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Reliability of data: data collected must be reliable, they must not
contain erroneous or inconsistent data;
Security: Data must be accessible only by authorize persons;
Versatility: it must be adapted to the type of data collected;
Robustness should be able to use the system in degraded
conditions (crisis countries, developing countries).
In a broad sense, this data collection is generally established
according to the client-server model:
o The client uses a data collection terminal that can be a sheet
of paper, a computer or mobile phone. The client is the data
collector. This is usually a staff in a public service (doctor
who treats local populations, secretary, municipal agent,
agricultural agents etc.).
o A medium that connects the customer's terminal to the server
from the center of decisions. This medium may be the Internet
or mobile phone through computer network or a USB key into
a car, in case of transmission by surface or aerial (roads,
rivers, airplanes);
o Multiple protocols can be used to route data collected at the
client to the server: SMS, MMS, HTML, WML, i-HTML, text
file or data collection sheets. The protocols are generally
dependent on the transmission medium;
Once in the server at the center of decision, the data is stored in a
database to be further processed.
Below we give details the three main implementation of this
client-server architecture.
2.1. Computer-Internet-Server (CIS)
We are here as part of a standard web application: the client is a
computer (or smartphone) and the communication medium is
Internet. The protocol for data exchange is usually the HTML
language or assimilated. This architecture is commonly
implemented in industrialized countries in almost all sectors
(banks, municipalities, health, politics etc.). It has been used in
France in 2010 for the prevention and monitoring of diabetes [6]
and described in [11] as a good tool for e-democracy.
This architecture ensures the timeliness of data because the data
transmission medium, the Internet is fast enough in terms of time
required by health systems. With data exchange protocols used,
the chances of obtaining reliable data are large. Indeed,
information gathered can be typed and verified (entered in a
form), the controls (either automatically by the web servers) and
transmission errors prevented by TCP/IP protocol. These
protocols will also help ensure a high level of security by
encrypting data. This system is also versatile: only the server
needs to be updated in case of modification of the application.
However, this architecture can be deployed in a context in which
the Internet is degraded or nonexistent as in countries in crisis
(war, natural disaster) or the developing countries. It does not
answer our criteria for robustness.
2.2. Mobile-GSM-Server (MGS)
This architecture consists of a cell phone as a client. The person
responsible for collecting the data types of SMS or MMS
containing data to be transmitted. SMS or MMS messages are
then transmitted via the Global System for Mobile communication
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(GSM) to the server. The GSM network is the most common
worldwide, it is often used in the management of health crises in
developing countries or countries hit by natural disasters that see
their wire line telecommunications infrastructure destroyed. It was
used in China in 2005 after the earthquake [16], in Cameroon in
2010 during the cholera outbreak [8], and in many other countries
in Africa [2, 4, 5, 10, 15].
This solution ensures the timeliness of data as SMS and MMS
messages are sent immediately. But completeness is not always
guaranteed because the data being entered into SMS or MMS, it is
possible that the data collectors forget to enter some data which
are confused (inverted data, invalid data). Security is not
guaranteed because the data are difficult to quantify. Finally, it is
not versatile because the change in one component can affect the
data collector and require a new formation of the latter. It is robust
against GSM networks as well resist natural disasters and are
present in most countries.
2.3. Human-Route-Server (HRS)
For this architecture, the client is a person who collects the data
with a data collection sheet paper or a computer for data capture
and recording in file that can be stored on removable media. Note
cards or removable media are then transmitted via the road, air or
river. This system is one that is most prevalent in developing
countries with no electronic system of data collection or in areas
where Internet and GSM networks are absent. It is used in most
countries south of Sahara in Africa [7, 12, 14].
This increases the chances of obtaining reliable and complete data
because the information collected may be typed (with spread
sheets in the case of computerized data input or when integrating
data in the case of data input on papers). Meanwhile, timeliness of
data is not always guaranteed because the distance between the
server and the client is often far apart and roads are bad. Data
security can be ensured through file (encryption) but more
difficult in the context of paper records. This system is not as
versatile an update paper forms or entry program on a computer
disconnected from the network is a difficult operation. For against
this approach is robust: it can use on a multitude of medium (road,
air, sea).
2.4. Synthesis
Given the table 1, no approach satisfies all the criteria of data
collection systems of NHIS simultaneously. The next section
presents our approach which opens way for the simultaneous
consideration of all these criteria.
Table 1. The different architectures
architecture completeness promptness reliability
CIS Good Good Good
MGS Bad Good Bad
HRS Good Bad Good
architecture security versatility robustness
CIS Good Good No
MGS Bad Bad Yes
HRS Bad Bad Yes