In 2018, the Africa CDC established a Health Information Exchange Task Force of 24 members to provide expertise and guidance in the development of AU HIE guidelines and standards document. The document was critically reviewed and validated by Member States in all AU regions through several validation workshops; West Africa (validation workshop took place in Senegal), Central Africa (Congo-Brazaville), East Africa (Rwanda), South Africa (Namibia) and North Africa (Mauritania) through validation workshops. Representatives of Africa CDC, Regional Collaborating Centres (RCC), World Health Organization (WHO), West African Health Organization (WAHO), East, Central and Southern Africa Health Community (ECSA), and Economic Community of Central African States (CEEAS) have also participated in the validation workshops. Following the validation workshops, comments and recommendations from Member States were addressed and incorporated accordingly. Subsequently, the document is endorsed by the African Union.

The Africa CDC recommends adopting and domesticating the document by the Member States in Africa. Three African countries (Ethiopia, Nigeria, and Uganda) have initiated processes to adopt and domesticate elements of the AU Health Information Exchange Guideline and Standards document for internal country use.

The Ethiopia HIE guideline and standards document serves to domesticate elements of the African Union Health Information Exchange Policy and Standards document for Ethiopia as envisaged in the original AU document. Although originally envisaged for the exchange of surveillance data between member states, the document was extended to apply to other aspects of health information systems within and among the Member States. The contents of the document are intended to apply both to health information systems within Ethiopia as well as the exchange of health information with other African countries

and bodies such as the Africa CDC and WHO. The goal is to provide recommendations for use within Ethiopia and also to build on previous policies and work in this area to provide guidance for strengthening these areas.

Goal

The aims of the domestication of the document include the following:

1. Adapt the contents of the AU Health Information Exchange Policy and Standards Document to apply to internal systems in Ethiopia;
2. Guide Ethiopia in developing its own internal HIE Policy and standards policy.

Activities

The University of Gondar and the Jembi Health Systems in collaboration with the Ministry of Health have adopted the  AU HIE Guidelines and Standards to the Ethiopia context. The adopted document was validated in two validation workshops involving experts from the Ministry of Health, stakeholders, partners, and Universities. Following the validation workshops, comments and recommendations from the two workshop participants were addressed and incorporated accordingly.

The document comprises three sections: (i) frameworks for governance and a national data exchange architecture; (ii) a review of current HIE standards and technologies in Ethiopia and recommendations, and; (iii) an implementation framework for the Ethiopia HIE using three example use cases to demonstrate how this framework could be applied.

The first section of the document describes the Ethiopia HIE Policy for Digital Health Systems and includes the governance framework and a framework for a national data exchange architecture, reporting, and sharing.

The second section of the document describes the Ethiopia HIE Standards for Digital Health Systems. It includes a review of current standards and technologies related to HIE in Ethiopia as well as sections on different recommended standards for data exchange, interoperability, and privacy and security.

The third section of the document presents an implementation framework for the Ethiopia HIE and three illustrative use cases: COVID-19 case-based surveillance, HIV case-based surveillance, and Antinanatal Care Services.