USAID Transforms Health Data Collection and Reporting in Timor-Leste

Improved internet connectivity and capacity strengthening make all the difference for health officers

Eugenia Borges, a district health officer, uses an improved internet connection to upload data to the national online system in August 2023. (Photo: Emilio Dos Santos/USAID LHSS Project-Timor-Leste)

Timor-Leste faced numerous health system challenges during the COVID-19 crisis, not least being chronic difficulties in managing data on vaccination rates. Health posts across the country were required to enter vaccination and other health information into national databases, but limited and unreliable internet connectivity often made this impossible.

For national health officials, this resulted in insufficient data for evidence-informed decision-making on COVID-19 vaccinations and other important health matters. Responding to the government’s call for collaborative solutions, the USAID Local Health System Sustainability Project (LHSS) provided the Ministry of Health (MOH) with an internet connectivity package through an in-kind grant.

Through the grant, telecom companies distribute monthly internet packages directly to health management information officers’ mobile devices at health centers in 13 municipalities. The officers then use their mobile devices as a hotspot to connect their work computers to the internet and enter data into the Timor-Leste Health Management Information System (HMIS). They can also use their phones directly to enter data through a web app.

LHSS also provided training to these officers on how to use the national data reporting platform effectively for timely and complete reporting. In addition, the project team, along with Health Management Information Department officials, conducted site visits to coach and mentor the officers.

Eugenia Borges, a district health officer serving the Bobonaro municipality, witnessed firsthand the positive impact of these capacity-strengthening interventions. Despite having a bachelor’s degree in health information systems, Ms. Borges, like many of her colleagues, had faced difficulties updating and entering data into the Timor-Leste HMIS in a timely manner.

“The support the USAID Activity provided to us through the ministry’s HMIS Department has benefited our HMIS work, especially in terms of data completeness and timeliness of data reporting,” said Ms. Borges.

Not only did the grant improve Ms. Borges’ ability to report data, but it also opened doors to new opportunities. The free internet access on her mobile phone allowed Ms. Borges to complete online courses on DHIS2, the country’s platform for collecting, reporting, and analyzing health data, further enhancing her professional skills and knowledge. She also created short tutorial videos on using the national system’s data analysis tools and shared them online with other community-level HMIS officers.

Timely and complete data is now the norm

The success of the HMIS grant extends beyond individual stories like Ms. Borges’. In one year, the 13 covered municipalities saw the rates of timely and complete data reporting improve 48 percent and 21 percent, respectively.

Data on routine health services and COVID-19 vaccination coverage is updated daily, and managers at hospitals, municipal health centers, and the MOH can now rely on accurate and up-to-date information for effective planning and decision-making.

“The USAID LHSS grant has improved the Timor-Leste health information system utilization rate, leading to an increase in the completeness of reports submitted from the health posts level up to the national level,” said Narciso Fernandes, Director of the Cabinet of Policy, Planning, and Cooperation of the ministry’s HMIS Department.

To ensure lasting impact, the LHSS Project convened telecom providers, the government’s information technology agency TIC Timor, and the Ministry of Health to explore long-term support for internet service to the municipality-level HMIS officers. At the same time, the MOH’s HMIS Department has begun work with the Budget and Financial Management Department to include internet packages for health officers in the ministry’s budget plan for 2024.

For HMIS officers like Ms. Borges, the improved internet connectivity has meant fewer frustrations and greater job satisfaction. For the HMIS Department as a whole, the changes are providing national health leaders with the most accurate real-time picture they’ve ever had of the health status and needs of their constituents.