Okay so let's get started. Hello and thank you everyone for joining us today. Today it's the first of a series of quarterly webinars that we are going to organize to be focused on the use of the HHS to for immunization programs that have been developed together with the WHO, and UNICEF. In these webinars we are trying to like bring forward some real-world use cases and to share a little bit of experiences of implementations and best practices among end users, so a bit of everyone here and also stakeholders. The first webinar so today is going to be about innovations and challenges of implementation, especially of COVID-19 related immunization implementation toolkits. And today like the real protagonists are going to be the HISPs network and the work on developing and implementing these tools for data collection, analysis and reporting. So just to get a little bit an overview of the HIS to immunization toolkit, what we have been developing together again WHO, the UNICEF just mentioned a few. It's a wide range of toolkits that can be used either to measure coverage distribution of vaccines, so the EPI module for routine vaccinations as much as for example for mass campaigns or in general emergency campaigns such as for example the COVID-19 that we are approaching now. And we are planning also now to ensure that individuals for example are monitored throughout the doses, so immunization e-registries for individual data as much as the management and the overview of supply chain readiness. So we have both aggregated and individual data for supply and management. And as you will see also we also have the possibility to link also to have vaccination record or certificates. In general overall we have a wide range of vaccination toolkits and they're all there to help us out to inform strategy adjustments, to have quick like real time overview uptake data on a take and coverage. And as much as to have for example data for trends in geographic spread and just general visualization and to have also a good standards of data so we can have such for example the Botanic analysis or the vaccination app or as well for example the data quality app. Overall just to give you an overview of this spread or the use of the HS2, 45 countries use the HS2 for immunization data and already 30 countries have already installed the WHO EPI package. Specifically for the COVID vaccine toolkits we have here the general overview. We have already 25 countries that are operational and running their activities based on the HS2 and eight are in development and there are more to come. So without further ado I think that we can move forward with the real essence of this first webinar. And today we're going to have three HISPs groups that are going to present us their experiences of implementations with different key elements for success but also challenges and ways that they have overcome these barriers. So the first one is going to be his Mozambique, so Digitus, with an example of real-time analytics at data clinic for Sotomay and the pre-registration experience that they had for Mozambique. And then afterwards we're going to switch to his Uganda and we're going to show us their work for approaches of real-time monitoring and also the hybrid implementation between aggregate and individual data for Uganda and Mauritius. And finally Sri Lanka with their work for the Scale-Up Immunization Registry for Sri Lanka and Timor-Lester. So I leave the stage to his Mozambique and therefore Zephyrino. Good morning everyone or good afternoon I think. So I'm Zephyrino Saojen, I'm leading the team. So calling it SaoDigitus is always Mozambique. So as it was mentioned previously we have been supporting the Luzofon community with the implementation of the COVID vaccine packages and it's also now the experience that we're going to share is the main related to the work that we did in Sotomay and Mozambique. So for Sotomay the package was after getting from the University of Oslo we did adjustments of the package and presented to the country to you know and then make the adjustments for those to make sure that they align to the national guidelines and also the plan, the COVID was in planning that was developed for the country and then yeah. So basically as part of this of this process we did some activities and then there were some success activities, process activities which were mainly linked to the aiming to improve the planning for the vaccination teams and also developed some real-time monitoring dashboards that aimed at helping the team that were managing the vaccination process, the API program, the HMIS and the surveillance teams in order to have the view of what is happening, what was happening in each vaccination site. There were some, there were also allocated in each of vaccination site supervisors both to monitor the vaccination process and the HMIS allocated also focal points that were monitoring or actually they are monitoring the data entry process. So this has helped to get the data on somehow on time that could be used to do the monitoring of all the process. So with regard to the training, we did provide some face-to-face trainings and then also visited most of the sites, 99 plus sites that aimed at helping the users on the issues that they were facing. So for Santome, these were the first truck, let's say implementation, national wide truck implementation. The country was using DHIS too but the focus was on aggregate and even though we did start the customization of the truck from the beginning of the year but there was not yet, it was not yet rolled out national wide. So there were some challenges which for example the training that we did here, two days before the start of the vaccine, the vaccine process. So those that also brought some challenges that needed us to visit the sites to fix and also there were some devices, Android devices that were prepared to be used for the vaccination process but when you came to the training we found that it was not a good approach because the users were only the first time for them to use the Android app. So we did decide not to use that but for the second dose, so we were training some of the users that they might be or they are using those devices to enter data especially and then also we did create some WhatsApp groups with both with data and reflex to share the experience and also there were some other groups that were used to share the experience with the supervisors so that they could use that to share all the problems that they were facing and then what are the approaches that could be used. With regard to the visits, there was a first visit and then a second visit to the first visit was meant to provide the first training and then do the follow-up. The second visit it was targeting to try to, because there were some issues that we had to go through after the vaccination which was data cleaning where some duplication of the data and then those things happened in between the two doses so we had to go there for the second, before the second round to make sure that we trained the users and then they went and give them the tricks that how they could deal with the several issues both for the HMIS that they are demonstrating the process as well as the users. With the barriers, I mentioned some which are the trainings and also the planning process and also there's a pressure to have the data to be entered and then sent one time. It was one of the barriers and then one of the ways that we did it was to have the double both the aggregated individual level to be sent the data to be entered in DHS to the hybrid process so that the data could be or at least they caught the managers at the national level they could have the clear picture what the total number of people that we have vaccinated. Next, going back to Mozambique, the approach was similar in Mozambique the experience now is related to the above, how we also, as part of the process before even the vaccination, for the first round in the planning, in the process that the country was targeting to vaccinate health workers. Because of that we requested to have pre-registration we have the list of all entered before in DHS so that they could speed up the whole process but of course this list was not provided in full and there were some information that was only received during the vaccination process that also did not make for example the users to benefit from having this pre-registration approach within DHS too. At the moment we are working on this for the next groups of people that are going to vaccinate it, we know that there is also a project that the company, private company, they are gathering themselves to be buying, bringing some vaccines to the country and those they will be using the system to provide those vaccines so we are preparing this pre-registration to be of benefit to all that are going to be used and then based on the experience that we had previously to make sure that we won't face the same challenges. For Mozambique it was also hybrid implementation, truck and aggregator, even for now for the second dose we are still using the same approach because the country is huge, there are some, there were some challenges for example related to the internet in the beginning so that it could be, it was difficult for them to be able to send all the individual level as compared for example to something where it was easier to have that so that's why until today the approaches are great, they send the individual the data at the end of the day also they send aggregator so that they know what is the target of the day and the WhatsApp groups who are also used to, especially to share, especially on the first days we did have every day meetings with the supervisor that we are shipped to the countries, to the provinces and then those that were their responsibility to us to deal with the users and also the focal point in the districts so at the end of the day we had to sit with them and then find all the problems, try to address the problems, align all the strategies that were used for example the approach that were used in one province which was different from other provinces so we could share and then make sure that the process of flowing smoothly as well as the pre-registration also difficult so approach that we are using one one province could be shared and then also to with other with other provinces. We did as also training with the training were mainly virtual virtual training which also brought some barriers because of the COVID. That was the reason why for example we decided to use the hybrid approach and the planning it was there were some internet and device issues that we are not very well organized in the beginning but with the process the country started putting what was required to make sure that the process is flowing smoothly and I also mentioned about the number of people that were not what at least that were not received this one that was a barrier for the use of this pre-registration or for the benefit of the pre-registration so the approach these approaches are also used in other countries like in Cape Verde where they were doing the interoperability and yes that's what I have to share at the moment thank you very much. Thank you very much Setharino. I think we can pass to Uganda so Dr. Brospet I'll leave the floor to you. Yeah thank you very much and good morning, good evening to all our participants for this today's webinar. Yeah what is very interesting is that I mean with the DHIS2 Upload and implementation it's all the same so pretty much of what Zephania presented is the approach that we try to follow across the different implementation but actually for Uganda it was at the point where we had started from paper tools development so we provided TA to the team to the UNEPI team and the Ministry of Health to develop registers, vaccination cards, reporting tools. We were able to install the package and customize it to the requirements of the of the Ministry of Health in terms of COVID vaccine management. We participated in all the trainings online most of them have been online and we've been consistently supporting trainings we have we are ongoing trainings and we're also supporting the end users. We've used the approach of a district to take advantage of the knowledge and the skills within the district for the general DHIS2 support, training and roll out the lower most TOT so we train the districts and then the districts in turn train the lower levels but it's happens that you know being online whoever even the health facilities are able to join into the weekly trainings that we have even facilities including the partners who are supporting these districts and facilities at the lower levels are joined into our trainings and so training, question and answer and the teams sharing their challenges and we step by step are able to take them through the demos, some follow-up with phone calls, WhatsApp messages and all that is the approach we use for the training. We've had quite a lot of support because the funding was not really available for the vaccine campaign. We've had a lot of partners coming in to support this initiative. We've had CDC support with laptops for all the districts 152 of them that we dispatched this Monday. We've had knowledge supporting data bundles for some of the districts. We had the UNICEF with some tablets in some districts, USID and WHO with tools and also some partners have supported with HR at facility level to do data capture and reporting. We have one solution so far. I'm saying so far just because what we have seen especially in the COVID vaccine, the COVID surveillance, instead of partners and coming to support what is already existing, we've found to see partners introduce some parallel systems which have parallelized time of the system. So at the moment we're still using the HIS-2 and the COVAX package as our immunization registry. As I said again, we are using weekly meetings half a day and the waiver is able to log in. It's a public coming and we are able to train them and then specifically address some of the challenges that teams are facing. In terms of the challenges, like any other country, any developing country, this was not planned for so we have limited funding from the government to support all this hardware, human resource and the requirements for a registry. Dedicated staff for data capture, we are now vaccinating in over 1500 vaccination points so that would require over 1500 data input cracks to be able to use the devices if they were available on site. We have limited devices, as I said, CDC just gave 152 but that's about the district level and each district has at minimum five vaccination points so you can imagine. We also have a challenge of using both paper and the electronic, so again this of course introduces a lot of backlog but most importantly the handwriting challenges that has to be transcribed from the registers to the train system later on. And because of the funds and the challenges of travels, we have done all our training remotely and limited support supervision so you do find that some of the districts who have connectivity challenges are not meeting regularly. So with this delayed update of eRegistry to be able to inform planning, we had to advise next slide, we had to advise means of how we can be able to quickly get data from the vaccination center for planning. So at every end of the day at each vaccination point they are supposed to submit their daily report and this is basically looking at the key elements, just six of them, to really inform the next meeting for the city reporting and also for the planning of the distribution of vaccines and also checking the progress. So we have both SMS reporting that we're going through the government prepared SMS short code that all the health workers can be able to submit this data at the end of the day. They could also be able to use the web to enter this report and they could also be able to use their DHS to Android to enter the report. So that's the format, very simple but very key elements that we need to get and monitor the reporting rate on a daily basis. Next. So again we also do through our HISP networks and support to other countries during one of our webinars when we're introducing the COVID vaccine package, the HISP package. The militias picked interest and they over on their own trying to install because militias have always been using the HISP as their HMIS team. They are just starting right now this year and all this has been happening during the lockdown. So militias picked interest and because the HMIS team at the ministry has been participating in several DHSU trainings, academies. So they were able to quickly set up and we supported them to install the package to be able to support the COVID vaccine registry. Of course it's a small country with a few facilities. It's been very easy for them and they have they set up from the start. We support from partners WHO they were able to set up to allocate human source for electronic data entry and so the staff were trained. So for them they have really implemented a fully fledged electronic COVID registry. Later on they were able to introduce the online registry and booking system which we supported them to be able to integrate directly to the DHSU tracker so that when the people come to the vaccination center they are able to be retrieved and on the internet for the vaccination. Of course the barriers they have had is because of the travel restrictions we have had to do all this online. They have had to bear some sleepless nights to catch time from Uganda to be able to go over some issues and and and and implementation. They were very very keen team that they really wanted to run on jobs so that's why we had hold some you know late evening sessions to be able to take them step by step and and and support the customization and implementation. Of course the challenges with the IT personnel at the national level being fact that they had not used DHSU for information. They had a lot of issues around cyber management which we've been able to remotely support on. Mauritius has been a good example of where you start from no DHSU and you quickly jump on this registry and within all the time you have real-time data on an individual level basis. So that's some of the few things that we can share with you but it's been a lot to learn from these two implementations over to you. Thank you very much Prosper. Super interesting. So next one we're going to get started with with Sri Lanka. So Alidu the microphone to Pamod. Thank you very much. So good morning. Good afternoon. Good evening everyone. I'll be briefly talking about what we have done with COVID vaccination and DHSU in Sri Lanka. So just like the use of COVID-19 for general use of DHSU for general COVID-19 surveillance, Sri Lanka was the first country that we implemented the immunization modules on DHSU and the package that we installed on DHSU it had all these components which is the immunization tracker where we are tracking the individual persons across their immunization schedule and of course we had aggregate component for stock monitoring. We also had to do some custom development to enable the digital vaccination certificate and we also have integration with the government vaccination appointment system so that we get the information pushed from that system to our existing DHSU based immunization module. Next slide please. Right so like since we started off this very early it was in November last year we had a lot of challenges. The initial challenge that we had was like we needed to have some guidance on how to design this tracker or rather the immunization module on DHSU because at that time this was a whole new concept so we had to obtain some assistance from some experts locally as well as internationally for that one and then again another major challenge that we had was one requirement from the Ministry of Health was to pre-register the entire population rather the entire adult population of Sri Lanka so we are talking about enrolling 16 million tracking instances to the vaccination program in DHSU so it was considered a major challenge how to get this information. We of course got it from the the elections commission who had it in a kind of a CSV file and then how to push this 16 million entities into the DHSU was a major challenge and then because we are talking about 16 million it was of course a large-scale tracker implementation so when your instance become very large everything about managing that instance become really complicated like from for example starting and time taken to run the analytics and in case if you do some mistake how to correct it so all these things become much much complicated when you have such a large-scale tracker so we had a lot of challenges with that and then of course with the large-scale tracker and the way we set up our instance was like we set up analytics and dashboards available for all the levels so with that one major requirements from the Ministry of Health was to have analytics real-time analytics enabled so in addition to capturing data we had to serve this requirement of giving analytics based on dashboards so this was again kind of pushed the platform beyond its limits so there were like some challenges related to the platform performance as well and then with the WHO smart vaccination certificate release candidate one first release candidate guidelines the Ministry was keen on having a digitally verifiable in fact the cryptographically verifiable digital vaccination certificate so we had some challenges related to that as well so the success of course we were able to set up this instance which had the tracker and the aggregate both at the time we received the first batch of vaccine so in fact like we were ready with the system when the when the vaccines came so the very next day when the country was ready to start the vaccination program we were ready with the system and then the pre-registration of the entire population so it was a major task we had not tackled an instance with 16 million before so this is where we got support from the DHS to community and the DHS to experts in at the UI level and the his community so we had a couple of discussions with all of them to decide on the best way forward so with help of many we were able to successfully import all these people the person set up at our population the DHS to system so which was a major success for us because we were able to do it in a short span of time and of course optimum use of tractor aggregate and custom development so we kind of leveraged on capacity that we had and the experience from our past implementation on covid surveillance to see that we have to have a combination of all three methods to get a successful implementation so similarly even for the covid vaccination we got our tractor aggregate and in addition whenever something is not possible we went custom solutions on DHS too and of course we had the smart vaccination certificate which was done based on WHO recommendations and for this one of course we again used few other open source solutions that were there to produce this vaccination certificate so we made use of available resources then trying to reinvent the wheel and we did the integration so that we we just pushed the relevant information and get this certificate generated and then again conducting training programs was a major challenge but of course we used this single page user documents and the zoom platform to conduct trainings at different levels so we initially trained the district level they again used the zoom mainly zoom to conduct their end user trainings and we also use Vibe platform instant messaging platform for troubleshooting as well as remote desktop solutions to connect to the users remotely whenever we find it difficult to troubleshoot so multi-sector engagement was again a major success in Sri Lanka so we not only the history Lanka we work very closely with the Ministry of Health administrators and the health informaticians and in addition we we obtained the support of the government ICT agency who looks after our infrastructure as well as the other people who are supporting with the integration with this diverse platform so these are few of the factors we can contribute it to our success in Sri Lanka and next slide please so next we will briefly talk about Timor Leste and my colleague who is based in Timor Achala will proceed with over to you Achala. Thank you Farmer good morning good afternoon and good evening everyone I'm Achala Jaisal from Timor Leste let me start with a bit of history of DHS2 in Timor Leste it's a new country back in 2013 the Ministry of Health decided to use DHS2 as the platform for national HMIS called Timor Leste Health Information System abbreviated as TLHIS in 2017 TLHIS was implemented countrywide to collect aggregated data in Timor Leste even the existing poor infrastructure there were no plans to implement the tracker this soon until last December to COVID-19 was not a big issue in Timor Leste but with the surge of cases around Christmas last year everyone was interested in vaccine in January we learned that we are going to get about 130,000 doses of vaccine under COVAX towards the end of February then came the question how are you going to manage vaccine information in January we were listening to a presentation from Sri Lanka on COVID vaccine tracker based on DHS2 after listening to that presentation after several discussions it was decided to customize a tracker to capture vaccine information in Timor Leste that was in mid January we had only less than two months to customize the tracker and train the users as you may know here Timor Leste is a very new country with very limited resources I'm single-handedly providing technical assistance to the Ministry of Health in DHS2 however with the help of WHO country office and his Sri Lanka we managed to complete the customization of new DHS2 instance for the tracker and use the training by end of February meantime vaccine arrival was postponed to 15th April and it was decided to launch the tracker along with the vaccine launch on the 7th April World Health Day next slide please on 7th April tracker was officially launched by his Excellency the Prime Minister and his Excellency the President of Timor Leste next slide please so these are some screenshots maybe we can skip that next slide please so let me discuss some success and some challenges we had to face in this project let me start with success we managed to get a buying from Ministry of Health and National roll out the system after training of entire HMIS staff target population was enumerated and pre-registered in the system and currently we are planning to issue a smart vaccination certificate for those who are completing the second dose from June in Timor Leste we use aggregated data capture forms as a backup system and we use event capture for supervision and monitoring of the vaccination campaign so let me move on to the challenges so lack of internet and frequent electricity failures are the main challenges we had to face in some remote areas no internet in some areas no electricity for days so how are we going to enter data that was the main challenge so we had some similar experience back in 2018 we used SMS like some some of our colleagues explained before us from Uganda so now this time we used WhatsApp platform to share images from the remote they send send the images of lists to the center and centrally we enter data and from the system administration point of view number of organization units kept increasing we have to add vaccination post to the system on almost daily basis that is time consuming and challenging another challenge we had to face was COVID lockdowns during the training as online training is not an option in Timor Leste so I had to undergo several PCR tests while traveling to the district and that is not so exciting with the successful implementation of the tracker for COVID-19 vaccine Timor Leste is currently planning to expand it to the ruining protein immunization as well I think that is all I have for today thank you thank you very much to both it was really really interesting and finally we have a quick overview of the country implementation support and for these I leave the stage to Rebecca good afternoon good morning everyone depending on where you are and thank you to our presenters for really sharing with us such a great range of both the successes and the challenges and so I think we have done a couple webinars to the public already focusing on the global public goods so of course today we really wanted to focus on these implementation lessons and learning that can be applied by others are there scaling up their DHS2 based immunization systems so we'll be able to share some of these resources that are all available on our website that's linked through the community of practice but we do want to point everyone to several pieces of guidance around the implementation guide in general tracker implementation if a country is doing first for the first time individual level data capture or also using using the Android DHS2 Android app for their implementation we also made available some some COVID-19 specific vaccine budgeting guidance to give countries a starting point including an excel sheet to sort of think through which modules they would be adopting and be able to adapt some of these units and unit costs for their own environment and really understand you know what is the budget that's going to be needed to to facilitate particularly the country operational costs on this rollout we produced some end user training templates I believe it was Achala and Pamad who pointed to some of these resources where we've developed these end user training templates that can be easily downloaded and then adapted so that you can leave your trainers with a resource or job aids and and just trying to make sure we're avoiding reinventing the wheel while we try to to scale up these systems at unprecedented speed and lastly I did want to mention you know we are very grateful to to our long-term donors and to Gavi who has invested quite a bit in the global toolkit as well as through a TCA grant mechanism and as well as to to NORAD who have given us some catalytic funding to mobilize not only the global goods but to be able to provide some TA to countries so we did just want to emphasize that Gavi countries if you are interested in your on-the-call you can reach out to your your his focal points and your Gavi SEM to explore those opportunities for mobilizing TA funding and to be able to to strengthen the immunization system so I think it's all of our all of our goals that this COVID-19 momentum will transform into actually really strengthening the integrated EPI or national immunization system overall and lastly I will leave you with some of these resources as well as some contact information in case you are coming from a ministry or a country you don't know who your local his group might be do feel free to email us at COVID-19 or COVID at dhiis2.org and we'll help to identify the regional his groups that are closest to provide that support so with that I thank you very much and I think we can move to some Q&A if that's all right and I know we have a few that are in the chat so perhaps we can start with the first one from Hussein so it can offline android application will it work when there is no internet or SIM card and I'll come on you already started to answer that one I'm not sure if we have any representatives with android as part of their implementation on the call from our his groups who might want to respond to the use of the android app as part of the dhiis2 implementation yeah I think I can share this yeah so um what we do find out with the android app um it's basically uh most of the time offline so it will not it will just only require you to have uh connectivity to before you leave your you live when you live to the remote area that that is for you to be able to log in and the data gets synchronized to a device so you can go offline with no connectivity no need for gmsm uh network and not even a SIM card uh we're using tablets which have no SIM cards in some of our implementations so when you come back then you can use the wi-fi to be able to upload the data yeah it does it does support that all right thank you prosper and I actually think maybe this next one from um from matt might also be a good one for you prosper so uh some of these deployments where there are already an epi registry um he's mentioning ugando where they also have deployed open srp for immunization what are the long-term plans for harmonizing the data um or duplication in training so I think harmonizing the data and also harmonizing training activities yeah thank you very much matt for sharing that yeah so um what's what has happened in most of these pandemics is establishing some kind of pyro registries um yeah particularly for uganda the covid vaccination uh has been uh established as a DHS to uh standalone um uh instance but using basically the uganda hmi's metadata that in terms of organization units and all that so uh what has happened with most of the other immunization registries um is they've been focusing for the children and and under age so they couldn't quickly come into support with what is registered there when it came to for covid vaccination because we're looking at over 18 and probably the priority clients but the long-term goal is to be able to have these harmonized and particularly for uganda we are we are now in the process of developing what we call the patient to client registry uh so whatever data will be picked and uh already we have in the covid vaccination and we have in this open srp uh would be uh sharing shared record that will be accessed through the central client registry so the harmonization is going to happen uh this was done in in time for the for the for the sake of the the emergency but once we settle down this all will be harmonized the trainings of course yes uh we've looked at the platforms that have been used for covid training and we also looked at what has been existing in terms of immunization support uh this can easily be able to be harmonized as we move forward so there are always uh a lot of synergies for us to be able to harmonize this and and be able to move forward over thank you so much prosper um and i think i can add to that a bit matt perhaps from a more global perspective um for for many of the countries that have been deploying these dhi's to chocolates many of them have um most of them probably almost all have established uh dhi's to as a sort of the um backbone of their his architecture so um really being able to have those strong governance uh mechanisms in the country and being able to have these different types of uh mobile apps and tools like open srp to be able to harmonize that data collection and follow a data flow that gets into the national system um we believe would be pretty important um the the second question was around the who epi module um with support for product tracking and supply chain capabilities um curious about deployments where their existing digital lma s solutions that must also be interoperated with so this is a really excellent question um and maybe vittoria can can have a word around how how the court of core aggregate packages and incorporate some of this uh reporting of the facility level this sort of last mile um point of logistics uh delivery and data capture so could be also considered the first data mile for that logistics data from the facility because what we've learned from various global um assessments on lma s um systems in country is that many of them if there is an electronic lma s uh that's functional and works across programs it's not maybe just used for one or two vertical disease programs uh many times it does not reach uh below perhaps the district warehouse um but many countries are filling that gap by being able to capture the site level logistics data and um then be able to exchange that between the lma s the electronic lma s um and one of the solute one one of the ways that dha is two is able to to contribute to that is that it has a reasonably a quite robust analytics platform that um sometimes logistics platforms don't don't necessarily have for example open lma s um so many of countries have found it useful to to also get some of that um logistics data from the lma s system in into their national system um and be able to uh triangulate that data with their vaccination service delivery um i believe pamad actually has uh a quite great example from from shrilanka around having these sort of data triangulation dashboards with the stock data so i don't know if pamad or veto would like to add to this uh response um so my side just to add that as you said um the the strongest point the strongest point even for something as consider as basic as an aggregated data set is the fact that you can have a quick overview of the supply chain and the management of your of your pharma store let's say um directly from the point of care so you can have like a quick overview of your status of how many items are coming in out um stock days and such both from uh as as you also mentioned like a stronger analytic ability that the has as well as like a geographic um visualization that you can have also from a higher level in case of need because you can monitor your your information both at at health side as much as um a higher like a hierarchical level and um and yeah um so far it has been used uh integrated in the in the in the data collection procedures integrated very well also in the in the flow of information especially in those countries where the the information flow is much more established because of like the hms side of things but it's it's very simple yet incredibly intuitive and and and working very well for the point of care and the incredible um added value of having in one single platform the ability to triangulate data on the use and consumption of your of your goods of your items and see what kind of impacting has on your activities on your medical activities or health related activities it's uh it's been it's been a challenge but it's been super interesting and super useful to see up like being uptaken so I think for more like a use case I think promote can definitely add something more to that yeah thanks to Toria so when it comes to how we use dhs to post stocks is like we have a separate stock monitoring component which is aggregate model so what we do is now when we when we get the stocks at national level and when the stocks are distributed at each of the levels we get aggregate counts I mean it's like a daily count we have asked everyone to update so we are using like I mean it's not just a simple aggregate data and reform that we are using we are using also predictors as well to take take the stock forward and things like that and based on that we are getting updates from the vaccination centers and at the regional level and as at national level the vaccination stock information we use that to update our vaccination dashboards but I must say that this is not kind of replacing right now the the the stock management system which the Ministry of Health has so that's a separate system that that we use to track the the other supplies the medical supplies as well but in the same way we set up for all other activities around COVID-19 this dhs has to has been the kind of the pioneer in the solution that we were able to get it up and running to provide the useful information for us to monitor our vaccination campaign but how we are going to have a integration know how we are going to combine these different workflows into our generic hmi as workflow is something that we are we are really eagerly looking at next few months to come but at the moment we are using stock monitoring which is feeding aggregate data into our dashboards. Thank you very much Pamad while I have you I there was one more question for Shiloka but I would like to pull up um is the dhs to vaccine COVID-19 data instance linked with other dhs to instances or it's or or is it standalone and what might be the plans for linking the different systems or instances in the country? Right again a very good question so as I mentioned before we have one dhs to instance for incorporating all the COVID-19 related information like we have one for I mean contact freezing we have one for laboratories quarantine ICU beds so all these are in one particular main dhs to instance for COVID-19 but because we were anticipating a lot of challenges with the COVID immunization tracker which because it was going to be a large-scale implementation we set it up separately but what we actually do is we take the aggregate data I mean like the summary data from this instance and we feed it into our central dhs to instance similarly there are like some other third-party applications for example laboratory level data collection which are which which are being used by the ministry of health we have plugged them also to feed data into our central surveillance system so that we are getting aggregate data which we can use to produce dashboards so same thing we are doing for vaccination system as well we have a separate instance but it is feeding data periodically to our central COVID-19 dhs to instance. Thank you Pamad, let's see we have a little bit of a tricky question so any insights around LMAC is that might already have a dhs to system installed and operational so they're using dhs to in the country but perhaps haven't shown a willingness to install the COVID-19 dashboard modules and so what are the challenges there I think there there could be many but I don't know if any of our his groups wanted to to speak a little bit or to the opposite side why maybe we believe that these modules should be considered if the country is using dhs to as their national immunization platform in terms of sustainability I don't know if anyone had any comment on I think maybe the answer is it would be quite difficult for us to speculate but I do think we believe that there are some some efficiencies to be gained by really aiming to integrate some of these modules with the existing national immunization system and partly there are a couple notes in the chat here around how does this relate to the overall EPI system and I think this is a really important question that I might also ask Vito or maybe if Jeffrey knows also on the line to input a bit as these COVID-19 modules it's really just another type of vaccine and so there are some things that we have designed and accounted for for example you know capturing that data by the specific brand of the vaccine recognizing that many countries are really aiming to monitor this coverage and rollouts as close to real time as possible so having you know either individual level real time or at least some sort of daily data sets to make sure that that data is coming in faster but I didn't know if Zeferino or Vito wanted to comment on some of the linkages with the the routine EPI modules and also within that health information architecture within the country and what are the benefits for the countries to to be able to integrate COVID into what they already have? Well from my side I would say that of course right now COVID-19 is an international emergency and has much more visibility so it required something that could stand out and have quick access especially for for those countries that didn't have necessarily an integrated EPI module from the HIS especially so they needed something to monitor either in surveillance for the case itself but of course here we're talking about immunization if countries have both the routine immunization program and package installed in their in their system having the added value of having COVID-19 vaccination system it's in the end it's it's just a fork of the of the same of the same family let's say it's just that at the moment it has this particular need of being on its own also because it's something new we don't know in the long run how it's going to become it could be that in the long run it's going to become just simple part of the EPI family because it's going to become a routine vaccination itself but for the moment it would be just a simple triangulation or simply an addition of those indicators that are normally used for for the EPI and simply adding as well those that are currently used in the in the dashboards or that anyway in the system for for COVID-19 so having both is it can be integrated very easily in a single dashboard if needed because they're part of the same system and they are part of the same family in the end because yes it it was more of a let's call it mass campaign but we don't know how we're going to go forward from that and I mean I don't know if if Zephyrino wants to add anything to that but I would say yeah I mean it's it's pretty straightforward how to integrate it it's just like consider almost a triangulation of of different packages that are installed in the same instance so I wanted to thank you all for bringing your great questions into the chat here we will try to to update the posting on the community of practice to try to summarize some of some of these answers and I think it's you know it's just very clear that we still have so much to learn from real implementation challenges and and experiences and so we were very grateful to have a child in Pamad and Zephyrino and and prosper here today to actually share with us some of those country implementation stories that I think we will continue to learn a lot in the months to come so I think at this point we have answered most of the questions that came through life and so max I think from here we can close the webinar and we look forward to continuing the engagement on the community of practice and please do not hesitate to reach out to us or contact us if you also have a country implementation that you would like to connect with us to organize how you might have some support so with that thank you very much and I think we can call this a close thank you


250mg of cordyceps vs 500mg vs 2000mg. Some believe cordyceps is one of the most potent tropics on the market for brain function, but is it really? And what's the optimal dosage? Is it even safe? Well, I tested different dosages for a month and in this video, you're going to learn everything about its benefits, side effects, dosages, my experience and at the end, whether you should consider buying cordyceps or not. Hi friends and welcome to your Inception's YouTube channel. My name is Greg Gostinkar and on this channel, we are on the hunt for the best products, the tropics and supplements to boost brain performance. If that interests you, then be sure to subscribe and hit the bell for notifications. Is the 10-1 extras of cordyceps that I was just taking really 10 times stronger? And what happened when I increased the dosage from 250mg to 2g per day? We'll answer all of that in this video. But first, what exactly is cordyceps? Well for one, it's a type of fungus that promises some pretty amazing health benefits. This larvae-invading fungus has been used for centuries to treat ailments such as fatigue, sickness and kidney-related diseases. It is used so commonly that it has found its way to the present as a popular supplement, so popular in fact that I decided to try it out myself. So if you are ready to find out what a daily routine with cordyceps looks like, then keep watching this video to find out if this supplement is the one you've been looking for. Now, cordyceps have been proven to improve the delivery of energy to your muscles. This can help improve your exercise performance on a daily basis. They also have the potential to carry anti-aging properties, which means young, healthy features for longer. Now, while the following benefits have been scientifically proven, they have only been tested on animals, which means professionals are unsure if this results fully translate to people. First one, various animal studies and test tube analysis have shown that cordyceps do have the potential to treat cancer and cancer treatment related side effects. They could also be considered for diabetes treatment as they can initiate the properties of insulin to keep blood sugar levels low. Cordyceps have historically lowered LDL or bad cholesterol levels, and they can reduce inflammation in the body. In addition, the mushroom seems to possess some neuroprotective features that may be beneficial in enhancing mental clarity, and people also use cordyceps to improve athletic performance as it can improve the production of ATP, a key carrier of energy within cells that enhances oxygen utilization. And this is particularly beneficial during exercise. But remember, these results came from animal studies and have not yet been tested on humans to determine whether the outcome is the same. Now, the potential for cordyceps as a medicinal ingredient is great, but for now, let's stick to what I've experienced while using it as a daily supplement. Now, during my test, I was taking cordyceps mushroom powder made out of 10 to 1 extract of the whole fruiting body. In my case, it was cordyceps militaris and not cordyceps sinensis. Since the optimal date dosage is unknown, I reached out to a friend of mine who is a herbalist and who recommended taking 250mg of my extract per day. Now, keep in mind that the extract I was taking was extremely potent and that's why such a low dosage was recommended. So for the first few days, I noticed no real benefits. I took the powder in the morning with some other general supplements like b-complexion omega-freeze. But after about a week, I noticed a mild improvement in my cognitive performance and well-being. Now, this could only be a placebo effect. But keep in mind, I didn't feel it during the first few days, which was quite surprising. After about 2-3 weeks of taking cordyceps, I also noticed feeling calmer during the day. Most importantly, a small crash that I sometimes experienced after a lunch was more or less gone. Now, I was often in this flow and I stayed in the flow for a longer period. I also felt more creative, but that was just me. Then, for the last week, I decided to increase the dosage. I first tried 500mg and at the end I even took 2000mg. Now, to be totally honest, I didn't feel any difference between 250mg and 500mg, which kind of makes sense, since dysentropic is known for its long-lasting benefits and not the short-term effects. But then, I took 2000mg of the extract.  Well, the fact is that there is no agreed upon dosage when it comes to cordyceps, but the most common range is from 1000 to 3000mg per day. This is of a 1-1 extract and not 10-1 extract. Now, 10-1 extract doesn't mean it is actually 10 times stronger, but it uses 10 times more material for the same extract, and studies show it is way more potent because it contains more of the cordycepin content, which is one of the many healing substances in cordyceps. You also need to know that cordyceps have long been used in traditional Chinese medicine and are even approved by the Chinese government for use in the hospitals, recognized as a natural and safe drug. So, just playing with radically high dosages isn't the smartest thing to do, even if you are not aware of any potential side effects, and we know that cordyceps is considered safe for supplementation. So, back to my test. When I took 2000mg, I felt a bit weird for most of the day. Instead of feeling well and being productive, I felt kind of lazy and even had brain fog. I also experienced some cramps, and yeah, overall, I just didn't feel good. Of course, there could be many factors contributing to my well-being, but I believe it was the too high dosage of the extract that caused it. So, I decided not to take 2000mg of this potent extract again, for now. Anyway, before I share my verdict, let's talk about the pros and cons of supplementing cordyceps. By the way guys, are you on the lookout for the best on tropics to boost your brain performance, but don't know where to start? Take a look at our free in-tropics quiz, link below, to get personalized recommendations that will be the perfect choice for you. Okay, let's start with the pros. Now, cordyceps have been used for a long time in traditional Chinese medicine, having a history of helping users improve their well-being. Cordyceps can boost their performance when exercising or during productive activities, and this makes it a great daily booster for yourself. Cordyceps, if they reach their full study potential, can help with overall health, covering everything from chronic diseases to healthy, hard aging. Now, it's time to look at some of the shortcomings of cordyceps. And one of the biggest issues when it comes to using cordyceps is insufficient research. There is just not enough research on the benefits of cordyceps on humans, while there is plenty in relation to the benefits of animals. And second, cordyceps are not easily harvested, which means they are harder to supply. This makes cordyceps a pricier supplement to invest in. Now, you can find different qualities of cordyceps on the market at quite a different price range, but for a monthly dosage of a quality 10-to-1 extract, expect to pay about $30 or 30 euros. Now, if you want to order cordyceps that I trust, check out the link below. All right, now, despite the limited research, there is no doubt that cordyceps have a lot to offer, both health-wise and performance-wise. Regular use will show an improvement in overall health, especially boosting immunity. And the athletic minded are sure to notice boosted performance as well. Based on this, I believe that if you're willing to make the investment, cordyceps are a worthwhile supplement to try out. They've been working for centuries in Chinese medicine, so there is a good chance that they'll work out for you as well. However, stick to the low dosage and take it for a longer period instead of taking a massive dosage for just a short period. I just believe that long-term supplementation is way more effective, so there is that. And the same is true if you take my favorite naturopics text of this year. Watch my next video to learn more. Thank you guys for watching and I hope to see you soon again. Stay well.


So, I got four of my friends and I was like, what should we call ourselves? John Freddow, what's the perfect name? I didn't want nothing thuggish. I didn't want an army, I didn't want a crew, I didn't want anything like that. I wanted something that was symbolic to Dodgers without saying Dodgers.  I was taking a shower in one night. I always wear Dodger hats and I was like, I need a new hat, I'm a graphic designer. And I was like, man, I wonder what the future color of the Dodgers is. So I stopped, turned the water off, went straight to the computer, I googled what's the official color of Dodgers, Pantone 294, I think it's here. I photoshopped a quick logo and I was like, Pantone 294, that's it. People always talk about Dodger Blue being so symbolic, Dodger Blue is Dodger Blue, right? Well, what is Dodger Blue? It's Pantone 294.