# One record for the health center, and the HMIS return built from it > ANC, delivery, EPI, NCD, ART and TB registers on one record, with the monthly HMIS return and DHIS2 export built from them. For Ethiopian health centers. Source: https://www.medicine.et/for/health-centers Site: Bloom Medicine — https://www.medicine.et --- ANC, delivery, immunisation, chronic care, HIV and TB on one record per patient — and the monthly HMIS return, the disease returns and the weekly IDSR report built from the work your staff already recorded. For private, mission and NGO health centers, and the regional programmes digitising public ones. ## Measured in Ethiopia - **41%** — of HMIS service reports arrived on time nationally in 2015 EFY, against 85% completeness ([MOH Annual Performance Report](https://ethiopiadup.jsi.com/wp-content/uploads/2023/11/Annual-Performance-Report-2015-EFY.pdf)) - **13.4%** — of 224 facility departments in Eastern Tigray met national routine-information quality standards — health centers worse than hospitals ([BMC Med Inform Decis Mak, 2026](https://doi.org/10.1186/s12911-026-03450-z)) - **26%** — of institutional-birth records were consistent across the register, folder and card (Central Gondar, 2022) ([BMC Health Serv Res, 2023](https://doi.org/10.1186/s12913-023-10127-0)) - **78.5%** — bin-card accuracy across primary health care units in Gamo Zone — and 62.2% at health posts ([Research note · Stock records](https://www.medicine.et/research/inventory-management)) ## The problems we hear from health centers - **The monthly HMIS return, tallied by hand** — The same visits are counted again at month-end from a dozen registers — late, and only as accurate as the tally sheet. - **A register for every programme** — One mother can appear in the ANC, delivery, EPI and family-planning registers, and one patient in NCD, ART and TB — each written separately, none agreeing. - **Children who start the vaccine schedule and drop out** — The dropout happens after the child is already on the books. A list of who is due and who is missed turns outreach day into follow-up, not search. - **Stock-outs, expiry and logistics reports** — Bin cards drift from the shelf, and the RRF is rebuilt each period from the same books. - **Insurance claims cut at audit** — Claims are reduced for arithmetic errors, duplicate orders and services outside the covered list — money the facility had already spent. ## What changes - **The return built from the work** — Monthly, quarterly and annual HMIS service returns on the official reporting calendar, OPD and IPD disease returns by sex and age band, and a DHIS2 export keyed by FMOH indicator code. - **One patient, every register** — Maternity and child health, NCD, HIV and ART, TB and leprosy, and SRH registers all hang off the same patient record. - **Surveillance on time** — Notifiable-disease alerts as cases are recorded, and the weekly IDSR return from the same data. - **Logistics from the same ledger** — Bin cards, Model 22 vouchers and the RRF and IFRR come from the ledger the dispensing window already writes to. ## Which national registers are included Each programme is an add-on module, switched on for the services the center runs. All of them record against the same patient, so a woman’s ANC visits, her delivery, her child’s vaccinations and her own NCD follow-up are one history. - Maternity & child health: ANC, labour with the partograph, newborn, PNC, IMNCI, growth monitoring, EPI - Chronic care: hypertension, diabetes and other NCD registers with WHO cardiovascular risk - HIV & ART: unique ART number, viral-load loop, defaulter tracing and the cohort report - TB & leprosy: unit TB register, treatment and DOT cards, contact screening and the cohort report - SRH: family planning, HIV testing, STI cases and outreach recorded without a visit ## The modules health centers use - [HMIS & Surveillance](https://www.medicine.et/features#hmis) — The national returns a facility is legally required to file, produced from the work already recorded. - [Maternity & Child Health](https://www.medicine.et/features#maternal-child) (add-on) — From antenatal care to growth monitoring, with or without a labour ward. - [Chronic Care (NCD)](https://www.medicine.et/features#ncd) (add-on) — Registers for long-term conditions, with follow-up and control tracked per patient. - [HIV Care & ART](https://www.medicine.et/features#hiv-art) (add-on) — The ART clinic on one record: enrolment, follow-up, viral load and the cohort report. - [TB & Leprosy](https://www.medicine.et/features#tb-leprosy) (add-on) — The unit TB register and treatment cards, with results flowing in from the lab when you have one. - [Sexual & Reproductive Health](https://www.medicine.et/features#srh) (add-on) — The registers a youth-friendly service keeps, including work done away from the building. - [Pharmacy](https://www.medicine.et/features#pharmacy) (add-on) — A dispensing window that knows the prescription, the stock and whether the visit is paid. - [Inventory & Stock](https://www.medicine.et/features#inventory) (add-on) — Purchasing, receiving and consumption in one ledger, so the screen matches the shelf. - [Insurance & Claims](https://www.medicine.et/features#insurance) (add-on) — The payer and patient share split on the bill, and claims batched per payer. - [Mobile App](https://www.medicine.et/features#mobile-app) — The facility in a pocket for staff, and still readable when the connection drops. ## From the visit to the return 1. **Register** — One record per person, found by name, phone or card — or by Fayda national ID through the client registry. 2. **See the patient** — The visit is recorded against the programme it belongs to: ANC, EPI, NCD, ART or TB. 3. **Follow up** — Due and missed doses, overdue reviews and defaulters show up on lists as they happen. 4. **Dispense** — Medicines come off the same ledger that produces the bin card and the RRF. 5. **Report** — At period end, the HMIS return, disease returns and DHIS2 export are produced from the month’s records. ## Questions ### Does it follow the national reporting calendar? Yes. HMIS service returns follow the official reporting calendar — the 21st of one month to the 20th of the next. ### Can it feed DHIS2? It produces a DHIS2 export keyed by FMOH indicator code, plus Word and Excel exports. It exports; submitting to DHIS2 stays with your HMIS focal person. ### Does it do the weekly IDSR report? Yes, along with notifiable-disease alerts. ### Does it produce the RRF and IFRR? Yes, from the Pharmacy module, with bin cards and Model 22 vouchers from Inventory. ### We are a public health center. Can we use it? Public health centers usually adopt systems through their regional health bureau and the Ministry. Bloom fits private, mission and NGO health centers directly, and public centers through regional or partner programmes. It does not replace DHIS2 or integrate with national EMRs such as SmartCare. ### What happens when the power or internet goes down? Recording work needs a connection. The staff mobile app keeps records readable offline, but new entries wait until the connection returns. ## Cited research - [Reporting on time and reporting correctly are different problems](https://www.medicine.et/research/dhis2-data-quality) — Ethiopia runs one of the world's largest DHIS2 deployments — 30,000+ facilities, 95% reporting rates. The national maturity assessment scores data quality and infrastructure far lower. Submitting a report and submitting a correct one are not the same achievement. - [One in five children unvaccinated: reading the dropout curve](https://www.medicine.et/research/zero-dose-immunisation) — 20% of Ethiopian children aged 12–23 months have received no vaccinations at all. But the more actionable number is the gap between the first dose and the last — a tracking failure, not an access failure. - [Ethiopia's first full DHS in nine years: what moved and what stalled](https://www.medicine.et/research/edhs-2024-25) — The EDHS 2024–25 Key Indicators Report is the first national demographic and health survey since 2016. Maternal and child survival improved sharply. Nutrition and routine immunisation did not. - [The chronic caseload private clinics actually see](https://www.medicine.et/research/ncd-caseload) — Self-reported non-communicable disease in Addis Ababa runs at 11.5% of adults. Among Ethiopians already diagnosed with type 2 diabetes, pooled hypertension prevalence is 55%. This is recurring, appointment-driven care — the kind paper registers handle worst. - [Stock records in Ethiopian health facilities: what the studies measured](https://www.medicine.et/research/inventory-management) — Ethiopian facilities do not mainly run out of medicines because nothing was ordered. They run out because the record of what is on the shelf disagrees with the shelf. The published measurements are consistent, and unflattering.