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Ebuka John
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OpenMRS / NigeriaMRS

National HIV, TB & COVID-19 Programme Metadata

NigeriaMRS clinical forms for live HIV/TB programmes, adapting to COVID-19 and evolving national register requirements

Nigeria's national HIV and tuberculosis programmes run on NigeriaMRS, an OpenMRS distribution used across facilities for patient care, lab workflows, and donor reporting. When COVID-19 emerged, teams had to extend the same platform to capture a new disease alongside established HIV/TB workflows, while national specifications for DR-TB registers and TB screening kept changing. I contributed metadata module design and implementation (2020 to 2024) within the nmrs-nigeria community, supporting CCFN/Caritas Nigeria deployments where inaccurate forms directly affected programmatic reporting and clinical data quality.

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Problem

Nigerian HIV/TB programmes rely on NigeriaMRS for longitudinal patient records, lab orders, pharmacy workflows, and national register reporting to donors and the Federal Ministry of Health. That creates a high bar for metadata accuracy: a wrong concept, missing field, or outdated register can break reporting pipelines across many sites.

In 2020 to 2021, COVID-19 added urgency and uncertainty. National guidance on COVID/TB co-infection, specimen collection, and data elements was still stabilising. Teams needed to adapt OpenMRS forms quickly without disrupting live HIV programme workflows. Separately, DR-TB treatment registers and TB screening forms had to track evolving national specifications: drug-resistant regimens, specimen results, and screening algorithms that differed from the pre-COVID baseline.

Solution

Worked with clinicians, programme leads, and the nmrs-nigeria open-source community to translate national HIV, TB, and COVID-19 reporting requirements into OpenMRS metadata: concept dictionaries, form definitions, and register structures used in live deployments.

This meant mapping clinical workflows before changing production metadata, reconciling fast-moving COVID-19 data needs with established HIV/TB programme forms, and iterating registers (DR-TB, TB screening, recency testing, lab orders) as national guidance matured. Changes were contributed upstream so facilities running NigeriaMRS could adopt aligned metadata rather than maintain divergent local fixes.

My Role

Health informatics and metadata module contributor (2020 to 2024). Translated national HIV, TB, and COVID-19 programme requirements into NigeriaMRS/OpenMRS metadata; configured modules and mapped clinical workflows for multi-site deployments at CCFN/Caritas Nigeria; collaborated upstream in the nmrs-nigeria community.

CCFN selected me among its technical specialists and programme leads to represent the organisation at the UCSF IGHS Mombasa hackathon (March to April 2023) and the 2023 Global OpenMRS Implementers Conference (#OMRS23) in Abuja, based on my NigeriaMRS module delivery work.

Selected contributions

  • PR #322: DR-TB register + TB screening

    Updated DR-TB treatment register and TB screening form

    @Ebuka-John

    Merged 2022-12-02

    View on GitHub
  • PR #288: COVID-19 / TB modules

    COVID-19, TB module and drug-resistant options

    @Ebuka-John

    Merged 2022-02-21

    View on GitHub
  • PR #276: COVID metadata

    Updated COVID metadata

    @Ebuka-John

    Closed, not merged

    View on GitHub
  • PR #316: DR-TB, TB screening, specimen form

    DR-TB register, TB screening form and specimen result form

    @Ebuka-John

    Merged 2022-09-21

    View on GitHub
  • PR #332: Recency form validations

    Recency form validations and updates

    @Ebuka-John

    Merged 2023-06-18

    View on GitHub

Implementation support

Supported module configuration, clinical workflow mapping, and multi-site health informatics at CCFN/Caritas Nigeria (2020 to 2024). Work focused on keeping facility-level metadata aligned with national HIV, TB, and COVID-19 programme requirements as guidance evolved, so clinical teams could capture accurate data without reworking forms site by site.

Key Features

  • National DR-TB treatment register alignment
  • TB screening and specimen workflow forms
  • COVID-19 data capture alongside HIV/TB modules
  • Lab order and viral load workflow metadata
  • Multi-site configuration and rollout support
  • Register consolidation as national specs evolved

Community & events

Clinical deployments and OpenMRS community participation.

NigeriaMRS clinical home screen at facility level — patient search, active visits, vitals capture, and programme administration workflows.

Results & Maturity

Metadata contributions adopted in live Nigerian health programme deployments through CCFN/Caritas Nigeria (2020 to 2024). The work improved the accuracy of clinical capture and national register reporting across HIV, TB, and COVID-19 workflows, especially during the early COVID period when form requirements were changing rapidly.

Lessons Learned

  • National programme metadata must follow clinical workflow mapping, not the reverse
  • COVID-19 response showed why HIV/TB platforms need safe extension paths for new diseases without breaking existing reporting
  • Multi-site rollouts fail when metadata changes lack clear documentation and versioning

Next stage

Document additional programme metadata work and continue upstream contributions as national HIV/TB guidance evolves.

Interested in this kind of work?

Let's discuss how I can help your team build production SaaS platforms.