World Health Organizatic� Eastern Mediterranean Reaion Office Infonnatics Programme
REGIONAL WORKING PAPER
FOR THE
13TH WHO/ISS COORDINATION MEETING
GENEVA, 10-14 DECEMBER 1990
Alexandria
October 1990
ISS/EMR0/90/18
13th WHO/ISS Coordination Meeting Geneva, 10-14 December 1990
1.0 INTRODUCTION
LIST OF CONTENTS
2.0 EHRO POLICIES AND STRATEGIES 2.1 Policy basis 2.2 Objective 2.3 Targets 2.4 Proposed Programme Activities 2.5 Computer Security and access to EMR databases
3.0 CORPORATE SYSTEMS: Development/Implementation 3.1 Status of corporate systems under development 3.2 Proposed new corporate systems
4.0 CORPORATE DATABASES: Development/Implementation
ISS/EMR0/90/18
4.1 Status of corporate databases under shared development 4.2 Present and potential corporate databases 4.3 Access to WHO corporate databases
5.0 COMMUNICATION TECHNOLOGIES 5.1 The status of WHO local area networks - progress in EMRO 5.2 Status of telecommunications links (WHO wide area network) 5.3 _Status of planned telecommunication services/facilities in EMRO
6.0 USE OF E-MAIL 6.1 The status of E-mail facilities in EMRO 6.2 Experimenting with E-Mail
7 .O !!FF.ICE AUTOMATIOU 7.1 Word processing/Desktop Publishing applications 7.2 Status of Arabic Word Processing in EMRO 7.3 Optical disk applications, including CD/ROM 7.4 Workstation and printing technologies
8.0 SUPPORT TO THE ADMINISTRATION ANO FINAIICE INFORMATION SYSTEM 8.1 Status of developmental work at EMRO 8.2 Plans for further development of AF! system in EMRO
9 .O INFORMATICS SUPPORT TO WHO REPRESENTATIVES IN EMRO 9.1 Status of EMRs informatics support to WHO representatives 9.2 Planned developments in EMRO 9.3 Coordination of informatics support to WHO representatives
10.0 STANDARDS FOR WHO-WIDE COMPATIBILITY 10.1 Data standards 10.2 Informatics standards 10.3 Telematic Standards 10.4 Other standards
11.0 TRAINING 11.1 Status of training support to WHO staff 11,2 Status of training support to Member States 11.3 Future training requirements
13th WHO/ISS Coordination Meeting Geneva, 1C-1� December 1990
12.0 SUPPORT TO MEMBER STATES IN EHRO
12.1 Status of support provided by EMRO !?.?. Coo.'dination of WHO technical informatics support
13.0 RESEARCH AHO DEVELOPMEHT 13.1 Kn�wledge-Based systems 13.2 Other activities 13.3 Collaborati�� centres
14.0 UPDATIUG THE WHO/JSS MASTERPLAN
15.0 MISCELLANEOUS ISSUES 15.1 Regional lnfonnatics Management Committee 15.2 Staff Resources and organizational impacts
ISS/EMR0/90/18
15.3 Coordinatic:11 activities between HIRO, HQ, and other Regions
AN!IEXES
A. EMRO-LAN FEATURES
8. HIRO- LAN STATUS AS OF OCT 1990
C. MICROCOMPUTER PROCUREMENT TREND: 1985-1990
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1.0
1.1
1.2
1.3
1.4
2.0
2.1
2.2
INTRODUCTION
In tht: Eastern Mediterr�nean Region ( EMR) use of computing technologies is undergoing a period of dramatic change with an increase in the number of equipment in all divisions and progra�mes in the Region. A significant increase in the types of informatics services available to users resulted in increase in number of ways computer technology is utilized by the user community. At EMRO/ISS, we carefully watch the trends in the Region as well as the WHO secretariate and develop software that meets the changing situation, yet also allow flexibility to adapt as future technologies emerge.
Throughout the past year, EMRO/ISS has been committed to developing a workable Local Area Network {EMRO-LAN) technology with major breakthroughs in importing low cost LAN technology with the state-of the-art capabilities and at the same time maintaining WHO-Wide connectivity. EMRO was the first Regional office to use Uovell Netware technology which can co-habit with the Ungermann Bass based HHO-LAN.
Lona-Range Information System plannin� for EMRO is conducted via the Informatics Management Committee (IMC) comprised of representatives from both the administrative and technical areas under the chairmanship of the Director of Support Programme . The mandate of the IMC is ta oversee what direction of system development should be in two to three years and, more importantly, monitor the move towards that goal. For the first time this year consideration was given to more integration of informatics/telematics planning activities with the strategic planing of Regional programme management activities. IMC begun active review of current activities, considers any new systems need that resulted from senior management's long-range need analysis, and forecast future resources and hardware needs.
ihis report is structured in a way such that only those areas of ISS coordination meeting agenda items are addressed which are relevant to EMRO and which has implications in formulating the WHO's global Master Plan on Informatics. Each agenda item presented here gives status as of the date of preparation of this report and future developmental plans.
POLICIES AND STRATEGIES
In the Proposed Programme Budget for the Financial Period 1990-1991 for the Eastern Mediterranean Region, the informatics management programmes policies and strategies are presented as follows:
Objective
To develop and manage effectively.and efficiently the Organization's informatics activities in the Region, and to strengthen and adapt informatics technology for the planning and implementation of national HFA strategies, including assessment of progress towards HFA in the Member States.
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2.3
2.4
Targets
By 1995:
(1) All levels and programmes in W HO will have cost-effective access to informatics and telematics support services and the ability to make use of common information systems and computer-based communication services appropriate to their needs;
(2) The Regional Office, WHO Representatives' offices and Member States wil l have received informatics support concentrating on the financial and technical implementation and evaluation of WHO programmes in support of national HFA strategies;
(3) All Member States in the Region requesting informatics support will have received the information, technical advice and support necessary for optimal utilization of modern informatics technology to strengthen their capacity to manage and evaluate their national health programmes;
(4) The necessary informatics support mechanisms for monitoring and evaluation of national and Regional strategies for UFA wil l have been established and maintained;
(5) The use of General Purpose Comput ing technology for an integrated Regional Programme Management Information System (EPM IS} wi 11 be functional to support Regional programme monitoring and manageme:.�t.
Proposed Programme Activities
During the biennium 1990-199 1, Informatics Management will aim to strengthen Member States' informatics capabilities in order to effectively monitor HFA strategies. It will support country projects which incorporate any of the following activities:
a feasibility study of the nat ional information system;
automated information exchange systems between the Regional Office and national institutions and cooperation in applying a telecommunications link-up among the Member States;
assistance with training in managing informatics services;
evaluating the appropriateness of new informatics technology in Member States.
Information, advice and training in heal th information will be provided to Member States en request from Regional or Headquarters informatics resources.
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2.5
At the Regional Office level a number of activities are to be carried out during 1990-1991 .
The management system of the managerial process for WHO's programme development will be computerized and collaborating centres for informatics in health in the Region will be identified. Internationally recognized standards for textual and numerical data transmission will be disseminated and the Regional Office will prepare system guidelines and informatics procedures for Member States concerning access to data bases maintained or used by the informatics and telematics facilities to support programme management and administrative support system; this will also ensure sharing of data between programmes and collaborating centres in Member States.
Appropriate telecommunication linkage will be established between the Regional Office and selected collaborating centres in Member States. This facility will enable sharing of technical data bases and optimize the cost of development of a Regional data base of information . For educational institutions involved in research in the health sector these data bases will be available for access via telecommunication link-up.
Computer Security and Access to EMR Databases
Th� introduction of the microcomputers into a network environment with host servers capable of downloading and uploading data from minicomputer and or mainframe systems has had a profound impact on the effectiveness of control measures applied for access to sensitive financial and administrative data. In EMR. controlling access to LAN based microcomputers involves both physical and logical control. All downloading of AFI data are maintained under complete security control of the computer centre. Access to these data are then controlled via logical access control of the network manager of the LAN. Access to LAN databases are defined to the data record and data field level. In some areas they are further defined as read only.
Direct access to IBM S/36 minicomputer based data are controlled via strict identifier password given only to budget and finance designated users. No users outside budget and finance are allowed access to S/36 AFI data except in down 1 oaded form on LAN servers or on floppy diskettes . Password and data access profiles are controlled by the computer centre which are updated/changed frequently to maintain integrity of the system.
Backup and recovery of both minicomputer based software and the LAN servers have always been an important concern of EMR/ISS unit. Computer centre operations management have the capability to restore programs and data files from backup files in case of disasters or disruptions due to power related problems or whenever computer viruses brings down the systems. No foreign software are a 11 owed to enter EMRD-LAN without being certified virus free .
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3.0
3. 1
CORPORATE SYSTEMS
Status of Corporate Systems under Development
Status of three Corporate Systems earmarked for EMRO's development as discussed and agreed upon during the 11th and 12th ISS coordination meeting are as follows:
3.1.1 EMRO's Budget and Finance Information System iaQ.S. 2.JU
The microcomputer based EMRO/BQS had been undergoing a number of changes and modifications to accommodate programme area requirements. With the installation progress of EMRO-LAN the new BQS version 2.0 was released on LAN servers in the Regional Office thus allowing technical units facilities to pull out S/36 based RO/AFI data on expenditure details by allotment number and/or a sticker number. In addition to that, the new LAN version has linkages to Project Monitoring Sub-System (PMS) which allows monitoring project by activity and develop managerial information for monitoring status of project and implementation rate. BQS version 2.0 also downloads data to the other corporate system on the LAN, the Fellowships (FEL) management system and the Personnel (PER) system. The BQS software had been converted to FoxBASE+ LAN version and documentation for corporate distribution are being in final stage of production.
3.1.2 EMRO Fellowships Administration System l.Efil
The FEL microcomputer system provides complete management of Regional Office Fellowships unit. The system is now fully integrated with BQS downloaded data and thus enables user to monitor funds and expenditure details. The system also has the capability to prepare payment vouchers on WHO printed forms. The new FoxBASE+ LAN version has an additional module (PAR) which monitors all participants of WHO conducted courses, symposiums and meetings. The system in its present LAN environment allows access by all users in the Fellowships unit. The software with its user documentation have been forwarded to SEARO and WPRO for evaluation and comments. Documentation for corporate distribution will be finalized once inputs from other regions are available.
3.1.3 Documentation Production Control System .L.!l!:£1
The HBI Production Control system consists of five different modules to monitor five different document classes (reports, publications, ROs messages, governing bodies, and translations). The document cycle differs from class to class. The system provides recording, updating and follow-up of the documents according to their cycle. It monitors the steps undertaken from the time of entry of a documents in HBI Production Control unit and its follow-up until it is printed in final form. In addition, the system includes query functions to monitor the document status, processing stage, and target date for completion.
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Recent enhancement to Publication Control Module incorporates automated means to keep track of all publ ication work in progress for the Region as wel l as it allows online status monitoring. The user of this systemJ the Regional office Health and Biomedical Information (HBI) unit, have proposed additional modification to this package and intends adaptation of the other HBI modules combined under the control of a single integrated Management Information System for HB I. Similar intent for adaptation for use in Headquarter and other Regions were expressed by Chief PUB/HQ and DSP/EURO in May 1990 during their participation of an inter-regional HB I group meeting in EMRO. Our estimate for this task is six man-months for systems analysis and 12 man-months of programing effort. It is envisaged that the package can be devel oped within the EMRO-LAN environment with facil ities to inter-connect with HQ and other Regions via E-Mail.
3.1.4 Proposed New Corporate Systems
(a) library System:
The Library system which has three modules (1) Catalogues module; (2) Medical index module; and the (3) Teaching and Learning Material (TLM) module had.been converted to FoxBASE+ software. This package is in use in EMRO library and Member States Ministry of Health Libraries. Eight countries in the Easter Mediterranean Region now have EMRO software installed in their MOH Libraries. The TLM package was also sent to three countries in AFRO Region.
The existing modul es of L IB systems needs minor modifications to run under the Foxbase+ LAN environment and few enhancement are needed in the output listings.
(b) Regional Office Personnel Administration System:
The development of an integrated Personnel administration software on a LAN environment begun in September 1989. The software when compl eted wil l have five distinct functions:
PER Administration GS Sal ary Survey Recruitment Control Roster of GS Candidates Rental Subsidy (presently available on S/36 will be converted to microcomputer environment)
Partial implementation P ER Administration module which includes maintenance of PER-ADM databases sent to EMR from Headquarter has been completed.
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(c) EMRO Programme Management Information System (EPMJS}:
EMRO Programme Mon itoring Information System (EPMIS) was conce ived to carry out informat ion monitoring of Reg ional Offices various important management documents, such as Summary Workplan/Plan of Action (SWP) , Summary Country Profiles (SCP) , Summary Programme/Project Prof iles {SPP) , and Nat ional Health Strategies (NHS). Each of these areas of information are of s ignificant importance to WHO's programme management, and ideally, should be mon itored and managed centrally in the Reg ional Office with continuous input from various sources with in WHO secretar iat and from the Member States.
The experimental System was designed such that the initial Summary Workplan/Plan of Act ions from Member States reaches ISS with prior validation checks for correctness by Reg ional programme advisers, and programme directors. These inputs were entered in a specific computer readable formatted mask which identifies the four activity types in each document:
I Staff Cost; I I Supplies and Equipment; I I I Fe 11owships; IV Local Costs.
Each of these activit ies has f ive data fields, these are:
I What act ion to be taken and purpose; II By whom action to taken; III Funds: RB/Other Resources; IV Amount of RB Resources/or other funds; V Implementation Status.
Of the five fields above, the item V, Implementation Status, was added to exist ing EMRO document to indicate status of completion of an activity, which is used as the key indicator of programme implementation.
The system first validates the data to match the standardized computer input format and prepares itemized records by activity, programme and country. In this process the system looks up from system tables of various WHO codes to make sure the data conforms to a standardized way of presentation. Also, while validating the data, it checks the budgetary f igures from other computerized information system data in BQS, FEL, etc. to ascertain the valid ity. The system allows a user to v iew an assorted l ist of reports on a computer screen or if he/she wishes print on a printer. Following reports are standard outputs:
All activ ities sorted by country and/or programme; Activities of a spec ific country/programme/type; Activity completion status: Activity target completion status by quarter; Activity utilization/completion status.
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for the purpose of developing the prototype system with all possible options, ISS had to improvise a number of expected inputs while processing the data, such as: an activity planned within a three month period of a year were designated by a quarter, when an activity is planned for a certain period it is quantified as 100% to be completed during that period, etc. These assumptions were necessary to produce meaningful reports for demonstration purposes only. However, in reality, they must be identified and quantified by programme managers as and when actual data is available.
The WORKPLAN module constitute 25% of the overall integrated EMRO Programme Monitoring Information System. The demonstration module was completed and demonstrated to the Regional Office management and technical staff for critical review and refinement of decision indicators. Completion of user requirements and funding for resources required for development of the total EPMIS package on a relational database package was delayed due to a number of factors involving existing staff resources in EMRO/ ISS and lack of agreement by various technical programme managers on how to coordinate management of data-entry, validation, updates of the on-line system.
(d) WHOTERM and the Unified Dictionary
The fourth edition of Unified Medical Dictionary is expected to contain 100,000 terms in English, French, and Arabic. Existing WANG based data files need to be converted to easily accessible WHOTERM database files. PUB/HQ have carried out feasibility discussions in EMRO and believes maintenance and updating of the Arabic part will be assigned to EMRs Arabic linguistic experts. Methodo 1 ogy for this corporate WHO database of WHO TERM wi 11 requ ire further consultation and logistical support from HQ.
4.0 CORPORATE DATABASES
4.1 Status of Corporate Databases Under Shared Development
4.2
There are several common databases in EMRO which are now part of EMRO/LAN. All three Corporate System databases mentioned in 3.1 are intended for "common 11 access from microcomputers on LAN or the terminals to VAX II I minicomputer system. The RO/AFI database now being downloaded to microcomputer will be available on a LAN server as a 11common 11 database for all other EMRO application's needing interface to EMRO's financial data.
Present and Potential Corporate Databases
In consultation with EMRO, HQs developmental work has begun to design the Arabic Module of WHO Terminology Information System (WHOTERM) for the WHO Global Arabic programme. The Regional Drugs and LAB programme are al so actively pursuing installation of their respective international �atabases in the Regional Computer Systems. Access to Euro-American databases, via an EARN/BITNET node in Cairo, was tested, and procurement of necessary leased l ine and interfaces for the Regional Office computing facility was authorized. Three technical programmes in the Regional Office will be the initial users of this facility, which
will allow them easy access to up-to-date information in over 500 research institutional databases networked around the world.
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4.3 Access to WHO/EMRO Corporate Databases
The Centre for Environmental Control in Amman (CEHA), Jordan have completed a computerized database on information pertaining to environment control. The database al lows easy identification to relevant regional and international publications and periodical s on the subject. Communication link-up for access and dissemination of infonnation to member states in the Region is planned in the near future via the CEHA Network. Later this year, the Regional Office Division of Environmental Health will be linked up with CEHA-NET via the X.25 communication facility.
5.0 COMMUNICATION TECHNOLOGIES
5.1 The Status of WHO local Area Networks= Progress in EMRO
5.1.1 EMROs Digital. VAX 3500 minicomputer was instal led during the second half of 1989. Early 1990 active work was initiated in planning and testing installation of Ungermann Bass {UB) LAN utilizing the VAX as the network server. Various hardware and software compatibility problems kept the VAX based LAN installation suspended up till updated version of ISTAR ( I*) were available for the VAX.
5.1.2 In order to find al ternative solutions to EMRO's specific vendors support related problems with UB, the Regional Office undertook pilot testing other LAN vendor's products locally available and where vendor support exists in Alexandria. The main criteria of our test included a necessary requirement that vendor guarantees DEC VAX-3500 to HQ WHO-LAN connectivity via X.25 Gateway connection and application level compatibility with WHO/LAN based applications in HQ.
5.1.3 The solution accepted in EMRO today is a combination of US-LAN for Wide Area Networking, i.e. intercity data communication, with HQ and other Regions with the VAX-3500 as the network server. This main server is bridged with Novell's LAN distributed among several application based 386 microcomputer servers. Each server has a primary application and it's databases (such as BQS Server, FEL Server, PER Server, SUP server, etc.) Individual servers are intended to serve a segment of the LAN with capability to bridge with the other segment's servers for access to a network of distributed databases. Connectivity between servers are maintained via the G/REMOTE BRIDGE from Gateway Communications to Novell's 386 NETWARE V 3.1. Advantages of distributed servers are reduced cost for smal ler host server hardware and software, modular growth of the LAN with customized users application profile, and ease of maintenance of smaller segments of LAN without bringing down the entire EMRO-LAN (See Annex -A and Annex-8 for detailed schematics).
5.2 Status of Pl anned Telecommunication Services/Facilities in EMRO
Data communication between EMRO and HQ, EURO, WPRO and AMRO/PAHO is possible today in one or both of the fol lowing two methods: via dial-up telephone connection from an IBM microcomputer in the Regional office equipped with Hays 2400 BAUD modem to the WHO/HQ E-Mail host, and via the X.25 Public Data Network (PON) connection to EMRs VAX-3500 system using the G/X.25 GATEWAY LAN to VAX Bridge (see Annex-B). Use by Regional technical units wil l be initiated as soon as HQ's WHO-Wide Area Network host's communication protocol is released for our use.
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6.0 USE OF E-MAIL
6.1 Status of E-Mail Facilities in EMRO
6.2
Two commercial E-Mail services were tested in EMRO: GE-Quick-Comm Mail services to HQ and other international GE nodes around the world and the Cairo University Node for EARN/Bitnet. In addition to these two the DEC VAX- I I I All-in-1 software allows in-house E-Mail on a LAN environment. EMR has acquired the necessary connections and interfaces for the Regional Office computing facility link-up with HQs Digital VAX host for E-Mail under All-in-1 software. In-house procedures and guidelines for incoming and outgoing messages will be established with EMRO Registry as soon as the connection to HQ is operational.
Experimenting with E-Mail
At the initial stage of E-Mail operation the DEC VAX I I I system will be used as a central E-Mail server. The All-in-1 software on DEC facilities storage and online or delayed retrieval of messages . Thus all users connected on a LAN with VAX II I would be able to send and receive messages by connecting through the LAN to the E-Mail system. With the availability of X.25 in EMRO more direct means of communication with HQ's VAX mainframe network server is now feasible.
7.0 OFFICE AUTOMATION
7.1 Word Processing/Desktop Publishing Applications
The Regional Office has, to a large extent, converted to a microcomputer based word processing environment in replacement of traditional WANG and electronic typewriters. Except for Arabic Text Processing, a major portion of all English Text Processing are carried out with Multimate Word Processing Software. The present 1-/ANG OIS system with its 10 workstations are dedicated for Reports/Publication unit and are being phased out in a careful manner.
Desktop publishing (DTP) is gaining rapid recognition for both stand alone type microcomputer users and in the production of Regional Office publications which require professional quality artwork and graphic design of production quality documents. With todays advanced DTP software integration of word processing with photo-typesetting and offset printing techniques is feasible and often inexpensive.
Present plans are for acquisition of hardware/software for Word Processing and DTP combination which can produce camera-ready work for the EMRs publishing of short-run items such as workshop material, EMRO journals, sales promotion and publication information material.
Hardware and software proposed for DTP operations are a 386/486 processor with 4MB RAM, high resolution A3/A4 monitor and mouse, Postscript· laser printer, Aldus PageMaker Version 4.0 DTP software with Corel Draw Graphics package.
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7 .2
7.3
Status of Arabjc Word Processing in EMRO
Three Arabic Word processing packages are in active eval uation process in EMRO . These are APTEC 2001 V 2. 1 7 1 U niversal Word, and Al Kaateb . In addition, EMR will acquire Al Arabi Publisher version 2.20, an Arabic/English version of Eng lish DTP software package 3B2. Result of the tests will be compared in relation to existing WANG based WP+ Arabic software ·in order to phase out WANG based dedicated word processing D IS systems.
Optical Disk Application , including CD/ROM
The use of CD/ROM-based technology in EMRO is limited to WHO supported Medical Libraries in the Region. A number of Member States have purchased the CD/ROM driver for their Library hardware in order to receive databases from MEDLARS and in the various fields of databases and bibliographical infonnation.
7.4 Workstation and printing technologies
8 .0
8 . 1
8.2
Laser printers are becoming more and more affordable. HP LaserJet and its compatible Laser printers are now widely used by those installation where volume is heavy and require high resolution quality outputs. As prices become more attractive, laser printer will be replacing "nlq " type dot matrix pr i nters, which are no i sy and not 100% production quality. EMRO does not have a col our laser printer yet. The technology is availabl e, but proper technical support from local vendor will be a deciding factor when purchase of such technology is considered.
SUPPORT TO RO/AFI SYSTEM
Status of Devel opmental Work in EMRO
The Regional offices ISS staff continued to provide routine operations and maintenance support to the system and its user , B&F unit . Daily updates and backup of system ' s data files, security profiles, etc. were carried out without any major problems. However, prior to 88/89 biennium RO/AFI data purge in April-May this year, the IBM S/36 disk capacity was in critica l phase and various manoeuvring of loading and unloading of RO/AFI software source codes were unnecessary to accommodate two bienniums data running concurrently. Operationally, overflow of data files and existing COBOL programs inability to detect problems prior to updated resulted in several long reruns.
Plans for Further Development of AEl System in EMRO
The Regiona l office received in July 1989 HQ/AFI proposed plan for the re-design of RO/AF! system on ADABASE/Natural. The plan was reviewed in deta il by B&F unit staff during HQ's staff visit to EMRO. The p lan call fo r an ADABASE/Natural database administration in the Regional I n view of above planned re-design of RO/AF I system , all pending modifications , changes and add-on modules to present S-36 software were postponed indefinitely.
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9.0
g .1
INFORMATICS SUPPORT TO WHO REPRESENTAT IVES lN EMRO
Status of EMRs Informat ics Support to WHO Representat i ves
Out of 16 WR offices in the Region, all are equipped today with microcomputers. All WR offices use the Regional Office Budget Query System software extens ively. Two of the off ices have contracted local software company to prepare WR 's office app l ication software for monitoring imprest account and other house-keeping functions. Although the major ity of the W R 's use the microcomputers for routine word process ing tasks, there is an ever increasing demand for expanded use of microcomputer for programme monitoring and statistical health data co 1 1 ect ion.
9.2 Planned Developments in EMRO
9 .3
A number of W R offices have trained their administrative and clerical staff on two or three commonly used microcomputer software: Multimate, Lotus 1 12, 3 and d BASE I II+. There has been increasing demand for Imprest Account management software and modules of corporate systems custom ized for WRs office need. The overal l level of technical informatics support to WR off ices for des ign ing. developing and maintain ing common systems require extra manpower resources in WRs office as well as in the Regional Office.
Electronic Mail w ith one of the WR off ices . Saud i Arabia. were c arried out on a test bas is for three months . The l ink-up was through the GE Qu ick-Connn serv ices based in two cit ies . Cairo and R iyadh. The eval uat ion of the three month test showed the communication w ith microcomputers easy and fairly s impl e. However , the vo lume of messages were not sufficiently large enough to compete aga inst cost of operat ing Facs imile machine. On the others hand, the test showed the v iab ility of E-Mail between the Reg ional office and any WR office in the Region through the PDNs where they exist . or commercial carriers l i ke GE or Cable & W ireless, or through d irect dial-up international telephone l ines. It is env isaged that the computer-based telecommun icat ion systems could be extended to WHO off i ces in the Region, primarily in countries that have the necessary infrastructure, and where cost effective.
, , Coord ination of Informatics Support to WHO Representat i ves
Co llaboration with WHO representative off ices (WRO) and health mi n i stri es conti nues to cxpanrt . as the need for informatics technol ogy and its appl ication becomes a necess ity in developing countries in the EMR Region . In most cases WRO coord inates al l request for informatics related supplies or iginating from member states ministries of health.
10 .0 STANDARDS FOR COMPATIB ILITY
10.1 Data standards
EMRO adheres to "The WHO standard for Compat i bi l ity" for a l l computer data fi l es and fiel d definit ions. WHO Data D ictionary is consulted when designing new software for the Region.
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10.2
10.3
Informat ics Standards
The WHO/HQ Ashell documentation and software were received in EMRO first week of August 1989. Since then the software package is used as the prototype for generating application packages in EMRO. Al l future application design and deve lopment will be utilizing the ASHELL.
Telematic Standards
For the VAX Wide area network communication wi ll require Digital All-in-1 software compat ible package. Alternatively, any public data network with X.25 communication faci lity can connect to the EMR computer centre. Protocols for handshake and password , etc. are yet to be made public due to delay in three month p i lot test experimentation with HQ and other Regions.
10.4 Other standards
10.4.1 Microcomputer Systems
Desktop Microcomputers:
IBM PS/2 - All Mode ls with Arabization COMPAQ - All Models with Arabization E PSON - All Models with Arabization
Laptop Microcomputers:
TOSHIBA E PSON COMPAQ
Peripherals :
- All Models with battery - All Models with battery - All Models with battery
IBM/COMPAQ/EPSON Monochrome & Colour (VGA, CGA , EGA) Monitors IBM and full compatible Memory Expansion Boards IBM and MS Mouse Seagate and IBM compatible Tape Back-up systems EPSON/FUJ ITSU DOT Matrix Printers HP LaserJet Series I I _ and EPSON GQ5000/EL7000 Laser Printers
10.4.2 Microcomputer Software
Operating Systems: MS-DOS Version 4.1 and above Languages: MS COBOL, MS FORTRAN , TU RBO BAS IC, TURBO PASCAL, Utilities: Nortron 's Advanced Ut ilities, PC Too ls Data Base Management: dBASE I I I P l us, FOXBASE P LUS Spreadsheet: LOTUS 1, 2,3 Release 2. 1 and 3 Card Image File Management: Cardbox Plus Graphic Presentation: Harvard Graphics, KODAK SHOW, Corel Draw Statistical Software: S PSS/PC + with D/E & Reports Word Processing - English: Multimate 4 .0 & V-1 1, Wordstar V, Word
Perfect VS Word Processi ng - Arabic: Arabstar 2000, Un iversal Word ,Al Kaateb
and Al-Arab i (being evaluated) Desktop Publishing: Ventura Publisher , Aldus PageMaker
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10.4.3 Minicomputer and LAN Standard
Digital VAX Family with VMS OS and A l l -in-1 I BM S/36 LAN Servers : 386 or 486 CPU with 4MB Memory and Novel l 's Netware
V-3 . 6
10.4.4 Database Management System Standard
The ADABASE/Natural standard DBMS for the minicomputer wi l l be instal l ed in the VAX system as soon as there is any application ava i labl e from HQ for running in the Regional office. The p l anned RO/AFI system would al so requ ire ADABASE/Natural. For the t ime being EMRO wou ld be instal l ing RECITAL on VAX for dBASE I I I type applications .
10.4.5 Knowledge Based Systems
The Regional office have begun evaluating Knowledge Based Systems for the development of an Expert System for Nutritional Surveil lance. The Software being considered for developing the package is LPA/Prolog and LPA/Too 1 kit.
10.4 . 6 Word Processing Standard
11 . 0
11.1
Mu l timate Advantage II and Version 4.0 has been widel y accepted on the Regional office standard for Word Processing in English. For Arabic text processing, WANG is sti ll the choice of Regional Arabic Programme. New releases of Arabstar 2000, Universal Word, Al Kaateb, and AL Arabi are being tested in the Arabic trans l at ion unit. for francophone countries in the Region, WORDSTAR Professional 5.0 is more commonly used than Mul timate Advantage I I, and therefore, is also a standard for the Region .
TRAINING
Status of Training Support to WHO Staff
Through the EMR/SDT , ISS have coordinated with l ocal computer firms training on micro computer for WHO staff of the Regional office. The training was necessitated by increasing demand by user community who were new to the organization and by those who wanted to know advanced features of Multimate I I and dBASE I I I+ packages.
More and more technical staff responsible for programme management are using some forms of computing facility today. This trend wi l l continue for the foreseeable future . Expanded user base requires more ISS support and often advanced training on specific packages. Without a permanent staff in the Regional office with adequate teaching experience in micro computing, the training support RO/ ISS ' s providing today are limited and not adequate.
13th WHO/ISS Coordination Meeting Geneva, 10-14 December 1990
ISS/EMR0/90/18 Page: 14
11.2
11 .3
Status of Informatics Training Support to Member States
On several occasions Member States requested specificall y consultants for training on microcomputers. Finding a good tutor STC for short durat ion mission to a country had been a difficult task . We expect this trend for additional training will grow as we supply more and more infonnatics technology to the Ministry of Health of deve loping nations.
A pennanent infonnatics tutor for the entire Region will be a good alternative to recruitment of STC's on a country by country basis. Core expertise to train and monitor, evaluate and app ly the emerging hardware and software technology in support of Member States wou ld be needed in the Regional office ISS which can contribute to research into infonnatics technology and its ever-expand ing relevance and appl ications for the health sector.
future Training Regujrements
It i s desirable that RO/ISS staff should h ave a professional infonnatics training staff on a permanent basis who can assist in the Regional Staff training, as wel l as conduct training missions for the Member States.
12.0 SUPPORT TO MEMBER STATES
12.1 Collaboration with Member States health min i stries in the use informatics for development of their health information system, particularly through intensified training of selected group of management staff continues under the auspices of Regional Leadership Deve lopment Programme. Member States requests for advisory services and evaluation of their needs for informatics equipment have increased in those sectors requiring preparation of nationa l masterplan on informatics. Member States continue to send sen ior officials - from the Ministry of Health to a series of international seminars on Applications of Computers in Health Services Management. Individual M�mber States received consultative and advisory support from the Regional Office, primarily to evaluate national informatics needs.
There were about 54 requests for microcomputer related support from Member States during this reporting period. Majority of these requests were for material procurement to set up computing environment in the Ministry of Health . All 54 microcomputer p rocurement requests were processed during second half of 1990 and the delivery is in process. Purchasing trends among the Member States show a considerable increase during the past five year period (See Annex-C).
12 .2 Coordination of WHO Technical Informatics Support
Seven Member States are sending, in March 1991, one responsible officer each from the Ministry of Health to EMRO ' s Leadership Development Programme in which management train ing on microcomputer technology wi l l be an important module. These seven officers will receive orientation on a n umber of computer software and basic training on software used by EMRO in the Regional Office for a period of three weeks . The software train ing is tailored for analysis of health statistical indicators and report preparation.
13th WHO/ISS Coord ination Meeting Geneva , 10-14 December 1990
ISS/EMR0/90/18 Page : 15
13.0 RESEARCH AND DEVELOPMENT
14 .0
15.0
15. 1
** No Reg ional Contribution **
UPDATING THE WHO/ISS MASTERPLAN
MISCELLANEOUS ISSUES
Regional Informatics Management Committee
The Regional Informatics Management Connnittee ( IMC) was established in pursuance to IAU recommendation of 7 February 1987 . The a ims and tems of reference of the are:
� to provide planning and guidance for EMR/ISS policy and the Reg ional Masterplan on informatics ;
- monitor its implementation ; - recommend priorities ; - and to provide regional input WHOs global masterplan on lnfonnatics.
The committee met seven times and is now concentrating on the strategic planning of informatics support to programme activities in the Region with an overall emphasis on Medium Term P l an ( Two to four Years) . In th i s connection, I MC will be promoting a functional plan of action and monitor its progress over the years.
15.2 Staff Resources and Organizat ional Impacts
In the area of trouble-shooting and maintenance of microcomputer , as the Regional Office builds up microcomputer equipment and the acquire of some, the need for a microcomputer maintenance Eng ineer as a regular staff member present on a full time basis wou ld be less expensive than paying 10% per year maintenance fess for 100 or more microcomputers to commercial vendors of microcomputer or ad-hoc on-call charges for fixing machines. Often, the fixes appl i ed by outside engineers are of simple nature and could have been avoided totally if a systematic preventative maintenance were carried out by an in-house technically competent WHO staff .
The Regional Off ice professional resources are maintained at the same level as 1985 while the support it provides has increased two to three fold. Microcomputers have increased from 10 to 100, one to two minicomputer, addition of new technology such as LAN , Electronic Mail and Desktop Publishing are supported by only two professional staff. Additionally the same staff have to supervise development o f systems/applications, conduct training and advise member States on Infomatics. Clearly the resources at the Regional Office level grossly inadequate and under represented.
As indicated in HQ/AFI proposal for re-design of RO/AFI software , to be able to adequately maintain and support the new system , the Regional Office, would require to hire one database administrator with substantial experience in ADABASE/Natural software and the DEC VAX/VMS operat ing System.
13th WHO/ISS Coordination Meeting Geneva . 10-14 December 1 ggo
ISS/EMR0/90/18 Page :16
15.2.3 For time to time . for devel opmental work and programing tasks EMRO has recru ited l ocal programmers on a contractual or Specia l services agreement (CSA/SSA) . These programmers are providing support to the one and only ful l -time programmer assigned to RO/ISS who had to distribute his t ime between maintenance of RO/AF I system on the IBM S/36 and a half of do:en microcomputer a pplications now in production mode in the Regional Off ice . Professional ly the l ocal ly recruited programmers are competent and economical in relation to WHO ful l time staff recruits , at EM7 or P2 level . On the other hand . without a context for the continuity of these programmers, often we find good EMRO trained programmers leaving us to find permanent j ob elsewhere. S ince we are in the near-term expecting the Regional Office's growth from a single RO/AFI applications support centre to a ful l fledged computer services unit with LAN . E-Mail and numerous corporate system running in parall el t o RO/AFI, rely ing on a singl e programmer may result in a crisis situation. Two additional programmers, one for microcomputer trouble shooting and maintenance and t he other for DEC VAX- II I AOABASE/Natural . Software would be the absolute minimum requirement.
15.3
To support minor hardware maintenance, trouble-shoot LAN problems in the Regional Office , E-Mail communication link-up with WHO offices . and a lso carry out instal lation of software updates, there is a urgent need for a ful l time e lectronics engineer dedicated to ISS area.
A new EMRO/ISS staffing proposal reflect ing above need is under consideration by the Regional Office management (see Annex-D) .
Coordination Act i vit i es hetween EMRO ,HO and other Regions
EMRO continues to support and actively participate in al l activities which require sharing of resources with HQ or other Reg i onal Office ISS focal points. Cooperation on matters related to heal th informat ics and telematics will be maintained with HQ and other ROs and special emphasis wil l be given to joint devel opment of corporate systems.
1 3th WHO/ ISS Coordination Meeting Geneva ;. 1 0-1 4 December 1 990
ANNEX - A -- -
EMRO - LAN FEATURES
I . NOVELL LAN
NETWARE 3 .x
386-SERV.
ISS /El-ffiO/ 90 / 1 8 Page : 1 7
G/REMOTE BRIDGE
COM-PC-SV X . 2 5
THIN-WIRE ETHERNET
Floor-A:
PC2 . . . . . . . . . .
PCl PC2 • • • • • • • • • •
Floor-B :
386 - SERV
NETWARE 3 .x
I I . NOVELL with VAX-3500 and FILE SERVERS
TES
TES or NetWare for VMS VAX/VMS + All-in-I
VAX - 3500
Ethernet Backbone
PC-02 . . . . . . . .
PCs or WSs
PC-a
PCX
PCY
COM-PC-SV -B G/REMOTE BRIDGE
NetWare 2 .x or 3 . x F i l e Server
386 - SERV
386 - SERV
PC-z
�PC-b 1 1
13th WHO/ ISS Coordination Meeting Geneva, 10-14 December 1990
ANNEX - I!
ISS/EMR0/90/18 Page : 18-i
EHRO -. LAN STATUS AS OF OCT 1990
F I RST FLOOR
3 500
1 1 1 1 1 1 1 1 1 1 1
NEHJARE 286
NETWARE 386
REPEATER
i · -- ' ... ... ··1 •• 1 ·•-♦
uuuu:::i1u::t:::
NETWARE
386
NETWARE
386
TW I STED PA I R TH I N W I RE T H I CK W I R E
13th WHO/ISS Coordination Meeting Geneva, 10-14 December 1990
REPEA TER
N0 . 2
F I RST FLOOR
1 1 1 1 1 1 1 1 1 1 1
BRG !a======.i LAN
ISS/EMR0/90/ 18 Page : 18-ii
NEHJARE
286
NETWARE 386
SECOND FLOOR I
EXTERNAL BRG. G\ETHER ( 2 ) PC LAN NEHIARE
386
NETl-JARE
386
TW I STED PA I R TH I N W I RE TH I CK W I RE AU l CABLE
13th WHO/ I SS Coord i nat i on Meet i ng Geneva , 10-14 December 1990
X . 25 GATEWAY SERVER
.EMRO LAN
REMOTE B R I DGE SERVER
X. 2 5 P D N
REMOTE LANa CONNECTED
TO G\REMOTE BR I DGE
ISS/EMR0/90/18 Page : 18-i i i
H I CRO V�X 3500
1 1 1 1 1 1 1 1 1 1 1 1 1 1
GENEVA
VAX
1 1 1 1 1 1 1 1 1 1 1 1 1 1
13th WHO/I SS Coord i nati on Meeting Geneva , 10-14 December 1990
I SS/EMR0/90/18 Page : 18- i v
T e l e c o m m un i c a t i on f a c i l i t i e s v i a E G Y P T N E T & E A R N / B I T N E T .
E H R 0
ALL I N !
V A X
D S V l l
J N E T s / w
P S I s / w
D C Mode m
A l e . Modem
1 9 . 2 K b / s
···•···· .. ......... . . ·•·· ...... ·····•··· . WEGVP T N E T ..... .. . m 1\1x 2 s P D N \11 . ;::::. :: �:; · :; : � : : :: : ::1:: �=: �:::::: ::
ALL I N ! V A
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7 . 6 K b / s
M ON T PELL I E R F r a n c e===
Com m u n i c a t i o n s S e r v e r E p s P C e
D C M o d e m
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E G Y P T . U N I V . N E T W O R K
W o r k s t a t i on s ( I S S )
W o r k s t a t i o r F i r s t .f 1 oc
N o v e l l L A N ( I S S & F i r s t F l oor )
M ICROCOMPUTER SUPPLI ES FOR MEM BERSTJ\TES 1 985 - 1 989
200 1 90
1 80 1 70
1 60
1 50 - 1 40
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Part of Registry
TECLECOMMUNICATION
Telex and fax are used
There are two telex machines and two faxes . One of the faxes is kept free
for receipt of communications. A computer is attached to the outgoing fax
machine for storing messages to be sent overnight .
On some occasions night cab les are sent through MARCONI . This is a public
telecommunication office . This is used when neither a telex nor fax number are
available, only street address or cable address .
It is planned in future to use Micro computer within the Registry ' s LAN
for telex and fax messages thus saving the time of using the telex manually. In
addition, the application on LAN is planned to connect it to all the
classifiers . (Presently the classifiers have to use the Telex Operator ' s files
for reference identification. )
Presently, there are also two dBase I I I + applications used by the
Classifiers , one
application will
any of them .
for meetings and the other for visitors. The proposed LAN
link them together to facilitate entering of information by