HIV Testing Services	30 Minutes	Describe the program. Value proposition Eligibility screening ML Scoring Documenting initial test Documenting confirmatory test Referral to preventive services for negative client Linkage to treatment for positive clients Referral to other facility HTS reporting i.e., MOH 362, CONFIRMATORY REGISTER
3	Contact listing, tracing and registration	15 Minutes	Listing of contacts by Index clients i.e., family, SNS, sexual, IDU Documenting contact tracing. Contact registration with emphasis on the workflow. Reporting – PNS register, Family testing register.
4	HTS Tracing	5 Minutes	Eligible clients for tracing Documenting tracing history Reasons for no contact
5	PrEP	30 Minutes	Describe the program. Value proposition Eligibility Criteria Forms to be filled to assess eligibility. Registration form – 15 years and above HTS Initial form – Final result must be negative. Triage – weight value must be updated. PrEP Behaviour Risk Assessment in the last six months – Willingness to take PrEP must be Yes. Lab order – Creatinine test. If not done, it doesn’t hinder enrolment. Enrolment into PrEP Documenting PrEP initial encounter Documenting a follow up encounter Documenting a monthly refill encounter Updating PrEP progress notes PrEP registers PrEP initiation register PrEP follow up register. PrEP reporting MOH 731B Other line lists i.e. Program discontinuation
6	VMMC	30 minutes	Describe the program. Outline value proposition Eligible population – Male Screening for eligibility Documenting procedure Documenting post-operative events Documenting follow up VMMC reporting Program discontinuation
7	Key Population		Key population types Enrolling a client to KP program using Contact form Enrolling a KP for clinical services on clinical enrolment form Documenting KP clinical services on the clinic visit form. Updating other services provided such as ( STI treatment GBV, PrEP assessment KP Treatment verification HTS Overdose reporting – Peer and HCW Peer tracking Violence reporting TB screening KP Diagnosis Updating peer calendar Program discontinuation Registers – Outreach worker summary, KP cohort register KP monthly reporting (KPIF) MOH 731B report Other line lists
8	Care and Treatment Module	2 hour	Describe the program Outline the value proposition Enrolling a client in HIV program Updating ART preparation session Initiating a client on ART Documenting regimen switches and substitutions Updating the clinical encounter form i.e., the green card Documenting other services such as Cervical cancer screening Enhanced adherence counselling Gender Based violence screening Alcohol and Drug abuse Depression scrrening-PHQ9 General anxiety disorder Managing lab orders i.e., Viral load, CD4 monitoring e-Prescription Assigning case/client to case manager Adding relationship Discontinuation from service
9	OTZ	10 minutes	Describe the program and the eligible population (10-19yrs) Enrolment into the program Updating OTZ activity form Discontinuation from the program OTZ register. OTZ reporting OTZ report Current on OTZ line list
10	OVC		Describe the program and the eligible population (10-19yrs) Enrolment into the program Discontinuation from program OVC report Current on OVC line list
11	HIV Client Tracing	10 Minutes	Accessing the list of clients eligible for tracing using either of the following line lists Missed appointment. Lost to follow up. Missed appointment and attrition report. Missed appointment r Accessing the tracing form Documenting the tracing history on the tracing form Accessing output on tracing on defaulter register
12	TPT Module	15 minutes	Eligible population Enrolling to TPT Documenting follow up encounter. Documenting outcome Discontinuation from TPT
	COVID	15 Minutes	Eligible population for vaccination – 12+ Documenting COVID19 infections and vaccinations on COVID assessment form COVID reporting
13	TB	15 minutes	Describe the program. Outline value proposition Enrolment to program Initiating TB treatment Documenting follow up encounters. Updating applicable TB related tests on lab order– GeneXpert, X-Ray, TB-LAM etc.
14	PMTCT Mother Service	2hrs	Describe the program and the eligible group. Outline the value proposition. Enrolment into the program Updating ANC services on MCH ANC Visit form Documenting obstetric history Documenting preventive services Updating labour and delivery event on the delivery form Mother baby pairing on delivery form Documenting discharge details on Discharge form Updating post nata services on the MCH PNC Visit form Discontinuation from the program MCH mother service registers ANC register Maternity register PNC register MCH Mother service reporting Maternal cohort analysis Other line lists
15	PMTCT Child service		Describe the program and the eligible group. Outline the value proposition. Enrolment into the program Adding relationship Documenting immunization history of the child Updating the HEI follow up on CWC follow up form. Documenting Early Infant diagnosis tests on lab order Prescribing infant prophylaxis on drug order Documenting HEI outcomes Discontinuing from program MCH Child services registers HEI register Permanent immunization register (MOH 510) CWC register (MOH 511) MCH Child services reports Immunization summary (MOH 710) HEI cohort analysis Other line lists
16	Lab order		Value proposition Creating an order Updating order reason where applicable Cancelling an order Updating results Viewing previous lab orders
17	Lab manifest		Prerequisites Value proposition Creating a manifest Must haves before adding a sample to manifest- regimen line must be updated. Adding samples to a manifest Changing manifest status Printing manifest Accessing barcode reader Checking manifest status Interpreting results on manifest Actionable results
18	Drug Order		Value proposition Updating a drug order for ART drugs Updating an order for other drugs Viewing past prescriptions Editing an existing prescription Saving and signing of the prescription by the clinician Sending prescriptions from KenyaEMR to WebADT Dispensing

Mode of Delivery

The training sessions will be conducted either in a classroom setup, virtually or through a hybrid approach. Appropriate delivery methods to be adopted include Facilitator lecturette, Practicums sessions, group work and presentations and individual assignments among others.

f) Instructional Materials and Equipment

To facilitate the training sessions, the facilitator will need the following training materials and training supplies:

LCD projector for conference presentations
Computers for the facilitator
Handout materials,
Internet,
Whiteboard/ Flip Charts
Marker pen

The participants are expected to have the following at a minimum:

Computer
Internet
Stationary i.e., Notebook and pens

Course Assessment

Trainings are evaluated to measure effectiveness and impact of the training. The following evaluations tools should be used.

Pre – Test: To be filled by the participants immediately before the onset of the training.
Post – Test: To be taken by the participant on the last day of the training.

Performance variance between pre-test and post-test will indicate the effectiveness and impact.

NB: Pre/ Post test quiz should be a set of same questions.

h) Recommended Reference Materials

i) Other course Journals & e-resources

2.2: mHealth Program

a) Code: mHealth Program: 16hrs

b) Course Purpose

The purpose of the course is to enable the student acquire knowledge and skills on the use and the value proposition of the various mHealth products.

c) Expected Learning Outcomes

At the end of the course the participants shall be able to:

Understand the various mHealth solutions available.
Understand the value proposition of each mHealth solution.
Develop skills to navigate through the various mHealth products
Develop competency in the use and application of mHealth solutions in their daily activities.

d) Course Content

Topics to be delivered within this unit include:

No	Product/ Solution	Duration	Key topics
1	Ushauri	2 hours	Describe Ushauri application. Outline the value proposition. Overview of the modules supported. Searching a client Registering a client Updating a client Consenting a client Booking an appointment Updating tracing history Call feature Appointment dashboards Tracking dashboards
2	Nishauri	1 hour	Describe Nishauri Highlight the prerequisites. Outline the value proposition. Searching and creating a patient Overview on various functionalities Updating dependencies Rescheduling ana appointment
3	ART Referral & Directory	30 minutes	Describe ART Referral and Directory Outline the prerequisites. Outline the value proposition. Registering a user USSD accessibility Initiating and accepting a transfer Notifying mother facility of refill for a transit client Notifying mother facility of a silent transfer How to get patient details
4	PSurvey	30 minutes	Describe PSurvey Outline the value proposition. Registering a user Creating a survey Updating an existing survey Accessing responses Accessing dashboards
5	C4C	20 Minutes	Describe C4C Highlight the value proposition. Register a health care provider. Recording an exposure
6	mLab	20 minutes	Describe mLab Outline the value proposition. Setting up a facility Pulling of results
7	AfyaSTAT	30 Minutes	Describe AfyaSTAT Outline the value proposition. Registering a client Screening for eligibility Recording testing services i.e., initial and retest Contact listing by positives. Syncing data to KenyaEMR server

e) Mode of Delivery

f) Instructional Materials and Equipment

To facilitate the training sessions, the facilitator will need the following training materials and training supplies:

LCD projector for conference presentations
Computers for the facilitator
Handout materials,
Internet,
Whiteboard/ Flip Charts
Marker pen

The participants are expected to have the following at a minimum:

Computer
Internet
Stationary i.e., Notebook and pens

g) Course Assessment

Trainings are evaluated to measure effectiveness and impact of the training. The following evaluations tools should be used.

Pre – Test: To be filled by the participants immediately before the onset of the training.
Post – Test: To be taken by the participant on the last day of the training.

Performance variance between pre-test and post-test will indicate the effectiveness and impact.

NB: Pre/ Post test quiz should be a set of same questions.

Training evaluation /Feedback: Training feedback is important for quality assessment and improvement. Feedback tool should be administered to all the participants to provide their comments and recommendation. The feedback should be incorporated in the future training session for improvements.

h) Recommended Reference Materials

j) Other course Journals & e-resources

2.3: Data and Information Products

a) Code: Data and Information Products: 40hrs

b) Course Purpose

The purpose of the course is to enable participants acquire knowledge and skills on the role of various HIS solutions and how they contribute data and information for decision making at various levels of use. This includes knowledge on data sources, data transmission utilities and available information products available for public use.

c) Expected Learning Outcomes

At the end of the course the participants shall be able to:

Apply the acquired skills to identify existing data sources and data collection solutions.
Understand the data extraction and transmission processes and the solutions supporting the process.
Develop skills to navigate and properly interpret the various dashboards and information products available in the national individual data repository (i.e., National Data Warehouse) for policy and decision making.
Understand and apply professional data handling practices, comply to data protection act 2019, apply values and ethical principles in the practice and use of health data.
Develop competency in self-service platform for data extraction, data visualization and reporting from individual level data repository for program specific utilities.

d) Course Content

The topics to be covered in this unit are as outline below.

No	Product /Solution	Duration (Time)	Key Training Topics
1	DWH	4 hrs	Introduce the Data warehouse features and functions. Describe the process of navigation different dashboards on NDW Discuss the NDW data flow from the data collection point at facility to the DW by describing the processes at each stage. (i.e. Kenya EMR, DWAPI, SPOT, NDW) Perform in-depth NDW Walkthrough by describing each dashboard (i.e Reporting rates, HIV Testing and Prevention, Care and Treatment, Data dictionaries (NDW) etc)
2	Self Service	36hrs	Take the participants through the key components of self-service including the following: Describe the concept of “Self-Service” and its significance in the data demand and information use. Describe various tools applicable for self-service while focusing on Apache Superset for external self-service utility. On the superset tool. Describe and demonstrate the following procedures: How to set up data warehouse accounts and access datasets via Apache superset. Registering and connecting to the data warehouse. Exploring availed line list and aggregate datasets, and how that can be used to create relevant charts. Navigating the Superset interface Creating basic dashboard Adding and arranging visualizations- Create Charts, graphs, etc. How to apply custom filters to dashboards. Customizing dashboard layouts and styles How to download/extract the data to create charts from the database. How to Publish dashboards and visualizations for sharing and collaborations Develop information products from the selected use cases using superset. Presentation of information products
3	SPOT	1hour	Describe SPOT and its application in the NDW upload continuum. Take the participants through the navigation and highlight key components of SPOT user interface. (i.e Facility upload history, application of filters, Facility metrics, extracts for each program etc) Describe and demonstrate how to monitor individual facility reporting and data upload performance.
4	HIS Management Portal	2hrs	Introduce HIS Management Portal by describing its function and application in managing HIS deployments. Describe the process of creating new facility, editing, and updating details of existing facility and the approval process. Take the participants through features and components of the interface. Demonstrate the following workflows: Account creation and management Available list of Facilities overviews Adding a new facility Updating details of existing facility Modules uptake report generation Approval process of various actions

e) Mode of Delivery

The training sessions will be conducted either in a classroom setup or virtually or through a hybrid approach. Appropriate delivery methods to be adopted include Facilitator lecturette, Practicums sessions, group work and presentations and individual assignments among others.

f) Instructional Materials, Supplies and Equipment

To facilitate the training sessions, the facilitator will need the following training materials and training supplies:

LCD projector for conference presentations
Computers for the facilitator
Handout materials,
Internet,
Whiteboard/ Flip Charts
Marker pen

The participants are expected to have the following at a minimum:

Computer
Internet
Stationary i.e., Notebook and pens

g) Course Assessment

Trainings are evaluated to measure effectiveness and impact of the training. The following evaluations tools should be used.

Pre – Test: To be filled by the participants immediately before the onset of the training.
Post – Test: To be taken by the participant on the last day of the training.

Performance variance between pre-test and post-test will indicate the effectiveness and impact of training.

NB: Pre/ Post test quiz should be a set of same questions.

Training evaluation /Feedback: Training feedback is important for quality assessment and improvement. Feedback tool should be administered to all the participants to provide their comments and recommendation. The feedback should be incorporated in the future training session for improvements.

h) Recommended Reference Materials

The following are reference sources are available for the participants for further learning.

KenyaHMIS project website ( https://kenyahmis.org/resources)
Project YouTube channel: (Palladium Kenya HMIS – YouTube)
KenyaHMIS eLearning platform (Faculty of Health Sciences e-learning platform (uonbi.ac.ke)

2.4: Technical System Administration Program

a) Code: Title of unit: Technical System Administration Program: 40hrs

b) Course Purpose

The purpose of the course is to enable the learners to acquire knowledge and skills on the administration and maintenance of the HIS products implemented across health facilities in Kenya. System maintenance is a core function in achieving systems sustenance and reliability. This function is carried out by System Administrators and selected EMR champions, which includes routine functions like database backup setup, HIS products installation, System configuration among others.

c) Expected Learning Outcomes

At the end of the course the learners shall be able to.

Apply the technical skills to be able to correctly install, setup and configure various HIS application.
Apply the knowledge to provide routine technical support and technical assistance to the active HIS implementations.
Develop mentorship competency in training other users on system administration.

d) Course Content

Actual topics to be delivered within this particular unit are listed below.

No	Product/ Solution	Duration	Key topics
1	KenyaEMR	2 hours	Provide key highlights of KenyaEMR. Outline KenyaEMR installation prerequisites. Describe key steps in installation of KenyaEMR. Showcase the actual installation process to the participants. Ask the participants to practically perform the installation up to the end. Take participants through the initial configurations including: Default facility setup Database backup End point configurations for IL and OpenHIM Demonstrate the user account creation and logging process and highlight key features of KenyaEMR interface
2	DWAPI	1 hour	Introduce DWAPI solution and its use cases. Outline installation requirements for DWAPI Describe various modes of use outlining the process for each mode i.e., Facility mode, boardroom mode. Ask the participants to perform the installation through a practicum session. Demonstrate the DWAPI configurations i.e., Database connections, end points etc. Describe data quality aspects of DWAPI i.e., data deduplication, data and missing data among others. Illustrate the process of data extraction and transmission to the DWH. Discuss and provide guidance on various troubleshooting techniques for DWAPI installation and configuration. Ask the participants to give feedback on the process through a FAQ method.
4	AfyaSTAT	2 hours	Introduce AfyaSTAT application with specific highlights on its use case and the core value proposition. Describe the requirements needed for AfyaSTAT installation. Through a practicum session, walk through the AfyaSTAT installation process with the participants while explaining every step. Show and describe how to perform all the necessary configuration as required including Pi-Hole. Demonstrate the process of user management. Illustrate various troubleshooting techniques. Highlight to the participants the key features of AfyaSTAT
5	mHealth Applications	6 hours	Outline all the supported mHealth application that exist and their value proposition to improved HIV care delivery i.e Ushauri, Nishauri, ART Dir/ Referral services, mLab, pSurvey and C4C Describe all the requirements needed for installation for each application. In a practicum session, take the participants through the installation of each mobile application clearly describing each step. Illustrate setup and configurations of each mobile application including user management. All participants to login and explore unique features of each application. Give time for FAQs and document feedback for future enhancements.
6	Interoperability Layer (IL)	1 hour	Describe interoperability Layer (IL) and its role in data sharing across different digital health platform. Highlight various IL solutions available in HIS Describe the process of IL installation and setup with focus on Setup of end points in KenyaEMR Setting up schedulers for data exchange intervals Changing scheduler intervals Describe data elements being shared (transmitted and received) Highlight specific participating systems in the IL ecosystem.
7	KenyaHMIS Toolkit	1 hour	Introduce the Toolkit application and describe its application in KenyaEMR installation and upgrade. Describe all the requirements needed for installation of the application. In a practicum session, take the participants through the installation the application while clearly describing each step. Illustrate setup and configurations of the tool. Highlight key features and functionalities of the tool. Give time for FAQs and document feedback for future enhancements.

e) Mode of Delivery

f) Instructional Materials, Supplies and Equipment

To facilitate the training sessions, the facilitator will need the following training materials and training supplies:

LCD projector for conference presentations
Computers for the facilitator
Handout materials,
Internet,
Whiteboard/ Flip Charts
Marker pen

The participants are expected to have the following at a minimum:

Computer
Internet
Stationary i.e., Notebook and pens

g) Course Assessment

Trainings are evaluated to measure effectiveness and impact of the training. The following evaluations tools should be used.

Pre – Test: To be filled by the participants immediately before the onset of the training.
Post – Test: To be taken by the participant on the last day of the training.

Performance variance between pre-test and post-test will indicate the effectiveness and impact.

NB: Pre/ Post test quiz should be a set of same questions.

Training evaluation /Feedback: Training feedback is important for quality assessment and improvement. Feedback tool should be administered to all the participants to provide their comments and recommendation. The feedback should be incorporated in the future training session for improvements.

h) Recommended Reference Materials

The following are reference sources are available for the participants for further learning.