5.2. Assessment of the Objectives

• (i): The health information system must facilitate statements on the health status of the population. Therefore suitable health indicators have to be defined. This objective is limited by the restriction, that new forms for data collection may not be introduced.
  The results of the systems analysis demanded a flexible approach for providing health indicators. Therefore the specification of special indicators was neglected in favor of a broad based design with the potential to create a variety of indicators. The restriction to the existing forms forwarded this decision, as the results of the systems analysis revealed, that the existing forms are subjected to frequent changes.
• (ii): The health information system must integrate existing structures for processing information. If necessary, these have to be supplemented or mapped onto an application software product. Therefore the existing structures have to be analyzed.
  The systems analysis covered a major portion of the systems engineering project. Based on the rudiments from chapter 2. "Fundamentals", a methodology for the systems analysis was elaborated in section 3.2. "Analysis of the Health Information System". The resulting activities were listed in the respective section of chapter 4. "Realization". Annex R "Report: 'The Kabarole District Health System - Description, Opportunities and Suggestions for Improvement'" contains the results of the systems analysis.
• (iii): The health information system must handle data which are obtained in the district by means of a database. Therefore a suitable database scheme has to be designed.
  Based on results from the systems analysis, a data base scheme was designed according to section 2.4. "An Object Oriented Method for Database Scheme Design". The data base scheme was designed with emphasis on storing most of the information needed for a flexible adaption of the resulting software application product. The description of this process is part of section 4.4.3. "Construction of the Software Application Product".
• (iv): The health information system must present the compiled health indicators to decision-makers on different organizational levels of the district health system. Therefore respectively suitable forms of presentation have to be found.
  Presentation of indicators directly with "Kabarole!" was realized in the form of summary reports. For further processing of data, an export function was provided. This enables evaluations and presentations with more sophisticated software application products. Examples for the processing with "EpiInfo", a common statistics software in the public domain are given in annex M "Manual: 'The ´Kabarole!´ Manual'".
  Presentation procedures of health unit data directly at the health units will be provided with the upcoming national health information system.
• (v): The application software product onto which parts of the health information system are being mapped must be easily accessible for inexperienced users. Therefore the results of (i) to (iv) have to be embedded into a lucid user-prompting. Also, a users' manual has to be provided.
  User promptings in "Kabarole!" were designed either graphically based for the use with a computer mouse, or text oriented, depending on the required speed of the prompts. Central part forms a district map, on which actions concerning health units can be done by selecting the health units from the map. All user promptings are designed with a context sensitive message line for on line help messages.
  The provided users' manual can be found in annex M "Manual: 'The ´Kabarole!´ Manual'".
• (vi): The application software product must run without future maintenance. Therefore it has to be programmed carefully and tested severely to enable extensive troubleshooting.
  "Kabarole!" was compiled into a single standing software application product, which allows only an adaption of the setup to the needs of the district, not the modification of program code. Therefore "Kabarole!" was installed in successive versions, allowing a stepwise introduction to the staff and pretesting. The performance was checked one month after the final implementation as described in section 4.5. "Implementation and Maintenance of the Components".