Introduction to eCHIS

Course Transcript

Session 1: eCHIS Basics

Slide 1:
Welcome to the online course, Introduction to eCHIS, the electronic community health information
system. In this course you will become familiar with how the eCHIS suite of apps works and how it is
used in the Ethiopian health system.

Slide 2:
The course is comprised of five sessions, each divided into between 1 and 5 classes.

At the end of each of the 5 sessions is a short quiz to check your learning. There is also a final exam
at the end of the course. Passing all of the session quizzes and the final exam will enable you to print
your certificate.

Slide 3:
The 5 sessions in this course are: eCHIS Basics, Using the HEW App, Using the Health Center Referral
App, Using the Focal Person App, and Troubleshooting Information Technology, or IT, Issues.

Slide 4:
By the end of this course, you will be able to:

• Discuss the purpose of the eCHIS suite of apps

• Explain how eCHIS is used in the Ethiopian health system and by whom
• List the three apps that comprise the eCHIS suite, their key components and features, and
how they work together
• Discuss how HEWs use the app to record and report on client health information
• Discuss how health center staff use the app to receive referrals, track client services, and
provide feedback to HEWs
• Discuss how focal persons use the app to monitor HEW performance and service delivery,
use supportive supervision checklists, and complete troubleshooting reports, and
• List common IT issues related to the eCHIS app and explain how they are resolved.

Slide 5:
In order to take the course, you will need access to an Android smart phone or tablet that has been
loaded with the three eCHIS apps and a user name and password to permit you to access them.
Please check with your instructor or supervisor if you do not have these prerequisites.

If you have questions about the course or any of its content along the way, please ask your
instructor or supervisor for help or email
DHAechis@[Link]. You might want to make a note of this email address in case you need to refer
to it during the course.

Slide 6:
Before we get started, let’s go over a few tips to help you navigate the course screen.

In the side bar you will find a “Menu” tab with a list of the topics in this class. You may navigate to a
topic that you have already visited by selecting the topic.

Also, in the side bar you will find a “Glossary” tab with key words and definitions and a “Notes” tab.
Select the “Notes” tab if you would like to read along with the narration.

In the upper right is an exit button if you would like to leave the session before completing it.

To pause, play, or replay a slide, use the control buttons and slider at the bottom center of the
screen. On the bottom left you can adjust the volume.

Except when you are asked to manually advance a slide, the slides will move forward through the
classes automatically. But you can also move forward or backward through the slides that have
already been played by selecting the “Next” or “Previous” buttons. Select “Next” now to continue on
with the class.

Slide 7:
Now we’re ready to start session 1 of the course. In this session, we will provide a basic introduction
to the eCHIS suite of apps, including what eCHIS is and how it functions.

This session will take approximately 25 minutes to complete.

Slide 8:
By the end of this session, you will be able to:

• Discuss the purpose of the eCHIS app

• Explain how eCHIS software is used in the Ethiopian health system and by whom
• Discuss key benefits of the eCHIS app
• List the 6 content components of the eCHIS app
• List the three apps that comprise the eCHIS suite, their components and features, and how
they work together, and
• List and discuss the five basic uses of the eCHIS app.

Slide 9:
We will start with an introduction to what eCHIS is, how it works, and some of its benefits.

eCHIS, or the Electronic Community Health Information System, is a suite of mobile applications, or
”apps” supplemented by a web-based monitoring portal that functions as a service delivery tool as
well as a data capture tool.

It is designed to support Health Extension Workers, or HEWs, to do their jobs better and more easily.
It functions as a job aid, strengthens referral linkages, and allows HEWs to collect and report data.

The system also provides data on community health status to decision-makers in an effort to
improve service delivery while improving quality of care and supporting longitudinal client tracking.
Slide 10:
By enhancing the ability to collect, report, analyze, and use data, eCHIS can improve data quality
while also promoting a culture of data use at the community level.

If you are currently connected to the Internet, please view a six-minute video on eCHIS before
proceeding with the session. Select the “Watch Video” button to view it. Otherwise, select “Next.”

Slide 11:
The Health Extension Program, or HEP, is one of Ethiopia’s major mechanisms for the delivery of
high impact priority health promotion, disease prevention, and selected curative services to the
community. It is designed to be delivered at household, community, schools, youth centers, and
health posts by health extension workers. Introduced in 2003, the HEP has succeeded in expanding
geographic coverage, infrastructure development, and service delivery across the country.

Slide 12:
Since 2004, the program has been using a family-centered paper-based information system called
Community Health Information System (or CHIS) for routine monitoring and management of
program performance. Through it, HEWs collect and report community-based data.

While successful overall, the paper-based system has drawbacks such as data handling and updating,
errors in data recording, poor data quality, low reporting rates, and work overload for HEWs.

To address these challenges, the digitized eCHIS system was launched in 2017.

Slide 13:
The key benefits of eCHIS are:

• Improving the accessibility, timeliness, and quality of community health information

• Serving as a job aid and support tool for HEWs by providing easy-to-follow prompts and
forms to assist during client visits
• Improving the health information system in collecting and using information for action at the
community level
• Advancing the culture of data use by providing up-to-date information to HEWs and
management at all levels, allowing them to review their performance
• Helping health consumers access quality health care, and
• Linking community health data to the national health information system, or HIS.

Slide 14:
The eCHIS mobile application suite actually consists of three applications, each with its own purpose
and used by different cadres of health workers.

These are the HEW app, the Health Center Referral app, and the Focal Person app.

Slide 15:
The HEW app is the primary eCHIS application. It is designed to support HEWs in client service
delivery and follow-up, and particularly management of the Family Folder. It also enables electronic
sharing of household and individual information between HEWs and other workers in the health
system by facilitating the creation of referrals and the receiving of updates of client status.
Slide 16:
The Health Center Referral app provides facility-based workers such as midwives and other clinicians
and support staff with access to community-based health data, improving continuity of care.

The app enables them to accept referrals from HEWs and, in turn, provide HEWs with referral
feedback.

Slide 17:
The Focal Person app is designed to support the job of the HEP supervisor or focal person by
allowing them to monitor HEW activity and supervise which program services are provided to which
clients.

The app provides supervision checklists, management of late client visits, and the ability to monitor
the progress and performance of individual HEWs. It also includes information on how to
troubleshoot problems that might arise with the devices or the HEW app.

Slide 18:
The three eCHIS apps work together as a system.

This illustration shows how they interact to facilitate client referral and feedback.

The HEW uses the eCHIS HEW app to record and access client information when working with clients
in the community or at a health post. The HEW then syncs the data through the system so that
facility-based workers can access information about any clients the HEW is referring to their care
and follow-up with these clients. The health center worker than syncs the updated information into
the system so the HEW can receive it.

The focal person can also access this information from the HEW so that they can monitor her work
and provide guidance as needed.

The dotted lines show the internal communication of the mobile users. This feature will be available
in the future. It will enable, for instance, HEWs to send an SMS text message to a client to remind
them of an appointment and also to communicate directly with the health center workers and focal
persons via SMS.

Slide 19:
This diagram shows the movement of data through the eCHIS system. Data entered into eCHIS travel
over the internet so that they can be accessed in real-time. For instance, an HEW can send client
data from her mobile phone or tablet so that they can be reviewed by facility-based workers.

Data in the system are synched to the central server at the ministry of health, or MOH, and stored
there. In return, system updates and setting data are sent from the MOH to the HEWs and other
users through the server.

Also through this server one can access the eCHIS web portal that contains dashboards and
databases for use by managers. woreda health offices, zonal health departments, and regional
health bureaus can gain access to eCHIS dashboards and reports via the web portal.

Slide 20:
Synching of eCHIS can take place whenever there is Internet connectivity, such as through Healthnet,
3G, or WiFi.
However, once the data are downloaded, eCHIS works in an offline environment. In these instances,
for example, an HEW can record the client data offline. Then she can bring her mobile device to a
health center or other location that has connectivity and synchronize the client data there. She can
also receive system updates and updated data at this time.

Slide 21:
The eCHIS web portal makes it possible to view system data, such as those submitted by individual
HEWs, in aggregate format.

Focal persons and other health administrators access these data to generate reports and dashboards
to inform their decision making.

National, regional, zonal, and woreda-level workers can also use information from the portal,
tracking program progress and performance and monitoring HEW activities.

Slide 22:
The eCHIS app is organized into six key components.

We will talk more about these components throughout the course but let’s review them briefly now.

Slide 23:
[Interaction]
Select each of the light blue buttons to learn more about each of the components. When you are
done, select the “Next” button to continue with the class.

The Family Folder is the main component of the eCHIS HEW app. This is where all household and
client information is entered and stored, including the members of the household and the health
status of each.

The Service Modules contain client information on reproductive, maternal, newborn, and child
health services, or RMNCH, as well as on communicable diseases such as tuberculosis, non-
communicable diseases such as diabetes, neglected tropical diseases, and logistics supply and
management. Other services are being developed and will be made available soon. For instance, a
COVID-19 service module has been developed to track information about that pandemic.

Mobile Reports is the module that contains service information including demographic reports,
service coverage reports, disease reports, and health management information system, or HMIS,
reports. These reports are created and stored in the app and can then be synched to the appropriate
parts of the health system for data analysis and use.

The web portal is a tool linked to the app that makes the data submitted by the HEWs available in an
aggregate format. These data can then be used by national, regional, zonal, and woreda-level
workers to track the progress and performance of the program. In addition to accessing these
aggregated data, focal persons can monitor HEW performance through this portal.

The Data Synchronization feature enables data to be pushed from the mobile device to the server,
pulled from the server to the mobile device, and exchanged between mobile devices. For this to
work, all users sync their devices at least twice a day or whenever they have an Internet connection.

Integration (or interoperability) permits eCHIS to work seamlessly with other nationally recognized
digital health information systems such as DHIS2 and Dagu2. For instance, interoperability with
DHIS2 permits monthly service delivery and disease reports to be transferred electronically from
eCHIS to DHIS2 without manual intervention.

Slide 24:
Let’s now summarize the five basic uses of eCHIS.

Select each of the buttons to learn more about that use.

Slide 25:
[home slide]

Slide 26:
In terms of service delivery, eCHIS allows HEWs and other staff to easily review household and
individual data to deliver tailored health services.

Slide 27:
The app also functions as a job aid that provides digital tools designed to help facilitate work
processes for HEWs. And it provides reinforcement of policies, procedures, and guidelines through
digital workflows.

Slide 28:
In the area of data collection, reporting, and analytics, eCHIS is used to collect client health care data
and produce reports on these data, permitting their analysis and use.

These main uses include:

• Digitizing the collection of client data so that they are easier to document and access
• Automating existing manual reporting processes to reduce time, resources, and reporting
errors
• Presenting collected and aggregated data in useful and meaningful formats to allow for
better informed decision making
• Tracking and monitoring the activities of HEWs, and
• Working jointly with other internet-based health information tools such as DHIS2, Dagu, and
EMR. This interoperability enables data to flow seamlessly between them.

Slide 29:
The eCHIS identification function creates digital links between unique identifiers and health
information about households and individuals. This enables the user to access information about a
specific household using the individual or household ID assigned to it in the application.

Further, the app prevents the creation of duplicate household or individual records. The app is also
integrated with a biometrics device enabling the identification of each registered member through
the use of his or her fingerprint.

Slide 30:
The eCHIS communication function:

• Enables electronic sharing of household and individual information between HEWs and
other staff
 • Allows HEWs to receive updates on client status so that appropriate and timely follow-up
can be planned and carried out, and
• Facilitates referral linkages.

Slide 31:
Now that you know the basics about the eCHIS suite of apps, here is information to get you started
using it.

These functions include how to launch, log in and out, and sync eCHIS, as well as how to navigate the
eCHIS home screens.

Slide 32:
All three eCHIS apps should already be installed on your Android smart phone or tablet. If they are
not, report this to your instructor or supervisor or send an email to the address on the screen.

To launch the app:

* Tap on the app’s icon.

* If you do not see this icon on the device home screen, look for eCHIS in the list of apps and tap it.
* After a few seconds the login screen will appear.

Slide 33:
Since for this training you will need access to all three eCHIS apps, you will be able to choose
between them by tapping the arrow.

Note that most health system users will only have access to one of the apps, depending on their role
in the system. For instance, the HEWs will have access to the HEW app while focal persons will have
access to that app.

Once you have selected the app you want to use, enter the user name and password that were given
to you by your instructor or supervisor and log into the app. If you do not have this information,
report this to your instructor or supervisor or write to the email address on the screen.

Slide 34:
When you first log into the app, you see this home screen. The home screens of each of the three
apps look very similar. They all have three main icons: The “Start” icon, the “Sync with Server” icon,
and the “Log Out” icon.

You can navigate to different parts of the app from this screen.

• Select this icon to start using the app

• Select this icon to sync the information in the app with the server
• You can find the time of the most recent synching here
• Select “Log out” to exit the app.

You can also set the app to work in the language with which you are most comfortable.

And you can confirm which of the three eCHIS apps you are using by looking at the title in the upper
left corner.
Slide 35:
Note that the app screens can be viewed either horizontally or vertically on either Android smart
phones or Android tablets.

Slide 36:
When eCHIS users sync their apps, the data that have been entered are used to update the central
data base and transmitted between the HEW, Health Center Referral, and Focal Person apps.

Synching with the server pushes pending data from the mobile device to the server so that they are
recorded and accessible to others in the system. For instance, when an HEW syncs her app, the
midwife at the health center receives it. Likewise, the midwife can update the client information
and, by synching, send the new information back to the HEW.

HEWs working in the same health post can also sync with each others’ devices, exchanging data to
avoid duplication.

All system users sync with the server at least twice daily, when first logging in at the beginning of the
work day and before logging out at the end of the work day.

Slide 37:
Users should always log out of the app when it is not being used.

This protects the client data and prevents others from editing or deleting these data. It also saves
battery life.

Slide 38:
This concludes session 1 of the course, Introduction to eCHIS. In this session you learned that:

• eCHIS, or the Electronic Community Health Information System, is a suite of mobile apps
that functions as a service delivery tool as well as a data capture tool
• Three interlinked apps comprise the eCHIS software suite: the HEW app, the Health Center
Referral app, and the Focal Person app, and
• eCHIS assists with health care service delivery by providing workers with job aids; facilitating
the collection, reporting, and analysis of data; and improving communication between
health care workers.

Now take the short quiz that follows. You will need to pass it with a score of at least 80%. You may
take the quiz as many times as you need in order to pass it.

Slide 39:
[Quiz]
Session 2: The eCHIS HEW App
Class 1: Introduction to the eCHIS HEW App

Slide 1:
Welcome back to the online course, Introduction to eCHIS, the electronic community health
information system.

Before we get started, if you would like to review how to navigate the class screens, select the
“Navigation” button. Otherwise, select the “Next” button (jumps to slide 3).

Slide 2:
In the side bar you will find a “Menu” tab with a list of the topics in this class. You may navigate to a
topic that you have already visited by selecting the topic.

Also, in the side bar you will find a “Glossary” tab with key words and definitions and a “Notes” tab.
Select the “Notes” tab if you would like to read along with the narration.

In the upper right is an exit button if you would like to leave the session before completing it.

To pause, play, or replay a slide, use the control buttons and slider at the bottom center of the
screen. On the bottom left you can adjust the volume.

Except when you are asked to manually advance a slide, the slides will move forward through the
classes automatically. But you can also move forward or backward through the slides that have
already been played by selecting the “Next” or “Previous” buttons. Select “Next” now to continue on
with the class.

Slide 3:
This is session 2 of the course. In this session, we will discuss the HEW app that is part of the eCHIS
suite of apps.

In session 3 we will discuss the Health Center Referral app and in session 4 we will cover the Focal
Person app.

This session is divided into four classes. The first class presents an introduction to the eCHIS HEW
app. Class 2 covers the Family Folder and Class 3 discusses the Service Modules. Other HEW app
functions are discussed in Class 4, specifically the use of referrals to a higher level of care and the
app’s reporting functions.

Slide 4:
By the end of this session, you will be able to:

• Explain the purpose of the eCHIS HEW app and its key functions
• Launch and initiate use of the eCHIS HEW app
• Sync the HEW app with the server to transmit information
• Discuss the Family Folder in the HEW app and how it is used to register and track households
and their members
• Discuss the Service Modules in the HEW app and how they are used to document client care
• Explain how HEWs use the app to refer clients to a higher level of care, and
• Describe how the HEW app reporting functions are used for data analysis and system
monitoring.
Slide 5:
We will start the first class in this session with an introduction to accessing and using the eCHIS HEW
app.

This class will take approximately 12 minutes to complete.

Slide 6:
The eCHIS HEW app is used at health posts by HEWs for household registration, service provision,
referral linkages, and data reporting and utilization.

The main screen of the app contains a series of icons such as in the image shown here. Please note
that this screen may appear different at times, depending on the modules available.

Slide 7:
For household registration, the HEW at the health post registers all households in the kebele with
information about its members and properties. This information is stored in the Family Folder that
we will discuss next.

The HEW app also contains modules for different aspects of service provision. The app automatically
determines which modules are pertinent for each client according to the client data entered in the
system and only those icons appear on the screen. After providing the appropriate service, the HEW
updates the information by entering it into the app.

When a client needs a higher level of care, the HEW issues a digital referral, linking their care to the
health center.

The HEW also uses the app to generate service delivery reports based on the information collected.
These reports are then sent through the system to be used by focal persons and other managers to
monitor and guide service provision.

In this session we will look at each of these functions in more detail.

Slide 8:
If you would like to review how to launch, log in and out, and sync the app, as well as how to
navigate the home screen on this and any of the eCHIS apps, select the Review button. If not,
proceed on with the session by selecting the Next button (jumps to slide 15).

Slide 9:
As you know from session 1 of this course, the eCHIS suite of apps should already be installed on
your Android smart phone or tablet. If it is not, report this to your instructor or supervisor or email
the address on the screen.

To launch the app:

* Tap on the app’s icon.

* If you do not see this icon on the device home screen, look for eCHIS in the list of apps and tap it.
* After a few seconds the login screen will appear.

Slide 10:
Remember that eCHIS consists of three apps. In this session we are concerned with the HEW app.
HEWs will have access to only this one of the three apps while health center workers will have access
to the Health Center Referral app and focal persons will have access to that app.

Since you have access to all three apps, first make sure that you select the HEW app. Do this by
tapping on the small arrow as shown. This will give you the option to select the HEW application
from the list on the screen.

Once you have selected the HEW app, enter the user name and password that was given to you by
your instructor or supervisor and log into the app. If you do not have this information, report this to
your instructor or supervisor or email the address on the screen.

Slide 11:
When you first log into the app, you see this home screen. The home screens of each of the three
apps look very similar. They all have three main icons: The “Start” icon, the “Sync with Server” icon,
and the “Log Out” icon.

You can navigate to different parts of the app from this screen.

• Select this icon to start using the app

• Select this icon to sync the information in the app with the server
• You can find the time of the most recent synching here
• Select “Log out” to exit the app.

You can also set the app to work in the language with which you are most comfortable.

And you can confirm which of the three eCHIS apps you are using by looking at the title in the upper
left corner.

Slide 12:
Note that the app screens can be viewed either horizontally or vertically on either Android smart
phones or Android tablets.

Slide 13:
When eCHIS users sync their apps, the data entered are used to update the central data base and
transmitted between the HEW, Health Center Referral, and Focal Person apps.

Synching with the server pushes pending data from the mobile device to the server so that they are
recorded and accessible to others in the system. For instance, when an HEW syncs her app, the
midwife at the health center receives it. Likewise, the midwife can update the client information
and, by synching, send the new information back to the HEW.

HEWs working in the same health post can also sync with each others’ devices, exchanging data to
avoid duplication.

All system users sync with the server at least twice daily, when first logging in at the beginning of the
work day and before logging out at the end of the work day.

Slide 14:
Users should always log out of the app when it is not being used.
This protects the client data and prevents others from editing or deleting these data. It also saves
battery life.

Slide 15:
The very first time logging into the app, the HEW will see the “Initial Application Setup” icon on the
main folder screen.

She needs to select this icon and answer the series of questions that follow. This includes
information such as how many ambulances there are in her catchment area and the drivers’ contact
numbers, and information about the gotes in the kebele.

Once the HEW enters this information into the app, following the prompts one at a time, she selects
the green “Finish” button to finish the set up and record the information.

Note that only one HEW at each health post needs to complete this information. Then, when the
apps are synched, the information will automatically be added to the apps used by the other HEWs
at the health post.

Slide 16:
Note that after the HEW enters this initial information, the Initial Application Setup icon will no
longer be displayed and she will not be able to edit the information that it contains. Only the focal
person can make necessary edits, for instance, if any of the information entered changes. In such
cases, the app will be automatically updated with the new information the next time the HEW syncs
her device with the server.

Slide 17:
Let’s now practice entering in initial information. This will help you better understand how it is done,
plus it will provide data for the app that will enable you to practice using the app throughout this
course.

Log in to your HEW app now and select the “Initial Application Setup” icon. Follow the prompts,
entering the information seen here. For the other questions that appear in the app, such as whether
the woreda has been selected for malaria eradication, add information of your choosing. When you
have entered all of the information, send the form by selecting the green “Finish” button.

Contact your instructor or supervisor or email the address on the screen if you have questions or
problems.

When you have finished, select “Next” to conclude this session.

Slide 18:
You have reached the end of the first class in this session.

In this class you learned about the purpose and key functions of the eCHIS HEW app. You also
practiced entering information into the app under the Initial Application Setup icon.

You may take a break now or continue on directly with class 2 of this session on the eCHIS HEW App.
Session 2: The eCHIS HEW App
Class 2: The Family Folder

Slide 1:
This is class 2 of session 2 of the course. In this class, we will discuss the Family Folder component of
the eCHIS HEW app.

This class will take approximately 30 minutes to complete, including performing the practice
exercises.

Slide 2:
You will recall that eCHIS consists of six key components.

The Family Folder component is where all household and client information is entered and stored.

Slide 3:
Traditionally, a paper-based Family Folder pouch was issued to every household in a kebele. The
pouch contained information that helped the HEW identify the family’s health service needs,
enabling her to either provide these services or counsel on them.

Slide 4:
This paper Family Folder has now been replicated electronically by eCHIS.

Slide 5:
Each household and its members are registered in the Family Folder module of the app so that HEWs
and other health workers can retrieve their health information and provide them with services.

Before any services can be provided, this information must be entered into the Family Folder!

Slide 6:
This includes the names of the household members and their contact information and ages, the
village in which they live, their insurance coverage, and other key information.

Slide 7:
To access the Family Folder and register a new household and information about its members, the
HEW logs into her app and taps the Start button. This brings her to the main folder screen that
contains icons linking to the app’s various modules. Note that sometimes the main screen may
include additional icons, depending on what modules are available.

Tapping on the “Households” icon will bring her to the Family Folder.

Slide 8:
She will then see a screen with the button that says “Register New Household.”

If a number of households are already registered, they will be listed on this screen and it may be
necessary to scroll down to the bottom of the list in order to see this button.

Tapping this button will bring up a screen in which the HEW selects the village in which the
household she is registering is located.
Slide 9:
She will continue to answer the questions that appear until the “Finish” screen appears. Selecting
the green Finish bar then sends the form, recording the information in the eCHIS system. And when
she syncs her app, the information will be sent to others via the Health Center Referral and Focal
Person apps.

Slide 10:
Now it’s your turn to practice registering new households in your HEW app.

Using the app on your device, enter the information for these two sample households.

Remember to start by tapping the “Households” icon and then following the prompts to register the
information.

Note that when you are prompted to enter the date, be sure to enter today’s date!

For any prompts for which the information is not supplied here, enter any information of your
choosing.

Remember to tap the green Finish button to save the information and then sync the app before
logging out.

Contact your instructor or supervisor or email the address on the screen if you have questions or
problems.

When you have finished, select the “Next” button to continue on with this class.

Slide 11:
Now that you have two households recorded in the system, the next step is to record information
for each household member.

To do this, you will select the household and then continue until you see the screen with the
“Household Members” icon. You will then select that icon to enter each member.

Slide 12:
Tapping on the “Register New Member” button and proceeding through the prompts will permit you
to enter the necessary information.

As always, selecting the green “Finish” button at the end sends the form, recording the information
in the eCHIS system.

Slide 13:
This process is continued for each family member until all members of the household are registered,
making sure that only one member of each household is registered as the “Head of Household.”

Each member is given a unique ID number in the eCHIS system, with the head of the household
usually given the number 01 and other family members given 02, 03 and so on.

Slide 14:
Now practice by adding these four members to the Bereket household in your app.
Following the prompts, enter the information seen here. For the other prompts that appear in the
app, add information of your choosing.
When you have entered all of the information, “send” the form by selecting the green “Finish”
button and then sync the app before logging out.

Contact your instructor or supervisor or email the address on the screen if you have questions or
problems.

Select the “Next” button when you are finished and ready to continue on with the class.

Slide 15:
In the same way, now practice adding Dani to the Chala household in your app.

When you have entered all of the information, send the form by selecting the green “Finish” button
and then sync the app before logging out.

Select the “Next” button when you are finished and ready to complete this class.

Slide 16:
This is the end of class 2, The Family Folder.

In this class you learned what the eCHIS Family Folder is and how to access it. You also learned how
to register households and household members in the Family Folder.

You may take a break now or continue on directly with class 3 of this session on the eCHIS HEW App.
Session 2: The eCHIS HEW App
Class 3: The Service Modules

Slide 1:
Welcome to class 3 of session 2 of the eCHIS HEW app. In this class, we will discuss the service
modules found in the app.

This class will take approximately 20 minutes to complete, including performing the practice
exercise.

Slide 2:
You will recall that eCHIS consists of six key components.

In class 2 we discussed the Family Folder where all household and client information is entered and
stored.

Now we will talk about the Service Modules component.

Slide 3:
The service modules are where HEWs enter information about clients during health care service
visits. As you can see from the icons on this screen, these visits include those for reproductive,
maternal, newborn, and child health services, or RMNCH, such as family planning and postpartum
care. Also included in RMNCH are modules on nutrition, sick children, and vaccinations.

Through these modules, the app tracks and documents health concerns and interventions across the
reproductive life cycle, from adolescent girls and women before and during pregnancy and delivery,
to newborns and children.

Slide 4:
Disease modules are another group of service modules. This is where client information about
communicable diseases, non-communicable diseases, and neglected tropical diseases is stored.
There is also a service module on logistics supply and management.

Other service modules can be added to the app as necessary. For instance, a COVID-19 service
module has been developed to track information about that pandemic.

Slide 5:
As an example of how the service modules are designed to work, let’s look at the Pregnant and
Postpartum Women service module. This module, one of the RMNCH modules, includes sections on
Antenatal Care, or ANC, Pregnancy Outcomes, and Postnatal Care, or PNC. The HEW uses this
module to identify pregnant clients and track their clinical care throughout their pregnancies and in
the postpartum period.

Slide 6:
To access the service modules for a specific client, the HEW taps on the “Client Files” icon on the
main folder screen.

Selecting this icon brings up the service module screen that lists various types of health services,
such as those for pregnant women or sick children.
Tapping any of the icons on this screen reveals a list of registered clients eligible for this service. For
instance, in this example selecting the Pregnant and Postpartum Women icon brings up the file for
Genet Meratu Tesfa who was previously registered as a pregnant woman. If no client names appear
on this screen, there are no clients registered for this service.

Slide 7:
Note that, throughout the app, the same color-coded visit symbols make it easy for the HEW to
manage her clients. These simple graphic elements permit the HEW to see the status of the client’s
appointments at a glance.

The visit priority symbols are color-coded for ease of use.

• Grey means that the appointment date is at some point in the future.
• Green means that the appointment is approaching, probably in the next 2-3 days.
• Yellow shows that the appointment date has passed by a few days, and
• Red shows that the appointment date was missed and the client is considered as a defaulter.

In addition, simple graphic symbols depict the type of visit scheduled, for instance, ANC, pregnancy
outcome, and PNC, and also the visit location, such as community, health post, health center, or
hospital.

Slide 8:
So on this screen we can see that Genet has missed her ANC visit at the health post and is
considered a defaulter.

Hiwot, on the other hand, has a family planning visit at the health post in the future.

Slide 9:
Returning to the client list, tapping on Genet’s name and then tapping on “Continue” brings up the
“ANC Visit” icon.

Slide 10:
Antenatal care, or ANC, visits are a common health service for which eCHIS is used. Pregnant women
are encouraged to have 4 ANC visits.

In Ethiopia, the first one, ANC 1, must be completed at the Health Center, so the woman can either
visit a health post and be referred to the health center, or they can go to the health center directly
without a referral.

After the ANC 1 visit, the HEW can then continue with ANC visits 2, 3 and 4.

Slide 11:
As with other modules in the app, when the HEW sees a pregnant client, she follows the prompts
and answers the questions as they appear on her screen. In the case of a new pregnant client, the
HEW would first ask if she has already completed her ANC 1 visit.

If she has not had her ANC 1 visit, the HEW uses her app to refer her to the health center. Once the
pregnant woman completes her ANC 1 visit at the health center, the midwife there uses her Health
Center Referral app to record this visit.

The HEW will receive confirmation of this visit through what is called an Action Card once the
midwife syncs her device in the system. With this confirmation about the client’s ANC 1 visit, the
HEW can continue to perform and document subsequent visits.

We will discuss more about how referrals and action cards work in Class 4 in this session and also in
Session 3 on the Health Center Referral app.

Slide 12:
If the client has already completed her ANC 1 visit at the health center, a referral is not necessary.
The HEW can obtain the updated information from the action card submitted by the health center
and continue providing the woman with subsequent care.

Slide 13:
With our ANC visit example, the HEW would work through the series of prompts that appear,
helping ensure that the visit covers all of the necessary information.

Slide 14:
In addition to prompting information about the client’s clinical history, the app also includes
counseling guidance and information about possible pregnancy risks.

As always, the series ends with a green Finish button that will then send the completed form to the
system.

Slide 15:
As another example, let’s look more in detail about how an RMNCH client is tracked through the
system, using Genet Meratu Tesfa as an example.

To access the service modules, you would select the “Households” icon from main folder screen.
The list of registered households will appear. From this list, you would then select the name of the
head of the household where the client lives. In this case, it will be Genet’s husband, Bereket Daniel
Mersah.

You would continue on until you see the screen with the RMNCH Services icon and tap on that icon.

Slide 16:
At that point, you will see the names of the members of the household who qualify for RMNCH
services. In this case, it would be the wife and daughter of the head of the household.

Selecting Genet from the list will bring up a series of screens that include her clinical history and
related information.

Slide 17:
Now let’s practice finding information in the HEW app for a client due for an ANC visit.

Remember that in the last class, you entered information for a pregnant woman named Dani.

Now look under Client Files and open the Pregnant and Postpartum Women service module to find
information about this client.

Answer the questions on the screen by looking for the information in the app. Then select the “Next”
button to see if your answers are correct.
Slide 18:
For what type of ANC visit is Dani next scheduled?

You can see under the Pregnant and Postpartum Women icon that Dani is next scheduled for an ANC
1 visit.

Slide 19:
Is Dani overdue for this next visit?

You know from the green symbol that Dani is not overdue for her ANC 1 visit since this symbol
means that the appointment is still in the future.

Slide 20:
Where is Dani’s next visit scheduled to take place?

Dani’s next visit is scheduled for the health center, as you can see from the health center symbol on
the screen.

Slide 21:
Another important service module is the one covering family planning visits.

As with the other service modules, tapping on the “Family Planning Clients” icon brings the HEW to a
series of prompts that guide her in the provision of family planning services to clients.

Slide 22:
First the HEW selects the client from the list of registered clients, or registers her if she is not already
listed.

Slide 23:
This will bring up a series of prompts to guide the HEW in providing the client with appropriate
family planning services.

Some of these prompts cover general guidance as to how to counsel the client and others provide
clinical information about each method.

Slide 24:
Other prompts ask about the client’s clinical information in order to determine her eligibility for
selected methods.

Slide 25:
At the end of the sequence of prompts, a family planning method for which the client is eligible
should be determined and the method can either be provided or, if necessary, a referral to the
health center can be issued.

Slide 26:
Other client-related information is also tracked in the RMNCH service modules in the HEW app. This
includes additional aspects of RMNCH, such as sick children, nutrition, and child vaccinations. These
modules are all used by following the same processes as the pregnancy and family planning
modules. Additional practice with the app will help you become familiar with these modules as well.

Slide 27:
As you will recall, other service modules available in eCHIS pertain to specific diseases. These include
modules on malaria, TB, leprosy, and other communicable and non-communicable diseases. Let’s
look at one of these modules now.

Slide 28:
As an example, let’s look briefly at a malaria screening visit.

Let’s say that established client Abdissa Behailu Memher presents at the health post with signs of
malaria. The HEW will need to screen him for the disease. So she would select the Client Files icon on
the app’s main folder screen. Then, on the next screen, she would select the “All Clients” icon to see
a list of all of the registered clients.

Slide 29:
From this member list, she would then select the name of the client in need of the service, in this
case Abdissa, and then tap on the “Malaria Screening Visit” icon.

Slide 30:
This will open the screening form for the HEW to complete.

As with the other forms in the app, this form consists of a series of questions to be answered one-
by-one, until the client’s health information is entered into the app.

Slide 31:
When the form has been filled, the app will provide the appropriate clinical guidance for next steps.

Slide 32:
The app then stores the newly entered malaria screening information. The HEW can find it by
tapping on Client Files, then All Clients, and then the Disease module. The large mosquito icon that
appears helps the HEW quickly identify this client as a possible malaria patient.

Slide 33:
The app also provides prompts to enable the creation of a referral to the health center. When the
HEW syncs her app, the referral will be sent to the Health Center Referral app. When the worker at
the health center opens their app, they will see the client’s name on the Client List under disease
referrals, informing the worker that a client is in need of care.

Slide 34:
Now it is your turn to practice entering information into the HEW app on your device.

Alem Abebe Chala should already be registered in your app as a head of household.

Find his registration and enter the information listed on the screen by following the prompts.

Remember to first tap on Client Files, then All Clients, and then on Alem’s name.

Then select Malaria Screening Visit and complete the form. For the questions not specifically
answered, you may enter data of your choice.

Contact your instructor or supervisor or email the address on the screen if you have questions.

When you have finished, select the “Next” button to conclude this class.
Slide 35:
This is the end of class 3, The Service Modules.

In this class you learned about the eCHIS HEW service modules, specifically those on antenatal care,
family planning, and the disease module on malaria.

We also reviewed the symbol guide that helps the eCHIS user see specifics about a client’s care at a
glance.

You may take a break now or continue on directly with class 4 of this session on the eCHIS HEW App.
Session 2: The eCHIS HEW App
Class 4: Other Features

Slide 1:
Welcome to class 4 of session 2 on the eCHIS HEW app. In this class, we will discuss additional
important functions of this app, specifically, the use of referrals and action cards and the app’s
reporting functions.

This class will take approximately 10 minutes to complete.

Slide 2:
The transfer of client referrals and other information between the HEW and Health Center Referral
apps is a key feature of eCHIS. There are two key ways in which client information travels between
these two apps:

• When an HEW sees a client in need of a higher level of care, she issues a digital referral to
the health center through her app.
• When a health center worker needs to send updated client information to the HEW, they
issue an action card so the HEW can receive this information through her app.

Let’s discuss referrals first.

Slide 3:
When an HEW needs to refer a client to a health center she does this through her eCHIS HEW app.
When she syncs the app, the information is sent through the system to the health center. The
client’s name is then included in the client list on the Health Center Referral app.

When health center staff sync their device and receive this referral on their Health Center Referral
app, they know there is a client in need of a health service and what type of service. They select the
client from the list, and deliver the service. They then document the updated client information in
their app so that the HEW will receive it when their device is synched.

Slide 4:
eCHIS supports three types of referrals that can be issued by the HEW to the health center:
standard, danger sign, and emergency referrals.

Slide 5:
Standard referrals are used when the client needs a higher level of care but the situation is not an
emergency. Examples would include ANC 1 visits or visits to obtain medications when the health
post is experiencing a stock-out.

For instance, when a pregnant woman presents at a health post she is referred to the health center
for her first antenatal care visit. In these cases, the HEW uses her app to send this referral.

Slide 6:
Danger sign referrals are issued when danger signs are noted during a scheduled service delivery
visit at the health post. For instance, any danger sign that is identified during an ANC 2 or postnatal
care visit would require a referral to the health center.

HEWs should screen for danger signs during all client appointments. If any danger signs are
observed, she should immediately use her app to refer the client to the health center.
Slide 7:
Emergency referrals are noted outside of scheduled service delivery visits, for instance, in the period
between ANC 2 and 3 visits.

An emergency referral may be made for a pregnant or lactating woman who experiences danger
signs such as convulsions, loss of consciousness, or eclampsia. In these cases, the HEW uses her app
to refer the client immediately to the health center.

Slide 8:
Action cards travel in the opposite direction from referrals. They are used when the health center
worker needs to send client information to the HEW.

When the health center worker issues an action card, it appears as a bright red icon on the HEW’s
app so she will be sure to see it.

If there is no new client information, the red action card icon is not displayed on the HEW app.

Slide 9:
When the HEW sees an action card on her screen, she taps on it to see the client or clients about
which there is new information.

When she taps on a client on the list, for instance Chaltu Hunde Bibco, she can then approve the
card.

Slide 10:
Once the HEW has confirmed the action card, she gains access to the latest information and can
then follow-up appropriately.

Slide 11:
A second important function of the eCHIS system is its reporting and analytics capability.

As we mentioned in Session 1, these features enable:

• The automation of manual reporting processes to reduce time, resources, and potential
reporting errors
• The presentation of collected and aggregated data in a useful and meaningful format to
allow for informed decision making, and
• The tracking and monitoring of HEW activities for supervisory purposes.

Slide 12:
The reports created by eCHIS are automatically generated from the data entered into the app.

Focal persons and other decision-makers use these reports to analyze the data in order to improve
services. They also use the information to monitor the performance of the HEWs under their
supervision.

Slide 13:
To create a report, the HEW taps on the “Reports” icon on the main folder screen of her app. This
brings her to a screen that contains the different report categories: household, HMIS, and disease, as
well as phone data information.
The HEW can then compile and send each type of report on a regular schedule, usually weekly or
monthly.

Slide 14:

• Household reports include information about the characteristics and profiles of the households
registered in the app.
• Disease reports document information about the incidence of diseases such as malaria and TB.
• And HMIS reports contain monthly, quarterly, and annual service delivery data.

Slide 15:
This is an example of the report that tracks family planning indicators in the monthly HMIS Report.

There are also HMIS reports that similarly track MCH, immunization, and nutrition indicators.

These completed reports are sent from the HEW app to the Focal Person app when the HEW syncs
her device.

Slide 16:
This is an example of an IDSR, or Integrated Disease Surveillance and Response, report that is
completed weekly by the HEW.

Slide 17:
The eCHIS reporting and analytics system also includes a password-protected web portal through
which users can see, manipulate, and export the data collected in the reports. The portal also allows
users to create customized dashboards in order to illustrate specific data and trends.

Managers such as focal persons use these reports to help them make programmatic decisions as
well as to monitor the performance of their supervisees.

Slide 18:
Seen here are examples of eCHIS dashboards created using the web portal. By filtering for specific
parameters and then displaying the data graphically, trends in community health and service
delivery are easy to comprehend at a glance.

We will discuss eCHIS reporting and analytics functions in more detail in session 4 of this course, the
eCHIS Focal Person App.

Slide 19:
This is the end of class 4, Other Features of the eCHIS HEW app.

In this class you learned about additional features of the app, specifically the use of referrals and
action cards and the app’s reporting and analytics functions.

You have now reached the end of session 2 of this course, the eCHIS HEW App.

Slide 20:
This concludes this session of the course, Introduction to eCHIS.

In this session on the eCHIS HEW app you learned that:

 • The key functions of the eCHIS HEW app are household registration, tracking service
provision, referral linkages, and data reporting and utilization
• The Family Folder is used to register and track households and their members
• The Service Modules are used to document health care services received by the registered
clients
• HEWs can make digital referrals to health centers and digital action cards are used to send
updated client information to the health post
• The reporting functions of the eCHIS HEW app are used to collect client data so they can be
analyzed and used for system monitoring.

Now take the short quiz that follows. You will need to pass it with a score of at least 80%. You may
take the quiz as many times as you need in order to pass it.

Slide 21:
[Quiz]
Session 3: The eCHIS Health Center Referral App
Class 1: Introduction to the Health Center Referral App

Slide 1:
Welcome back to the online course, Introduction to eCHIS, the electronic community health
information system.

Before we get started, if you would like to review how to navigate the class screens, select the
“Navigation” button. Otherwise, select the “Next” button [jumps to slide 3].

Slide 2:
In the side bar you will find a “Menu” tab with a list of the topics in this class. You may navigate to a
topic that you have already visited by selecting the topic.

Also, in the side bar you will find a “Glossary” tab with key words and definitions and a “Notes” tab.
Select the “Notes” tab if you would like to read along with the narration.

In the upper right is an exit button if you would like to leave the session before completing it.

To pause, play, or replay a slide, use the control buttons and slider at the bottom center of the
screen. On the bottom left you can adjust the volume.

Except when you are asked to manually advance a slide, the slides will move forward through the
classes automatically. But you can also move forward or backward through the slides that have
already been played by selecting the “Next” or “Previous” buttons. Select “Next” now to continue on
with the class.

Slide 3:
This is session 3 of the course. In this session, we will discuss in more detail the eCHIS Health Center
Referral app.

This session has 4 classes.

The first class presents an introduction to the eCHIS Health Center Referral app. Class 2 covers the
app’s use of digital action cards for the transfer of client referrals and other information. Class 3
presents the example of tracking a family planning visit using the app and class 4 covers other app
functions.

Slide 4:
By the end of this session, you will be able to:

• List and describe the key components and functions of the HCR app
• List the types of workers who use the HCR app and the services they use the app to deliver
• Explain how client referrals are received in the app from the HEW app
• Explain how action cards are used in the app to transmit client information to the HEW
• Describe how late visits are tracked in the app, and
• Explain how to update the HCR app settings.

Slide 5:
We will start with an introduction to the basic features and functions of the eCHIS Health Center
Referral app.
This class will take approximately 16 minutes to complete.

Slide 6:
The eCHIS Health Center Referral application is used by health center workers who deliver
reproductive, maternal, newborn, and child health, or RMNCH, services, such as midwives and
outpatient department workers. It is also used by workers who deliver disease management
services, such as for malaria and tuberculosis.

The app enables these workers to accept client referrals from Health Extension Workers, or HEWs,
and then provide information about the outcomes of these referrals back to the HEWs. The app also
enables the monitoring of late client visits and other necessary information.

Slide 7:
If you would like to review how to launch, log in and out, and sync the app, as well as how to
navigate the home screen on this and any of the eCHIS apps, select the Review button. If not,
proceed on with the session by selecting the Next button [jumps to slide 14].

Slide 8:
As you may know from previous sessions of this course, the eCHIS suite of apps should already be
installed on your Android smart phone or tablet. If it is not, report this to your instructor or
supervisor or contact the help desk at DHAechis@[Link].

To launch the app:

* Tap on the app’s icon.

* If you do not see this icon on the device home screen, look for eCHIS in the list of apps and tap it.
* After a few seconds the login screen will appear.

Slide 9:
Remember that eCHIS consists of three apps. In this session we are concerned with the Health
Center Referral app. Health center workers will only have access to this eCHIS app while HEWs will
have access to their app and focal persons will have access to that app.

Since you have access to all three eCHIS apps, first make sure that you have selected the Health
Center Referral app from the list on the screen. Do this by tapping on the small arrow as shown. This
will give you the option to select the HCR application from the list on the screen.

Once you have selected the HCR app, enter the user name and password that were given to you by
your instructor or supervisor and log into the app. If you do not have this information, report this to
your instructor or supervisor or email the address on the screen.

Slide 10:
When you first log into the app, you see this home screen. The home screens of each of the three
apps look very similar. They all have three main icons: The “Start” icon, the “Sync with Server” icon,
and the “Log Out” icon.

You can navigate to different parts of the app from this screen.

* Select this icon to start using the app

* Select this icon to sync the information in the app with the server
 • You can find the time of the most recent synching here

* Select “Log out” to exit the app.

You can also set the app to work in the language with which you are most comfortable here.

And you can confirm which of the three eCHIS apps you are using by looking at the title in the upper
left corner.

Slide 11:
Note that the app screens can be viewed either horizontally or vertically on either Android smart
phones or Android tablets.

Slide 12:
When eCHIS users sync their apps, the data entered are used to update the central data base and
transmitted between the HEW, Health Center Referral, and Focal Person apps.

Synching with the server pushes pending data from the mobile device to the server so that they are
recorded and accessible to others in the system. For instance, when a midwife at the health center
syncs her app, the HEW receives the updated information. Likewise, the HEW can update client
information and, by synching, send the new information to the health center workers and to the
focal person through the Health Center Referral and Focal Person apps, respectively.

All system users sync with the server at least twice daily, when first logging in at the beginning of the
work day and before logging out at the end of the work day.

Slide 13:
eCHIS users should always log out of the app when it is not being used.

This protects the client data and prevents others from editing or deleting these data. It also saves
battery life.

Slide 14:
As with the HEW app, the health center worker will see the “Initial Application Setup” icon on the
main folder screen.

They need to select this icon and answer the series of questions that follow. Information that is
entered here includes the names and phone numbers of the midwives that work at the center. Once
the worker enters this information into the app, following the prompts one at a time, they select the
green “Finish” button to finish the set up and record the information.

Slide 15:
Note that after this initial information is entered, the “Initial Application Setup” icon will no longer
appear on the main screen.

After this point, the “Update Application Settings” function is used to change or update any of the
entered information.

Slide 16:
Let’s now practice entering in initial information.
To set up your Health Center Referral app, log into it now and select the “Initial Application Setup”
icon. Then follow the prompts to enter the information seen on the screen. For any fields not
specified here, enter information of your choosing.

When you have entered all of the information, send the form by selecting the green “Finish” button
and don’t forget to sync your device before logging off.

If you have questions or get confused, contact your instructor or supervisor or email the address on
the screen.

When you have finished, select “Next” to continue on with this session.

Slide 17:
Now let’s look at the modules accessible through the main screen of the app.

As you can see, this includes modules on Pregnant and Lactating Women, Family Planning,
Vaccination, Disease Referrals, and other categories.

It also includes an icon for late visits and one that permits the user to update the initial information
entered into the app.

Note that this screen might look different at different times or for different workers, depending on
which modules are offered.

Let’s look briefly at some of these areas now.

Slide 18:
The Pregnant and Lactating Women section contains links to track client information on ANC 1 visits,
delivery outcomes, emergency referrals, and other essential information related to this population.

Slide 19:
Likewise, the family planning module contains links to track client data related to these services.

Slide 20:
Other icons on the main page link to sections on child health, vaccination, malnutrition, and diseases
such as tuberculosis and malaria.

These modules are used the same way as the others. The worker taps the icons and answers the
prompts as they work their way through the client visit, then saves the form and syncs to transmit
the information through the system.

Slide 21:
The Late Visits section tracks when each registered client is overdue for a scheduled appointment
and which type of appointment each is.

Note that red symbols bring attention to this crucial information.

Slide 22:
As already mentioned, the Update Settings section permits the user to change or update any of the
initial information entered into the app.

This includes specifics about who the midwives are and their contact information.
Slide 23:
You have reached the end of the first class in this session.

In this class you learned about the users, purpose, and key modules in the eCHIS Health Center
Referral app.

You may take a break now or continue on directly with class 2 of this session.
Session 3: The eCHIS Health Center Referral App
Class 2: eCHIS Referrals and Action Cards

Slide 1:
This is class 2 of session 3 of the course. In this class we will discuss the use of referrals and action
cards in the Health Center Referral app and the role they play in the continuity of client care.

This class will take approximately 6 minutes to complete.

Slide 2:
As we mentioned in session 2 when we were discussing the HEW app, eCHIS uses digital referrals
and action cards to transmit client information between HEWs and health center staff.

• When an HEW sees a client in need of a higher level of care, she issues a digital referral to
the health center through her app.
• When a health center worker needs to send updated client information to the HEW, they
issue an action card so the HEW can receive this information through her app.

In session 2 we discussed these features from the HEW’s perspective. Now let’s look at them from
the perspective of the health center worker.

Let’s discuss referrals first.

Slide 3:
When a client comes to the health post, the HEW sometimes needs to refer them to a higher level of
care. This is the case, for instance, for malaria care.

In such cases, the HEW, following prompts on her app, selects the client she wants to send to the
health center from the list of clients on her app, completes the form and syncs the app.

Once the health center worker syncs their app, the client referral will appear on the client list of the
appropriate module in the Health Center Referral app. For instance, if the visit is for a malaria
appointment, the client’s name will appear under the icon “Disease Referrals.”

Note that the health center worker will only see names in their client list if there are referrals from
the HEW. When there are no current referrals to the health center, no names will appear in the
client list.

Slide 4:
As we discussed in session 2, there are three types of referrals that HEWs may send to the health
center: standard, danger sign, and emergency.

Standard referrals are for services that are not emergencies, such as for ANC 1 visits or for when the
health post has a stock out of the needed medication or supplies.

Danger sign referrals are used when a danger sign is noted DURING a scheduled client visit, for
instance, during an ANC 2 or family planning visit.

Emergency referrals are used when a danger sign is noted OUTSIDE of a scheduled client visit, such
as if a pregnant woman experiences convulsions, loss of consciousness, or eclampsia.
Slide 5:
Alternatively, the health center worker can provide services for clients who come directly to the
health center without a referral and without visiting a health post first.

In these cases, if the client is not already registered in the app, the health center worker will need to
register them.

Slide 6:
In either situation, after the health center worker provides the client with needed services, they next
create an action card documenting the services the client received and other relevant details of the
visit. Once they sync their app, the action card is sent to the HEW who receives it in her app.

Slide 7:
This diagram shows how referrals and action cards are used together to help coordinate client care.

In this example, Lila contacts the HEW at the health post for family planning services. The HEW notes
the relevant information in her app, guided by the prompts, and then refers her to the health center
to obtain her chosen method. The health center worker becomes aware of that Lila is in need of
service when they see her name on the client list in the family planning module.

After providing Lila with her desired service, the health center worker records the visit information
and creates an action card. When the worker syncs their device, the information is sent back to the
HEW who receives it and then updates the information in the client’s file in her app.

Slide 8:
In cases in which the client presents at the health center directly without a referral, the health
center worker still initiates an action card.

For instance, Lila could contact the health center for family planning services without contacting the
HEW first. In this case, the health center worker would provide the needed service and then enter
the visit information into the app. If Lila had not already been registered in the eCHIS system, the
worker would first register her. The worker then sends Lila back to the health post for ongoing care,
issuing an action card so that the HEW will receive the updated client information.

Slide 9:
You have now reached the end of the second class in this session.

In this class you learned about the use of referrals and action cards in eCHIS. The referral function
enables HEWs to refer clients to a higher level of care. The action cards are used to send updated
client information from the health center to the HEW.

You may take a break now or continue on directly with class 3 of this session.
Session 3: The eCHIS Health Center Referral App
Class 3: Family Planning Visit Example

Slide 1:
Now let’s look at one function of the app as an example. This example will cover a family planning
visit.

This class will take approximately 10 minutes to complete, including performing the practice
exercise.

Slide 2:
Remember that although this example describes a family planning visit, other types of visits are also
tracked in the HCR app, such as those related to antenatal care, post-natal care, nutrition, and
vaccination.

We will not discuss these other areas in detail in this class but remember that the basic process is
the same. The app user follows the prompts that appear on the screen to enter or retrieve the data
as needed, then saves the form and syncs the device to transmit the information.

Slide 3:
Family planning visits are a common health service for which eCHIS and the Health Center Referral
app is used.

There are two main ways that the app is used for family planning visits, one is for when a woman has
visited the health post and is referred to the health center. The other is when the woman presents at
the health center without first visiting the health post.

Slide 4:
As we saw in the previous class, when a woman in need of a family planning method visits the health
post, the HEW will first make sure she is registered in the app’s Family Folder. If not, she will register
the new client. She will then provide the service if possible.

But if the health post has a stock out of the woman preferred method, or if she requests a method
like an IUCD that requires a higher level of care, the HEW would then use her app to issue a referral
for the client to visit the health center.

Slide 5:
When the women desiring family planning has a referral from the health post because she needs
care at the health center, her name will appear in the “Client List” of the Health Center Referral app.
This will alert the health center worker that a client has been referred for services.

The health center worker simply taps on the name of the client in the list and will see the woman’s
information and the reason she needs to be seen at the health center. At the end of the visit, the
worker will complete an action card so that the HEW at the health post will receive the updated
information on the client.

Slide 6:
Alternatively, if the woman goes directly to the health center for her family planning visit, without
visiting the health post first, the worker there will register her in the app if necessary, provide the
desired service, and then complete an action card to enable the HEW to access the updated
information.
Slide 7:
In this situation, the health center worker will need to register the client in the eCHIS system
because she has not previously been seen in the health care system and therefore is not already on
the client list.

To do this, the health center worker taps on the “Family Planning” icon on the Health Center
Referral app and then on the “Family Planning for Woman not on List” icon.

Slide 8:
This brings up prompts to guide the worker in registering the woman.

Slide 9:
Once the referral has been received or the new client has been registered, the health center worker
provides the desired family planning services by following the prompts in the app. This helps the
health center worker document the client’s relevant medical history and the services she is
receiving.

Slide 10:
Regardless of whether the client was already registered or if the health center worker registers her,
once the worker provides the desired service, they create an action card in the Health Center
Referral app so that the HEW will receive information on the new client.

Slide 11:
A new “Action Card” icon will then appear on the HEW’s app to advise her that new client
information has been received.

Slide 12:
Now let’s practice registering a woman for a family planning visit in the Health Center Referral app.

Enter the information seen on the screen in your app. In fields for which information is not provided,
enter information of your choosing. Remember to save the form and sync your app at the end.

Contact your instructor or supervisor or email the address on the screen if you have questions.
When you have finished, select the “Next” button to conclude this class.

Slide 13:
You have reached the end of the third class in this session.

In this class you learned about the use of the Health Center Referral app using the example of the
family planning visit. This includes either receiving a referral from an HEW or registering the new
client, providing the service, and then using the app to send the updated client information to the
HEW.

You may take a break now or continue on directly with class 4 of this session.
Session 3: The eCHIS Health Center Referral App
Class 4: Other App Functions

Slide 1:
The Health Center Referral app contains a number of important functions in addition to those
discussed in the previous classes. For instance, the app tracks when a client is late for an
appointment. This makes it easy to recognize when appointments need to be rescheduled so that
the client does not miss an opportunity for needed care.

The app also permits the settings initially entered into the app to be changed as necessary when
they need to be updated or corrected.

We will briefly discuss these two functions now.

This class will take approximately 8 minutes to complete.

Slide 2:
First, we will discuss late visits.

To see the status of the clients who are overdue for a scheduled visit, the health center worker taps
the red “Late Visits” icon on the main screen of the app and then on the icon for the type of visit that
is overdue, for instance, the “Late ANC/PNC Visits” icon.

Slide 3:
The names of all clients with overdue ANC or PNC appointments and the number of days overdue
will appear.

Tapping on the icon next to the client of interest will provide more detailed information.

Slide 4:
The app then asks how the health center worker will follow-up with the HEW to make sure the client
appointment is rescheduled.

Once the form is complete, tapping on the green “Finish” button sends it, recording the new
information in the app. When the app is next synched, the HEW and the focal person will also
receive this information.

Slide 5:
Similarly, it is possible to change or update the initial information previously entered in the app.

Recall that in class 1 of this session we discussed that, when logging for the first time, the user needs
to enter initial information into the app. This includes how many workers of each type work at the
health center and their contact information.

Slide 6:
When this information needs to be changed, the health center worker taps on the “Update
Application Settings” icon on the main page.

Slide 7:
The new information is then entered by following the prompts.
Slide 8:
As with all forms in eCHIS, tapping on the green “Finish” button when all prompts have been
answered will send the form and save the updated information in the system.

Slide 9:
This is the end of class 4, Other App Functions of the Health Center Referral app.

In this class you learned about how to track and address late client appointments and also how to
update the initial settings in the app.

You have now reached the end of session 3 of this course, the eCHIS Health Center Referral App.

Slide 10:
This concludes this session of the course, Introduction to eCHIS.

In this session on the eCHIS Health Center Referral App you learned that:

• The HCR app has a number of functionalities for guiding client care, including in the areas of
pregnant and lactating women, family planning, child health, vaccination, malnutrition, and
diseases like TB and malaria
• The app is used in conjunction with the other eCHIS apps to track and document client
service provision and respond to referrals from HEWs
• Digital action cards are used to transmit updated client information from the health center
back to the HEW
• The app tracks late client visits, enabling these visits to be rescheduled, and
• The initial app settings can easily be changed if they need to be corrected or updated.

Now take the short quiz that follows. You will need to pass it with a score of at least 80%. You may
take the quiz as many times as you need in order to pass it.

Slide 11:
[Quiz]
Session 4: The eCHIS Focal Person App
Class 1: Introduction to the Focal Person App

Slide 1:
Welcome back to the online course, Introduction to eCHIS, the electronic community health
information system.

Before we get started, if you would like to review how to navigate the class screens, select the
“Navigation” button. Otherwise, select the “Next” button [jumps to slide 3].

Slide 2:
Let’s go over a few tips to help you navigate the course screen.

In the side bar you will find a “Menu” tab with a list of the topics in this session. You may navigate to
a topic that you have already visited by selecting the topic.

Also, in the side bar you will find a “Glossary” tab with key words and definitions and a “Notes” tab.
Select the “Notes” tab if you would like to read along with the narration.

In the upper right is an exit button if you would like to leave the session before completing it.

To pause, play, or replay a slide, use the control buttons and slider at the bottom center of the
screen. On the bottom left you can adjust the volume.

Except when you are asked to manually advance a slide, the slides will move forward through the
classes automatically. But you can also move forward or backward through the slides that have
already been played by selecting the “Next” or “Previous” buttons. Select “Next” now to continue on
with the class.

Slide 3:
This is session 4 of the course. In this session, we will discuss in more detail the Focal Person app
from the eCHIS suite of apps.

This session has 5 classes.

The first class presents an introduction to the eCHIS Focal Person app. Class 2 covers the use of the
app’s supervision checklists and class 3 covers the tracking of late client visits. Class 4 discusses how
to compile reports using the app, including the use of dashboards on the eCHIS web portal, and class
5 introduces the app’s updating and troubleshooting functions.

Slide 4:
By the end of this session, you will be able to:

• List and describe the key components and functions of the eCHIS Focal Person app
• List the types of workers who use the Focal Person app and the services they use the app to
deliver
• Launch and initiate use of the Focal person app
• Describe the use of supervision checklists through the app
• Describe how late client visits are tracked via the app
• Discuss the eCHIS web portal, including the use of performance reports and dashboards
• Explain how to update health post and HEW information in the app, and
 • Explain how to troubleshoot problems with the eCHIS apps.

Slide 5:
We will start with an introduction to the basic features and functions of the eCHIS Focal Person app.

This class will take approximately 8 minutes to complete.

Slide 6:
The eCHIS Focal Person app is designed to be used by health extension program supervisors and
focal persons. The app provides these workers with supervision checklists and a mechanism for
managing late client visits, as well as guidance for updating settings and troubleshooting technical
issues with the app.

Through the use of the corresponding eCHIS web portal, the app also permits users to access service
reports from the health posts and monitor and document the performance of the HEWs under their
direction.

Slide 7:
If you would like to review how to launch, log in and out, and sync the app, as well as how to
navigate the home screen on this and any of the eCHIS apps, select the Review button. If not,
proceed on with the session by selecting the Next button [jumps to slide 14].

Slide 8:
As you may know from previous sessions of this course, the eCHIS suite of apps should already be
installed on your Android smart phone or tablet. If it is not, report this to your instructor or
supervisor or email the help desk at DHAechis@[Link].

To launch the app:

* Tap on the app’s icon.

* If you do not see this icon on the device home screen, look for eCHIS in the list of apps and tap it.
* After a few seconds the login screen will appear.

Slide 9:
Remember that eCHIS consists of three apps. In this session we are concerned with the Focal Person
app. Focal persons only have access to this app while HEWs have access to their app and health
center workers have access to that app.

Since you have access to all three eCHIS apps, first make sure that you have selected the Focal
Person app from the list on the screen. Do this by tapping on the small arrow as shown. This will give
you the option to select the Focal Person application from the list on the screen.

Then enter the user name and password that were given to you by your instructor or supervisor and
log into the app. If you do not have this information, report this to your instructor or supervisor or
email the address on the screen.

Slide 10:
When you first log into the app, you see this home screen. The home screens of each of the three
apps look very similar. They all have three main icons: The “Start” icon, the “Sync with Server” icon,
and the “Log Out” icon.
You can navigate to different parts of the app from this screen.

* Select this icon to start using the app

* Select this icon to sync the information in the app with the server

• You can find the time of the most recent synching here

* Select “Log out” to exit the app.

You can also set the app to work in the language with which you are most comfortable here.

And you can confirm which of the three eCHIS apps you are using by looking at the title in the upper
left corner.

Slide 11:
Note that the app screens can be viewed either horizontally or vertically on either Android smart
phones or Android tablets.

Slide 12:
When eCHIS users sync their apps, the data entered are transmitted between the HEW, Health
Center Referral, and Focal Person apps.

Synching with the server pushes pending data from the mobile device to the server so that they are
recorded and accessible to others in the system. For instance, when an HEW updates client
information and then syncs her device, the new information can then be accessed by the focal
persons as well as health center workers.

All system users sync with the server at least twice daily, when first logging in at the beginning of the
work day and before logging out at the end of the work day.

Slide 13:
eCHIS users should always log out of the app when it is not being used.

This protects the client data and prevents others from editing or deleting these data. It also saves
battery life.

Slide 14:
The main screen of the Focal Person app contains a number of icons through which the worker can
access the app’s various modules. Let’s briefly look at each of these now.

Slide 15:
Tapping on the Supervision Checklists icon leads to several checklists, including the Health Post
Checklist, the Visit Observation Checklist, and eCHIS App Checklist. The focal person completes these
digital forms when he or she visits the HEW at their Health Post.

Slide 16:
The Health Post HMIS Reports section allows the focal person to see monthly service reports from
each of the health posts that they support. They include data on family planning, immunization, and
other service delivery indicators.
Slide 17:
The IDSR, or Integrated Disease Surveillance and Response, reports section allows the focal person
to track the total number of cases seen of each disease each week at the health posts.

Slide 18:
The HEW Performance Reports section allows the focal person to monitor the performance of each
individual HEW or health post.

Slide 19:
Tapping on the Late Visits icon provides a list of all of the client visits each HEW is overdue to
conduct, allowing the focal person to take appropriate follow-up actions.

Slide 20:
The troubleshooting icon guides the user in solving technical problems that HEWs, health center
workers, or other focal persons may be having with their mobile device or eCHIS app.

Slide 21:
Through the Update Health Post and HEW Settings icon the focal person can update any information
in the app that pertains to the health posts or HEWs they support.

We will look at each of these app functions in more detail in the subsequent classes in this session.

Slide 22:
You have reached the end of the first class in this session.

In this class you learned about the users and purpose of the eCHIS Focal Person app. You also were
introduced to the icons on the main screen that link the user to various app functionalities.

You may take a break now or continue on directly with class 2 of this session.
Session 4: The eCHIS Focal Person App
Class 2: Supervision Checklists

Slide 1:
This is class 2 of session 4 of the course. In this class we will discuss the use of the supervision
checklists accessed through the eCHIS Focal Person app.

This class will take approximately 4 minutes to complete.

Slide 2:
Tapping the supervision checklists icon on the main screen takes the user to icons for the three types
of checklists available, the Health Post Checklist, the HEW Visit Observation Checklist, and the eCHIS
Application Checklist.

These checklists are to be used during regular supportive supervision visits to the health post. They
are completed on the app in real time by the focal person.

Slide 3:
The Health Post Checklist icon brings the user to the list of health posts and HEWs in their catchment
area.

Focal persons complete the Health Post Checklist during regular visits to the Health Post.

Slide 4:
The Health Post Checklist asks a variety of questions concerning the condition of the health post, the
types of client visits they manage, and other information specific to the operation of the facility.

Slide 5:
After the focal person inputs the information, the app calculates the health post’s scores in the key
categories. These scores can then be used to guide the supportive supervision discussions with the
HEWs.

Slide 6:
Similarly, focal persons complete the HEW Observation Checklist when they are visiting the HEWs
that they supervise.

Slide 7:
They observe each HEW conducting at least one client consultation every month, looking at whether
the HEW is following proper procedures and techniques in alignment with the required protocols. As
with other parts of the eCHIS app, the user simply follows the prompts on the screen to complete
the form.

Slide 8:
As with the Health Post Checklist, the app calculates a score for the visit based on the data entered
by the focal person. These scores can serve as a starting point for supportive supervision discussions.

Slide 9:
Finally, the eCHIS Application Checklist is also completed by the focal persons during their visits to
the health posts.
Slide 10:
They use this checklist to assess each HEW’s performance gaps as related to their use of the eCHIS
HEW app. The checklist can be completed during the visit, following completion of the Visit
Observation Checklist.

Slide 11:
As with the other checklists, the app calculates a score for the visit based on the data entered into it
by the focal person. These scores can serve as a starting point for supportive supervision discussions
and can provide the focal persons with a sense of how successfully the HEWs are using the eCHIS
app.

Slide 12:
For all of these checklists, completing them simply requires answering the series of questions as they
appear in the app.

Slide 13:
You have reached the end of the second class in this session.

In this class you learned about the three supervision checklists that focal persons can access and
complete on their eCHIS app. These are the Health Post Checklist, the HEW Visit Observation
Checklist, and the eCHIS Application Checklist.

You may take a break now or continue on directly with class 3 of this session.
Session 4: The eCHIS Focal Person App
Class 3: Late Visits

Slide 1:
This is class 3 of session 4 of the course. In this class we will discuss how the app notifies the focal
persons of late client visits.

This class will take approximately 4 minutes to complete.

Slide 2:
To monitor clients who are overdue for appointments, focal persons can select the “Late Visits” icon
on the main screen of their app.

They then follow the prompts to find the needed information.

Slide 3:
The Late Visit icon leads to a screen that categorizes the late visits by type of visit. For instance,
vaccination, ANC/PNC or disease-related visits. The focal person would tap on the appropriate
category to see which clients are late for a visit.

For instance, tapping the “Late ANC/PNC Visits” icon brings up the list of clients who are late for this
type of appointment.

With this knowledge, the focal person can help ensure that the relevant HEW reschedules the
appointment so that the client does not miss an opportunity for needed care.

Slide 4:
As you may recall from session 2, throughout the app, color-coded visit symbols make it easy to see
the status of the client’s appointments at a glance, including if the client is late for an appointment.

The visit priority symbols are:

• Grey means that the appointment date is at some point in the future.
• Green means that the appointment is approaching, probably in the next 2-3 days.
• Yellow shows that the appointment date has passed by a few days, and
• Red shows that the appointment date was missed and the client is considered as a defaulter.

So if the client has a yellow or red symbol next to their name, they have missed their scheduled
appointment, such is the case for Ayesha, who has missed her postnatal care appointment in the
community.

Slide 5:
Tapping on any of these symbols brings you to a more detailed view of this client’s information.

Then selecting “Continue” will forward the app to the next screen.

Slide 6:
Then a screen appears asking how the focal person will remind the HEW to follow-up with the client
about the late visit. This helps assure that the appointment will be rescheduled.
Once the form has been completed, the focal person selects “finish” to save the data which will then
be sent to the HEW when the app is synched.

Slide 7:
You have reached the end of the third class in this session.

In this class you learned how focal persons can track late client visits through their app and then
send reminders to the HEWs to reschedule the appointments.

You may take a break now or continue on directly with class 4 of this session.
Session 4: The eCHIS Focal Person App
Class 4: Reports and Dashboards

Slide 1:
This is class 4 of session 4 of the course. In this class we will discuss the use of reports and
dashboards in the eCHIS focal person app.

This class will take approximately 4 minutes to complete.

Slide 2:
Service reports issued by HEWs in the eCHIS HEW app can be accessed by focal persons and
supervisors through the Focal Person app.

Slide 3:
For instance, after an HEW sees a client, she completes the appropriate reports by entering the
client data into the HEW app.

After synching, the focal person can access the reports, viewing the data by client and also as
aggregated data. This information can then be used to provide needed supervisory guidance to
individual HEWs, as well as to monitor service delivery and identify where improvements are
needed.

Slide 4:
There are three main types of reports that can be accessed using the Focal Person app, all through
the app’s main page. They are:

• The health post HMIS, or health management information system, reports

• The health post IDSR, or Integrated Disease Surveillance and Response, reports, and
• The HEW performance reports.

Let’s look at each of these now.

Slide 5:
An example of an HMIS report is the report on the maternal, neonatal, and child health, or MNCH,
indicators.

The HEW enters the data for this monthly report and, once the app is synched, the focal person will
be able to review them.

Slide 6:
To find the report, the focal person taps the Health Post HMIS Reports icon, bringing up the available
reports, listed by date.

They then select the MNCH report of interest to open it.

Slide 7:
Indicators for other service areas, such as family planning and immunization, are tracked in the same
way.

There are also reports that track the types of services provided, for instance, services provided by
interactive voice response, or IVR.
Slide 8:
In addition to monthly reports, the HEWs also complete weekly IDSR reports.

These reports track the total number of cases seen for each disease each week, helping focal
persons and managers understand the key morbidities in their catchment areas, and helping them
improve the subsequent response.

Slide 9:
The third type of report, the HEW Performance Report, tracks the work performance of individual
HEWs so it can be monitored by the focal persons.

These reports can be accessed through the HEW Performance Reports icon and then selected by the
HEW’s name, the name of the health post, or by the date a specific report was submitted.

Slide 10:
A second way that focal persons and other managers and decision-makers can access data collected
in the eCHIS system is through the eCHIS web portal.

This tool includes data, reports, and graphic dashboards to help depict how well the health care
system is working and the areas that need improvement.

Slide 11:
The portal contains data that can be filtered and aggregated in various ways to produce customized
reports, making it easy for decision-makers to see updated service provision figures as well as trends
in illness prevalence.

Slide 12:
In addition to data from the regional, woreda, and kebele levels, users of the web portal can also
view the performance of individual HEWs.

Slide 13:
You have reached the end of class four in this session.

In this class you learned that focal persons can use their eCHIS app to view service reports from the
health posts and also that they can view and create data dashboards through the eCHIS web portal.

You may take a break now or continue on directly with class 5 of this session.
Session 4: The eCHIS Focal Person App
Class 5: Updating and Troubleshooting

Slide 1:
This is class 5 of session 4 of the course. In this class we will discuss how to update eCHIS information
and troubleshoot technical problems using the eCHIS focal person app.

This class will take approximately 10 minutes to complete, including taking the session quiz at the
end.

Slide 2:
It is possible to change the data entered into the app when it needs to be updated or corrected by
tapping on the Update Settings icon.

Similarly, the focal person can be guided to perform basic troubleshooting steps to address simple
technical issues with the devices. This function is accessed by tapping on the Troubleshooting icon.

We will briefly discuss these functions now.

Slide 3:
The icon called “Updated Health Post and HEW Settings” permits the focal person to update health
post data such as the number of ambulances available, the population targets, and specific data
about the gotes in the catchment area.

It is also possible to update or change information about specific HEWs through this icon, for
instance, their level of education.

Slide 4:
Once the “Update” icon is selected, icons pertaining to updating health posts and updating HEWs
appear.

Selecting the “Update Health Post Settings” icon, for instance, brings up prompts to guide the user
with updating this information.

Slide 5:
As with other sections of the app, following the prompts allows the user to add to or edit the
existing information.

Slide 6:
Similarly, the “Update HEW Settings” function permits information about specific HEWs to be
updated.

Tapping on this icon reveals a listing of all HEWs at each health post.

Selecting the name of one HEW…

Slide 7:
…brings up that person’s information.

A series of prompts will follow. Answering the questions and then tapping on the green “Finish”
button saves the updated information..
Slide 8:
The troubleshooting function in the app helps focal persons identify and resolve common technical
problems that HEWs, health center workers, or other focal persons may encounter with the eCHIS
app on their devices.

Slide 9:
Use of this feature is NOT meant to solve all of the problems that users may encounter, but it will
make the focal person aware of technical issues being experienced so that the correct persons can
be notified and resolve them.

Slide 10:
As with other parts of the app, the user follows the troubleshooting prompts in order to input the
relevant information.

Slide 11:
When the user comes to the end of the series of prompts, tapping the green “Finish” button will
record the information.

Synching will then send the form to the MOH server so that the issue can be documented and
addressed.

Slide 12:
You have reached the end of this class.

In this class you learned how to update the settings for health posts and individual HEWs in the app.
You also learned how to use the troubleshooting function to identify and document technical
problems that eCHIS users are encountering.

You have now reached the end of session 4 of this course, the eCHIS Focal Person App.

Slide 13:
This concludes this session of the course, Introduction to eCHIS.

In this session on the eCHIS Focal Person app you learned that:

• The Focal Person app is used in conjunction with the other eCHIS apps to track and
document client service provision and HEW performance
• The app provides digital supervision checklists for the focal person to use during health post
visits
• Late client visits can be tracked via the app
• The app links to the eCHIS web portal through which focal persons and other decision-
makers can view performance reports and create customized dashboards
• Health post and HEW information can be updated via the app, and
• The app provides basic guidance on how to troubleshoot technical problems with the eCHIS
apps.

Now take the short quiz that follows. You will need to pass it with a score of at least 80%. You may
take the quiz as many times as you need in order to pass it.

Slide 14:
[Quiz]
Session 5: Troubleshooting eCHIS
Class 1: Introduction to the eCHIS Troubleshooting Guide

Slide 1:
Welcome back to the online course, Introduction to eCHIS, the electronic community health
information system.

eCHIS users may encounter basic information technology, or IT, issues common among computer
and app users. In this session, we will discuss some of the most frequent IT issues related to eCHIS
and Android devices and how to resolve them.

Before we get started, if you would like to review how to navigate the class screens, select the
“Navigation” button. Otherwise, select the “Next” button [jumps to slide 3].

Slide 2:
In the side bar you will find a “Menu” tab with a list of the topics in this class. You may navigate to a
topic that you have already visited by selecting the topic.

Also, in the side bar you will find a “Glossary” tab with key words and definitions and a “Notes” tab.
Select the “Notes” tab if you would like to read along with the narration.

In the upper right is an exit button if you would like to leave the session before completing it.

To pause, play, or replay a slide, use the control buttons and slider at the bottom center of the
screen. On the bottom left you can adjust the volume.

Except when you are asked to manually advance a slide, the slides will move forward through the
classes automatically. But you can also move forward or backward through the slides that have
already been played by selecting the “Next” or “Previous” buttons. Select “Next” now to continue on
with the class.

Slide 3:
This is session 5 of the course. In this session, we will discuss how to troubleshoot common technical
issues with the eCHIS suite of apps.

This session has 3 classes.

The first class presents an introduction to the eCHIS Troubleshooting Guide. Class 2 familiarizes the
user with the first part of the guide, covering general troubleshooting for Android devices. Class 3
familiarizes the user with the second part of the guide, covering technical issues specific to eCHIS.

Slide 4:
By the end of this session, you will be able to:

• Describe the organization and key contents of the eCHIS Troubleshooting Guide
• Discuss methods of keeping data on mobile devices secure
• Identify where in the guide to find answers to common technical problems with Android
devices
• Identify where in the guide to find answers to common technical problems experienced by
users of the eCHIS suite of apps, and
• Report bugs in eCHIS to the ministry of health.
Slide 5:
We will start this session with an introduction to the eCHIS Troubleshooting Guide.

This class will take approximately 15 minutes to complete, including time to review the guide.

Slide 6:
This session is meant to accompany the 2021 document, eCHIS Troubleshooting Guide: Resolving
common technical problems with Android mobile devices and the eCHIS mobile application suite.

You may have already received a hard or soft copy of this guide from your instructor or supervisor. If
not, you can download a copy of it from under the Resources tab.

Make sure you have a copy of this guide handy as you will need to use it throughout this session. If
you have problems accessing the guide, notify your instructor or supervisor or email the address on
the screen.

Once you have the guide, select “Next” to continue with this class.

Slide 7:
Before continuing with this session, take a few moments to look over the guide. Notice how it is
organized and the types of information that it covers. This session will help you become more
familiar with the guide so that you can use it easily and efficiently when troubleshooting eCHIS is
necessary.

Notice that it is divided into two sections. The first section covers information about troubleshooting
problems with Android devices. Section 2 covers troubleshooting problems specifically about eCHIS.

Once you have reviewed the guide, select the “Next” button to continue with the class.

Slide 8:
As a health information technician, it is essential that you provide prompt IT support to eCHIS users
so confusion and problems with the app do not cause delays in use.

Focal persons also play a role in this process. As part of their supervisory duties, they observe each
HEW that they supervise as they provide services to clients. This includes completing the eCHIS
Application Checklist on their app and submitting the forms so that any technical issues with the app
can be addressed by ministry staff.

Slide 9:
Before we proceed further into this session, if you would like to review how to launch, log in and
out, and sync the app, as well as how to navigate the home screen on any of the eCHIS apps, select
the Review button. If not, proceed on with the session by selecting the Next button [jumps to slide
16].

Slide 10:
As you may know from previous sessions of this course, the eCHIS suite of apps should already be
installed on your Android smart phone or tablet. If it is not, report this to your instructor or
supervisor or contact the help desk at DHAechis@[Link].

To launch the app:

* Tap on the app’s icon.
* If you do not see this icon on the device home screen, look for eCHIS in the list of apps and tap it.
* After a few seconds the login screen will appear.

Slide 11:
Remember that eCHIS consists of three apps. HEWs have access only to the HEW app, health center
workers only have access to the Health Center Referral app, and focal persons have access to that
app.

Since you need to be familiar with all three apps, you have access to all of them.

You can move between them selecting the app you want to use from the list on the screen. Do this
by tapping on the small arrow as shown. This will give you the option to select whichever app you
want from the list.

Once you have selected the app that you want to use, enter the user name and password that were
given to you by your instructor or supervisor and log into the app. If you do not have this
information, report this to your instructor or supervisor or email the address on the screen.

Slide 12:
When you first log into the app, you see this home screen. The home screens of each of the three
apps look very similar. They all have three main icons: The “Start” icon, the “Sync with Server” icon,
and the “Log Out” icon.

You can navigate to different parts of the app from this screen.

* Select this icon to start using the app

* Select this icon to sync the information in the app with the server

• You can find the time of the most recent synching here

* Select “Log out” to exit the app.

You can also set the app to work in the language with which you are most comfortable here.

And you can confirm which of the three eCHIS apps you are using by looking at the title in the upper
left corner.

Slide 13:
Note that the app screens can be viewed either horizontally or vertically on either Android smart
phones or Android tablets.

Slide 14:
When eCHIS users sync their apps, the data entered are used to update the central data base and
transmitted between the HEW, Health Center Referral, and Focal Person apps.

Synching with the server pushes pending data from the mobile device to the server so that they are
recorded and accessible to others in the system. For instance, when a midwife at the health center
syncs her app, the HEW receives the updated information. Likewise, the HEW can update client
information and, by synching, send the new information to the health center workers and to the
focal person through the Health Center Referral and Focal Person apps, respectively.
All system users sync with the server at least twice daily, when first logging in at the beginning of the
work day and before logging out at the end of the work day.

Slide 15:
eCHIS users should always log out of the app when it is not being used.

This protects the client data and prevents others from editing or deleting these data. It also saves
battery life.

Slide 16:
Note that different Android devices and operating systems use differing user interfaces.

For this reason, the layout of the menu items on your device may look different or be found in other
places than is depicted in this session. If you find that the specific information provided in this
session does not apply to your device or version of your operating system, report this to your
instructor or supervisor or email the address on the screen.

Slide 17:
And a quick note on security: Good security is essential to keeping client and other data safe. Be sure
to use these methods of enhancing security at all times:

• Use secure and strong passwords that are changed every 90 days
• Update antivirus and anti-spyware programs regularly
• Download necessary patches to the application and operating systems regularly
• Create backups of all important data files
• Encrypt sensitive data, and
• Have an emergency response plan for mobile and wireless security breaches.

Slide 18:
You have reached the end of the first class in this session.

In this class you learned about the eCHIS Troubleshooting Guide, reviewed basic functions of eCHIS,
and were reminded of how to keep data secure.

You may take a break now or continue on directly with class 2 of this session.
Session 5: Troubleshooting eCHIS
Class 2: Android Troubleshooting

Slide 1:
This is class 2 of session 5 of the course. In this class we will discuss how to find information about
troubleshooting common Android issues in the eCHIS Troubleshooting Guide.

This class will take approximately 14 minutes to complete, including becoming familiar with the
guide and answering the questions in the class.

Slide 2:
Users may experience a number of technical issues with their Android smart phones or tablets.

We will spotlight a few of them, listed here, in this class. Others are described in more detail in the
Troubleshooting Guide.

Slide 3:
You will see that some of the first issues listed in the Guide relate to the use of Google Play Store,
sometimes just called Google Play. It is through the Play Store that the user downloads the eCHIS
app. Note that some issues related to this include:

• Google Play Store crashes

• Google Play Store doesn’t download eCHIS correctly, and
• Installing and reinstalling Google Play Store.

Take a moment now to read these sections of the Troubleshooting Guide. Note that these sections
are delineated by the number on the screen, with 1.1 meaning the first item in section 1 and 1.5
meaning the fifth item in section 1.

Select the “Next” button when you are ready to continue with this class.

Slide 4:
Now that you have read through the Google Play Store sections of the guide, answer the questions
on the screen. Feel free to use the guide in order to find the answers.

When you are ready, select the “Next” button to see if you are correct.

Slide 5:
If Google Play Store crashes after launching, you might have a corrupt cache. Most of the time,
simply wiping its cache fixes the problem. The guide provides the steps for doing this.

When most users think they’ve deleted Google Play Store, they actually have only disabled it. Again,
the guide provides the steps for resolving this issue.

Select the “Next” button when you understand these functions and are ready to continue with the
session.

Slide 6:
Having insufficient space and memory on a mobile device is a common problem and can prevent
eCHIS from being downloaded and used.
Several fixes are included in the Troubleshooting Guide to address this issue. This class will now
pause while you review the three guide sections listed here.

When you are ready, select the “Next” button and answer the questions that follow.

Slide 7:
While looking at the Troubleshooting Guide, find the answers to the questions on the screen. When
you are ready, select the “Next” button to see if you are correct.

Slide 8:
The easiest way to free up space on a mobile device is to uninstall apps, especially since the amount
of storage space on a device is fixed and can not be expanded. The guide provides step-by-step
instructions for doing this.

Memory problems tend to happen with users who store a lot of media directly on their devices.
Media files such as videos and photographs are large and use a lot of memory. To avoid this, these
files can instead be stored “in the cloud” through services like Google Drive and Dropbox or on
removable storage devices such as SD cards. Additional fixes are listed in the guide.

Select the “Next” button when you are ready to continue with the session.

Slide 9:
Another common problem with Android devices concerns downloading.

The class will now pause while you review these three sections of the Troubleshooting Guide.

When you are ready to resume the class, select the “Next” button.

Slide 10:
While looking at the Troubleshooting Guide, find the answers to the questions on the screen. When
you are ready, select the “Next” button to see if you are correct.

Slide 11:
When a downloaded file does not play, it could be because the cache is corrupted and needs to be
wiped. The guide provides steps for how to address this problem.

If a video won’t play, multimedia players VLC Player or MX Player can be used, as described in the
guide.

Select the “Next” button when you are ready to continue with the session.

Slide 12:
It is also common for mobile device users to experience problems connecting to the Internet.

The guide provides information about addressing some of the most common issues with
connectivity.

Take a few moments to review these sections of the guide. Then select “Next” to continue on with
the class.
Slide 13:
While looking at the Troubleshooting Guide, find the answers to the questions on the screen. When
you are ready, select the “Next” button to see if you are correct.

Slide 14:
The biggest cause of mobile Internet not working is improperly configured APN settings. If these
settings aren’t properly configured, you can manually set them. The guide provides steps for
configuring them.

If you can’t connect to the Wi-Fi network, it is probably due to the router. The best solution
oftentimes is to restart both the router and the device.

Slide 15:
A number of other common problems with Android mobile devices are addressed in the
Troubleshooting Guide.

Keep reading through the guide until you are familiar with the issues documented in it.

If you have questions, contact your instructor or supervisor, or email the address on the screen.

Slide 16:
You have reached the end of the second class in this session.

In this class you learned about common problems experienced with Android mobile devices and how
to find instructions for resolving them in the eCHIS Troubleshooting Guide.

You may take a break now or continue on directly with class 3 of this session.
Session 5: Troubleshooting eCHIS
Class 3: eCHIS-specific Troubleshooting

Slide 1:
Welcome to class 3 in session 5 of this course. In this class we will discuss troubleshooting key
technical problems in the eCHIS suite of apps using the eCHIS Troubleshooting Guide.

This class will take approximately 15 minutes to complete, including answering the questions in the
class and passing the session quiz at the end.

Slide 2:
As with Android devices, users can experience a number of technical issues with the eCHIS suite of
apps.

We will spotlight a few of them, listed here, in this class. Others are described in detail in section two
of the eCHIS Troubleshooting Guide.

Slide 3
Users of eCHIS sometimes experience error messages. A few of the error messages are covered in
these sections of the eCHIS Troubleshooting Guide.

Take a few moments to review these sections of the guide. Then select “Next” to continue on with
the class.

Slide 4:
While looking at the Troubleshooting Guide, find the answers to the questions on the screen. When
you are ready, select the “Next” button to see if you are correct.

Slide 5:
These are two possible error messages that you might encounter with eCHIS.

The first usually means that the Internet connection is not strong enough to perform the requested
download or installation.

The second means that the app has entered an inconsistent state and “Recovery Mode” needs to be
employed.

Slide 6:
You might encounter quarantined forms in eCHIS.
Review this section of the Troubleshooting Guide to learn more about this topic.

When you are ready to resume the class, select the “Next” button.”

Slide 7:
While looking at the Troubleshooting Guide, find the answers to the questions on the screen. When
you are ready, select the “Next” button to see if you are correct.

Slide 8:
A quarantined form is an eCHIS form that does not appear on the server as it normally would.
This is usually because it has become corrupted for some reason and removed from the queue of
forms.

eCHIS will automatically quarantine a form that it detects has become corrupted, although users can
also manually quarantine a completed-but-unsent form.

Select the “Next” button when you are ready to continue with the class.

Slide 9:
Since there are times when eCHIS devices can not access the Internet, there are alternative ways to
back up and send data.

Review these two sections of the Troubleshooting Guide to learn more about this topic.

When you are ready to resume the class, select the “Next” button.’

Slide 10:
While looking at the Troubleshooting Guide, find the answers to the questions on the screen. When
you are ready, select the “Next” button to see if you are correct.

Slide 11:
When there is no Internet connectivity, data can be transferring via an SD card or via Wi-Fi Direct.
When there is a choice, using an SD card is preferable.

And the statement is true, to transfer eCHIS data using an SD card, the card is inserted into the
HEW’s phone and the “SD Dump” process is initiated.

Select the “Next” button when you are ready to continue with the class.

Slide 12:
The Digital Health Helpdesk is the preferred way to report bugs in eCHIS. It can be found at this web
address.

After you create and activate an account, you will be able to report bugs you find in the system.

Now read section 2.31 of the Troubleshooting Guide to learn more about this important function.
When you are ready, select “Next” to continue.

Slide 13:
Remember that the Digital Health Helpdesk website includes a forum so you can view the bugs that
others have reported and how they have been addressed. Once you have registered, following the
instructions in the Troubleshooting Guide, you will be able to access this forum.

Slide 14:
You have reached the end of the third class in this session.

In this class you learned about common problems experienced by users of the eCHIS suite of apps
and how to find instructions for resolving them in the eCHIS Troubleshooting Guide.

You have also now reached the end of session 5 of this course, Troubleshooting eCHIS.
Slide 15:
This concludes this session of the course, Introduction to eCHIS.

In this session on troubleshooting eCHIS you learned that:

• The eCHIS Troubleshooting Guide is available to help health information technicians resolve
technical issues with Android devices and eCHIS apps
• Data in eCHIS can be kept secure through, among other practices, the use of frequently
changed passwords, antivirus and anti-spyware programs, and file back-ups
• The guide provides step-by-step instructions for resolving common technical problems with
Android devices
• The guide provides step-by-step instructions for resolving common technical problems with
the eCHIS apps, and
• Bugs in the eCHIS apps should be reported to the ministry of health to be resolved.

Now it is time to take the short quiz for session 5. Make sure to have the eCHIS Troubleshooting
Guide accessible so you can refer to it while taking the quiz. You will need to pass it with a score of at
least 80%. You may take the quiz as many times as you need in order to pass it. Select the “Next”
button to start the quiz.

Slide 16:
[Quiz]