Added FHIR IG

Reviewed-on: #12

Biometric.md

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+# Biometric Attendance System in Health Sector of Bangladesh
+
+## Background
+
+In remote areas of Bangladesh, absenteeism among health service providers at hospitals and health centers was a significant issue. This challenge is common not only in Bangladesh but also in many other countries. To address this, the Management Information System (MIS) under the Directorate General of Health Services (DGHS) introduced biometric time-attendance systems to track office attendance of government health staff at workplaces.
+
+## Implementation of Biometric Attendance System
+
+### Phase 1: Fingerprint Biometric Machines
+- **Installation Timeline:** 
+  - Introduced in 2012 and gradually expanded.
+  - Covered all Upazila Health Complexes (UHCs) and District Hospitals (DHs) in phases.
+- **Technical Details:**
+  - Low-cost fingerprint biometric devices.
+  - Each device can store up to 30,000 touch encounters.
+- **Operational Mechanism:**
+  - Staff fingerprints are registered during installation.
+  - Daily attendance is recorded through touch-based fingerprint scanning.
+  - Attendance data is captured by a central server at MIS-DGHS whenever local computers are connected to the Internet.
+  - Web-based attendance reports can be accessed remotely.
+
+### Performance Metrics
+- **Statistics:**
+  - In 2015: 423 active devices with 38.21% attendance.
+  - In 2016: 457 active devices with 51.05% attendance.
+  - In 2017: 476 active devices with 74.59% attendance.
+- **Impact:**
+  - Attendance rates increased by 36.38% from 2013 to 2017.
+- **Pre-COVID-19 Period (Till August-September 2023):**
+  - Attendance rate reached 92% with data from 600 active devices.
+
+### Impact of COVID-19
+- **Pandemic Disruption:** 
+  - Biometric attendance machines were shut down from 2019 to 2021.
+
+### Phase 2: Face Recognition System
+- **Introduction:** 
+  - Implemented from September 2023.
+- **Upgrades:**
+  - Face recognition technology replaced fingerprint systems.
+  - Devices are now required to remain online, connecting directly to the central MIS-DGHS server.
+  - Attendance confirmation is based on face recognition linked to the HRM ID of employees.
+  - Face ID registration occurs once per organization, and updates (e.g., transfers) are synchronized automatically.
+- **Features:**
+  - Supports outsourced employees and simplifies processes for reporting, leave management, scheduling, and activation/inactivation.
+  - Centralized server manages real-time data and reporting.
+
+## Coverage
+As of the latest update, the attendance system connects:
+- **Institutions:**
+  - Divisional Health Offices: 8
+  - Sadar Upazila Health Offices: 60
+  - District Health Offices: 63
+  - Chest Hospitals: 11
+  - Chest Clinics: 41
+  - Former UHCs, Sadar/District Hospitals, Specialized Hospitals, Medical Colleges, and Medical College Hospitals.
+- **Total Coverage:** 787 institutions.
+
+## Current Status
+The upgraded system has enhanced operational efficiency and attendance monitoring in government health facilities across the country. Regular attendance data is now being received from all connected institutions, ensuring better accountability and service delivery.
+
+---
+
+This article provides an overview of the biometric attendance system implemented by MIS-DGHS to improve attendance tracking in the health sector of Bangladesh. For further queries, please contact the MIS-DGHS support team.

CRVS.md

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+# Civil Registration and Vital Statistics (CRVS) in Bangladesh
+
+## 1. Overview of CRVS in Bangladesh
+
+Civil Registration and Vital Statistics, known as CRVS, is the national system in Bangladesh for recording births and deaths and producing official statistics about these events. The backbone of this system is the **Birth and Death Registration Information System (BDRIS)**, which is managed under the Office of the Registrar General. BDRIS is the legal authority for birth and death certificates in the country.
+
+The health sector contributes information into CRVS through the **District Health Information Software version 2 (DHIS2)**, which is managed by the Management Information System under the Directorate General of Health Services (MIS, DGHS). DHIS2 captures health-related events such as facility births and facility deaths, and also stores cause-of-death information certified by physicians.
+
+For community deaths, which occur outside health facilities, Bangladesh uses **Verbal Autopsy (VA)** tools. Currently, the data is collected using **Open Data Kit (ODK)**. Importantly, Verbal Autopsy is conducted only after a death has been legally registered in BDRIS. VA is not a trigger for registration; rather, it is a method to assign a probable cause of death for public health statistics.
+
+Some facilities in Bangladesh also use **OpenMRS**, which is an electronic medical record system. OpenMRS follows the same process of entering cause-of-death information, but at present, the data from OpenMRS is not yet fully integrated into the national Health Information System (HIS) for routine use.
+
+---
+
+## 2. Facility Deaths and the Medical Certification of Cause of Death (MCCoD)
+
+For deaths that occur inside hospitals or health facilities, Bangladesh uses the **Medical Certification of Cause of Death (MCCoD)** process. A physician fills in a **World Health Organization (WHO) cause-of-death form** on paper.
+
+The physician then selects the **Underlying Cause of Death (UCoD)**, which is the single disease, condition, or injury that started the sequence of events leading to death. This selection is based on the **International Classification of Diseases, Tenth Revision (ICD-10)** index and tabular list.
+
+After the physician’s certification, a nurse or health information officer enters the information into **DHIS2 Tracker Capture**. The ICD-10 code is automatically generated by the system from the physician’s text description of the cause. This digital entry allows the information to be centrally analyzed.
+
+At the central level, statisticians and physicians perform **analysis, validation, and tabulation** of the cause-of-death data. A tool called **ANACOD2** is used to evaluate patterns, check data quality, and produce tabulations.
+
+Finally, the validated mortality statistics are disseminated to and used by the **Health Services Division (HSD)**, the **Ministry of Health and Family Welfare (MoHFW)**, and the **Directorate General of Health Services (DGHS)** for policy and planning.
+
+Currently, Bangladesh uses ICD-10 for coding causes of death. However, **ICD-11 (International Classification of Diseases, Eleventh Revision)** is being piloted in six hospitals to prepare for future adoption.
+
+---
+
+## 3. Community Deaths and Verbal Autopsy (VA)
+
+Most deaths in Bangladesh occur outside health facilities. To understand the causes of these deaths, the country conducts **Verbal Autopsy (VA)**. Verbal Autopsy is a method where trained interviewers talk to family members or caregivers of the deceased to collect information about the signs, symptoms, and circumstances before death.
+
+In Bangladesh, Verbal Autopsy is conducted using **ODK (Open Data Kit)** on mobile devices. The collected data is analyzed to assign a probable cause of death. Currently, Bangladesh is using the **Smart Verbal Autopsy (SmartVA)** tool, but the country is now working towards adopting the **WHO standard Verbal Autopsy instrument**, which is internationally recommended.
+
+Verbal Autopsy in Bangladesh is not applied to every community death. It is conducted on a **sample basis**. At present, **69 upazilas (sub-districts)** have been selected for VA implementation. The national program aims to cover approximately **5,000 deaths per month** through Verbal Autopsy. This provides a representative picture of mortality patterns in the community.
+
+It is important to note that Verbal Autopsy is performed **only after the death has already been registered in BDRIS**. The VA data therefore does not feed into BDRIS for registration, but rather into statistical systems for public health analysis.
+
+---
+
+## 4. Interoperability Between DHIS2 and BDRIS
+
+The connection between the health information system (DHIS2) and the civil registration system (BDRIS) is a key innovation in Bangladesh’s CRVS. When a birth or death is recorded in DHIS2, a notification is sent electronically to BDRIS.
+
+If the person’s residence is in a rural area, the information is forwarded to the registrar’s office, and the **Registrar’s Office (RO)** follows up, sometimes with additional forms if required. If the residence is urban, the respective registrar monitors notifications directly through the BDRIS dashboard. Central monitoring can also be supported by sending government-issued SMS messages.
+
+After the registrar completes the registration, BDRIS sends an **electronic confirmation back to DHIS2**. This loop ensures that health events are matched with civil registration records and that DHIS2 always has an updated record of whether a birth or death has been legally registered.
+
+---
+
+## 5. Role of OpenMRS
+
+In some facilities, especially where OpenMRS is deployed, physicians and staff use OpenMRS to record deaths and causes of death. The process of certification and selection of the underlying cause of death is the same as in the MCCoD pathway described above. However, at present, the data from OpenMRS is **not yet included in the national Health Information System for routine reporting**. This means that although the information exists in OpenMRS, it does not yet contribute to the official CRVS statistics.
+
+---
+
+## 6. Key Performance Indicators for CRVS in Bangladesh
+
+To measure progress and data quality, Bangladesh uses several indicators in the CRVS system:
+
+* **Completeness of registration**: The proportion of births and deaths that are legally registered within a defined period.
+* **Timeliness of registration**: The time gap between the occurrence of a birth or death and its registration.
+* **Quality of MCCoD data**: The proportion of deaths with a correctly assigned underlying cause of death, the proportion coded to ill-defined categories, and the consistency of coding.
+* **Coverage of Verbal Autopsy**: The proportion of the monthly target of 5,000 community deaths achieved across the 69 upazilas.
+* **Interoperability efficiency**: The percentage of DHIS2 notifications that are successfully transmitted to BDRIS and confirmed back.
+* **Integration gap**: The extent to which OpenMRS data remains outside the national HIS.
+
+---
+
+## 7. Frequently Asked Questions
+
+* **Does Verbal Autopsy trigger death registration?**
+  No. Verbal Autopsy is conducted only after a death is already registered in BDRIS. It is used for statistics, not for registration.
+
+* **Which coding systems are used in Bangladesh?**
+  ICD-10 is used nationwide, but ICD-11 is being piloted in six hospitals.
+
+* **What tools are used for facility deaths?**
+  Physicians fill out WHO paper forms, causes are coded in DHIS2, and analysis is done with ANACOD2.
+
+* **How many deaths are covered by Verbal Autopsy?**
+  Verbal Autopsy is sample-based, currently in 69 upazilas, with a monthly target of 5,000 deaths.
+
+* **Is OpenMRS data included in official statistics?**
+  No. OpenMRS follows the same entry process, but its data is not yet integrated into the routine HIS.

HID.md

@@ -32,7 +32,7 @@ The Health ID system offers multiple convenient ways for citizens to register, e
         
 3.  **Online Portal:**
     
-    *   In selected pilot areas, an **online portal** (https://eappointment.dghs.gov.bd) allows citizens to book appointments for outdoor services. From this portal, anyone can get a health ID by providing their NID or birth registration number. However, getting an online appointment for outdoor services is limited to only piloting areas. This convenient feature enables access to health services even before visiting a healthcare facility and allows patients to obtain their own Health ID from home. Even if a person is out-of-country or abroad, they can also obtain a Health ID from this online portal.
+    *   An **online portal** (https://eappointment.dghs.gov.bd) allows citizens to obtain a health ID by providing their NID or birth registration number. In selected pilot areas, from this portal, anyone can book appointments for outdoor services. However, getting an online appointment for outdoor services is limited to only piloting areas. This convenient feature enables access to health services even before visiting a healthcare facility and allows patients to obtain their own Health ID from home. Even if a person is out-of-country or abroad, they can also obtain a Health ID from this online portal.
 
 ---
 
@@ -56,7 +56,7 @@ The Health ID system offers multiple convenient ways for citizens to register, e
 ---
 
 **Real-Time Monitoring of Health ID Distribution**
-The progress of Health ID distribution is monitored through a **real-time dashboard** at [https://pdb.shrlive.dgph.gov.bd/healthid](https://pdb.shrlive.dgph.gov.bd/healthid) and [https://dashboard.dgph.gov.bd/en/health-id-dashboard](https://dashboard.dgph.gov.bd/en/health-id-dashboard). This ensures transparency and allows for timely adjustments in the implementation process.
+The progress of Health ID distribution is monitored through a **real-time dashboard** at [https://pdb.shrlive.dghs.gov.bd](https://pdb.shrlive.dghs.gov.bd). This ensures transparency and allows for timely adjustments in the implementation process.
 
 ---
 
@@ -72,8 +72,4 @@ The progress of Health ID distribution is monitored through a **real-time dashbo
 ---
 
 **Conclusion**
-The Health ID system marks a significant step in Bangladesh's journey toward a **digitally empowered healthcare system**. By ensuring universal health coverage, preventing duplication, and enabling seamless data exchange, the Health ID enhances the efficiency and effectiveness of health services. With multiple registration pathways and real-time monitoring, the initiative is poised to transform healthcare delivery for millions of citizens.
+The Health ID system marks a significant step in Bangladesh's journey toward a **digitally empowered healthcare system**. By ensuring universal health coverage, preventing duplication, and enabling seamless data exchange, the Health ID enhances the efficiency and effectiveness of health services. With multiple registration pathways and real-time monitoring, the initiative is poised to transform healthcare delivery for millions of citizens.
-
----
-
-Would you like any further modifications or additional details?

ICD11.md

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+# Bangladesh's Transition from ICD-10 to ICD-11: A Journey Towards Modernized Health Coding
+
+## Introduction
+
+In late 2023, Bangladesh started the journey of transitioning from ICD-10 to ICD-11, aiming to modernize its health information system and improve disease classification and reporting. As part of this transition, a pilot phase was initiated in six hospitals, employing two different approaches for ICD-11 integration based on the existing digital infrastructure.
+
+## The Pilot Phase: Implementing ICD-11 in Six Hospitals
+
+To assess the feasibility and effectiveness of ICD-11, six hospitals were selected for piloting, categorized based on their health information systems:
+
+### 1. OpenMRS-Based Hospitals (WHO ICD-11 API Integration)
+
+Three district hospitals leveraged OpenMRS, integrated with the WHO ICD-11 API to facilitate morbidity (OPD, emergency) and mortality (MCCoD) coding. The hospitals included:
+
+- **Cumilla District Hospital**
+- **Nilphamari District Hospital**
+- **Barguna District Hospital**
+
+This integration enabled structured coding of patient diagnoses and causes of death.
+
+### 2. DHIS2-Based Hospitals (ICD-11 Codes in Dropdowns)
+
+Three other hospitals incorporated ICD-11 into the existing DHIS2 platform by manually adding ICD-11 codes into dropdown menus. These hospitals were:
+
+- **Cox’s Bazar District Hospital**
+- **Khulna Medical College Hospital**
+- **Rajshahi Medical College Hospital**
+
+Bangladesh initially planned for an integrated morbidity and mortality tracker within DHIS2. While WHO had already developed a customized ICD-11 application for MCCOD (Medical Certification of Cause of Death), there was no equivalent app available for morbidity coding at the time of piloting. As a result, ICD-11 morbidity and mortality coding had to be manually incorporated using dropdown menus. Bangladesh continued using this approach to maintain consistency while simultaneously requesting WHO to develop a customized morbidity app to enable full ICD-11 integration within DHIS2.
+
+## Challenges Encountered During the Pilot Phase
+
+### 1. Challenges in OpenMRS Implementation
+
+- **Limited Scope of ICD-11 Usage:** The inpatient module of OpenMRS is still under development. Consequently, ICD-11 could only be utilized in outpatient departments (OPD), emergency departments, and for MCCOD.
+- **Data Remains Locally Stored:** The lack of centralized synchronization meant that hospitals using OpenMRS continued entering routine health information into DHIS2, leading to a double workload.
+- **Limited Use of Postcoordination:** Findings from the pilot phase indicated very little usage of postcoordination in OpenMRS-based piloting areas, suggesting the need for further training and system improvements.
+- **Initial Absence of Foundation URI Storage:** Initially, only ICD-11 codes were stored, without keeping the `foundationUri`. Later, it was realized that storing `foundationUri` is essential for usability and data analysis. As a result, this functionality was added to the backend.
+
+### 2. Challenges in DHIS2 Implementation
+
+- **Dropdown Limitations:** Since DHIS2 lacked a built-in API connection for ICD-11, the dropdown approach was used. However, ICD-11 is not designed to function as a dropdown-based classification, making data entry cumbersome and inefficient.
+- **Dual Data Entry Burden:** As Bangladesh’s national health statistics are still produced using ICD-10, hospitals using ICD-11 in DHIS2 were also required to enter the same data in ICD-10. This double data entry requirement led to frustration among healthcare workers, resulting in low motivation to input ICD-11 data.
+- **Future System Constraints:** Given that ICD-11 was not intended to be used as dropdown selections, it became evident that long-term implementation should focus on full-fledged hospital automation rather than manual input into DHIS2.
+
+### 3. Inconsistent MCCOD Data Entry
+
+In Bangladesh, routine health information system (HIS) data is formulated by a statistician, while MCCOD data entry is performed by a nurse from the inpatient department. Regardless of the HIS platform (OpenMRS or DHIS2), nurses had to enter the same data twice. This redundancy led to minimal data entry for MCCOD. However, OPD and emergency departments performed well because physicians use the automation system in real time, eliminating redundant data entry and additional workload for them.
+
+## Lessons Learned and Next Steps
+
+The pilot phase provided crucial insights into the strengths and limitations of ICD-11 integration in Bangladesh’s healthcare system. The key takeaways shaped the country’s next phase of implementation.
+
+### 1. Establishing a Central Terminology Registry
+
+Bangladesh is in the process of formulating a **Central Terminology Registry**, which will adopt ICD-11 for coding symptoms, signs, diagnoses, and medications. This initiative paves the way for nationwide expansion of ICD-11 implementation in hospitals equipped with automation systems.
+
+#### Why ICD-11 for the Terminology Registry?
+
+- **Free of Cost** – No licensing fees are required, making it a cost-effective solution.
+- **Global Community Support** – ICD-11 is backed by a robust global community, ensuring continuous updates and improvements.
+- **Ready Technology** – WHO has provided APIs and tools that facilitate seamless integration with existing health information systems.
+
+### 2. Switching to Localized ICD-11 Deployment
+
+Initially, ICD-11 was deployed using the WHO ICD-11 API. However, Bangladesh is now transitioning to a **localized Docker container deployment**. This shift significantly reduces dependency on internet connectivity, ensuring a more stable and efficient system for hospitals, especially in remote areas.
+
+### 3. Scaling Up ICD-11 to 150 Hospitals
+
+Building on the lessons from the pilot phase, Bangladesh plans to **expand ICD-11 implementation to 150 hospitals** that have hospital automation systems. This expansion will facilitate the integration of ICD-11 data directly into a central shareable health record repository, eliminating the need for duplicate data entry into DHIS2.
+
+### 4. Future of DHIS2 and ICD-11 Integration
+
+- **MCCOD Application Adoption:** In DHIS2, the WHO MCCOD app with ICD-11 API will be adopted for mortality coding.
+- **Exploring Custom Morbidity Apps:** If a customized app for morbidity coding with ICD-11 API becomes available, Bangladesh will integrate it into DHIS2. Otherwise, ICD-10 will continue to be used for morbidity coding, but a **mapping system** will be developed to transition ICD-10 data into ICD-11 over time.
+
+### 5. Capacity Building for ICD-11 Data Analysis
+
+Bangladesh recognizes the need for **capacity building** in analyzing data coded with ICD-11. Training healthcare professionals and statisticians in **interpreting and utilizing ICD-11-coded data** effectively will be essential for decision-making and policy development.
+
+### 6. Gradual Phase-Out of DHIS2 for Hospital-Based Coding
+
+Over time, as hospital automation systems expand, **ICD-11 data will be directly recorded in these systems**. DHIS2 will gradually be phased out for individual patient coding but will continue to serve **program-specific purposes and aggregate data collection** at the national level.
+
+## Conclusion
+
+Bangladesh’s transition from ICD-10 to ICD-11 represents a **significant leap** in modernizing the country’s health information system. While the pilot phase revealed implementation challenges, it also provided a roadmap for future scaling. By addressing **data synchronization issues, reducing dependency on internet-based APIs, eliminating redundant data entry, and strengthening capacity building** for ICD-11 data analysis, Bangladesh aims to **enhance healthcare coding efficiency, improve statistical accuracy, and align with global health standards** for morbidity and mortality reporting.
+

fhirig.md

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+# Bangladesh Core FHIR Implementation Guide (BD-Core-FHIR-IG)
+
+The Directorate General of Health Services (DGHS) is leading the development of the **Bangladesh Core FHIR Implementation Guide (BD-Core-FHIR-IG)** as part of implementing the **Bangladesh Digital Health Blueprint**.  
+
+This initiative is designed to ensure that health information systems in Bangladesh can work together seamlessly. By following **internationally recognized standards**, Bangladesh is not only strengthening its own health data governance but also creating the foundation for **cross-border health information exchange** in the future.  
+
+For patients, this means clear benefits:  
+- Their health information will move more smoothly between hospitals, clinics, and programs.  
+- Duplicate tests and procedures can be reduced, saving both time and cost.  
+- Patients will experience better continuity of care when moving between providers or even across borders.  
+
+The Implementation Guide is available at:  
+👉 [https://fhir.dghs.gov.bd](https://fhir.dghs.gov.bd)  
+
+---
+
+## Why this matters
+- Supports the **national blueprint for digital health implementation**.  
+- Provides a **trusted reference** for all stakeholders in the health sector.  
+- Builds the pathway for **internationally compatible digital health services**.  
+- Ensures that the **patient remains at the center** of the health information ecosystem.  

vaxEPI.md

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+# VaxEPI: Integrated Vaccine Registration & Vaccination Information (Bangladesh)
+
+## 1) What VaxEPI Is (Overview)
+
+VaxEPI is Bangladesh DGHS’s public-facing portal (introduced in **2024**) for **integrated vaccine registration** and **vaccination information management**. It covers both **routine EPI** (Expanded Programme on Immunization) and **special campaigns**. VaxEPI is a **single-time registration** system: a child is registered once and remains trackable across programs and facilities. Registration is verified against the **Birth Registration Number (BRN)** to ensure identity integrity and deduplication.
+
+VaxEPI is interoperable with the national **Shareable Health Record (SHR)**, so each registered child receives a **Unique Health ID**; all vaccination events appear in the **Health Information Exchange (HIE)** for authorized use. Families receive a **vaccine card with a QR code**; vaccinators record doses and scan the QR to update the central record. Digital **vaccination certificates** are made available via the [VaxEPI portal](https://vaxepi.gov.bd), following EHR-style access patterns. Special campaigns such as **HPV**, **TCV (Typhoid Conjugate Vaccine)**, and **meningitis vaccine for Hajj pilgrims** are also managed through VaxEPI.
+
+**Retrieval cues:** “single-time registration”, “BRN verification”, “SHR Unique Health ID”, “QR vaccine card”, “routine EPI + campaigns”, “digital certificate”, “HIE availability”.
+
+---
+
+## 2) Core Objectives
+
+* **Universal, deduplicated identity for children** via BRN → SHR → Unique Health ID.
+* **Continuity of care**: one longitudinal vaccination timeline per child across facilities.
+* **Operational efficiency**: unified workflows for routine and campaign activities.
+* **Data quality & exchange**: real-time updates to HIE; fewer missed doses/duplicates.
+* **Citizen convenience**: QR-coded card and downloadable vaccination certificate.
+
+---
+
+## 3) Scope & Program Coverage
+
+* **Routine EPI**: BCG, OPV/IPV, Penta, PCV, MR, etc. (country schedule applies).
+* **Special campaigns**: **HPV**, **TCV**, and **meningitis/Hajj** drives, plus other MoHFW/DGHS-approved campaigns.
+* **Population focus**: primarily **children**; program extensions may include adolescents or adults for specific campaigns (e.g., Hajj).
+
+---
+
+## 4) Identity & Registration Model
+
+**Inputs:** Child’s **BRN**, name (Bangla/English), date of birth, sex, guardian details, address/upazila/district, contact number(s).
+**Verification:** Online verification of **BRN** (preventing duplicates).
+**Linkage:** On successful registration, VaxEPI requests/receives a **Unique Health ID** from **SHR**.
+**Artifacts:** **QR-coded vaccine card** (physical and/or digital).
+**Card Use:** QR encodes persistent identifiers (e.g., Health ID and VaxEPI record ID) to enable fast retrieval and updates at point of care.
+
+---
+
+## 5) Vaccination Workflow (Facility & Field)
+
+1. **Presentation:** Caregiver brings the child and **QR card** to a session (facility or outreach).
+2. **Assessment:** Vaccinator reviews **due/overdue doses** (per age and schedule) in VaxEPI.
+3. **Administration:** Vaccine is given; **dose details** are recorded (vaccine code, dose #, lot/batch, expiry, route, site).
+4. **Update:** Vaccinator **scans the QR**; VaxEPI loads the child record and **posts the dose event**.
+5. **Sync & Exchange:** Event is written to VaxEPI and **propagated to HIE/SHR**.
+6. **Certificate:** A refreshed **digital vaccination certificate** becomes available in the portal.
+
+---
+
+## 6) Citizen Experience
+
+* **Discoverability:** Public portal for registration and certificate download.
+* **Proof of vaccination:** **QR-coded card**; digital **certificate** view/print.
+* **Portability:** Records visible across facilities due to SHR Health ID.
+* **Notifications (if enabled):** SMS or portal prompts for upcoming/overdue doses.
+
+---
+
+## 7) Interoperability & Data Exchange
+
+* **SHR (Shareable Health Record):** creation/lookup of **Unique Health ID**.
+* **HIE (Health Information Exchange):** publishes vaccination events for authorized systems.
+* **Standards & semantics:** consistent vaccine codes, dose definitions, and schedule logic to support analytics and exchange.
+* **Result:** Authorized providers and national analytics can **query longitudinal vaccination history** for service continuity and planning.
+
+---
+
+## 8) Special Campaigns (HPV, TCV, Hajj Meningitis)
+
+* **Registration:** Uses the **same child record** (no duplicate accounts).
+* **Targeting:** Eligibility computed by **age/sex/risk group** (e.g., adolescent girls for **HPV**, child age bands for **TCV**, **pilgrim status** for Hajj).
+* **Delivery:** VaxEPI supports **bulk session lists**, on-site verification via **QR**, and rapid **dose posting**.
+* **Reporting:** Campaign-specific dashboards can aggregate coverage, dropout, and stock usage.
+
+---
+
+## 9) Governance, Roles & Access
+
+* **DGHS/MIS ownership**; national data stewardship.
+* **Roles:** Registrar (front desk), Vaccinator, Facility Manager, District/Upazila EPI Manager, National Analyst.
+* **Access controls:** Role-based permissions for read/write; certificate access controlled via authenticated portal flow and/or verifiable QR link.
+* **Auditability:** All vaccination events and edits have **provenance** (who/when/where).
+
+---
+
+## 10) Data Quality & Safety Nets
+
+* **Identity deduplication:** BRN check at registration; “possible duplicate” flags.
+* **Schedule validation:** Client-side/server-side checks for **age-appropriate** dosing and minimum intervals.
+* **Lot controls:** Prevent posting events for **expired** lots; require lot/batch.
+* **Correction workflow:** Voiding/mending mis-entries with reason and audit trail.
+
+---
+
+## 11) Privacy & Security (High Level)
+
+* **PII handling:** Minimal necessary disclosure; **BRN** and **Health ID** protected.
+* **QR contents:** Encodes identifiers or verifiable token, not full PII.
+* **Transport/storage:** Encrypted channels; secure storage per national policy.
+* **Access:** Role-based access; certificate retrieval bound to guardian verification or QR proof.
+
+---
+
+## 12) Typical User Journeys
+
+**A) First-time Registration**
+
+1. Guardian opens [VaxEPI](https://vaxepi.gov.bd) → enters **BRN** and child details → system verifies BRN.
+2. VaxEPI fetches/assigns **Unique Health ID (SHR)**.
+3. VaxEPI issues **QR-coded vaccine card**; child appears on due-list.
+
+**B) Dose Administration**
+
+1. Child presents **QR card** → vaccinator scans → due doses displayed.
+2. Dose given → vaccinator records details → **event saved** → **HIE updated**.
+3. Certificate refreshed → guardian can **download** from portal.
+
+**C) Special Campaign (e.g., HPV)**
+
+1. Eligibility auto-determined → session roster generated.
+2. On site, **QR scan** retrieves record → dose posted.
+3. Coverage reports update in near-real time.
+
+---
+
+## 13) Frequently Asked Clarifications (for RAG)
+
+* **Q:** Is VaxEPI only for routine EPI?
+  **A:** No. It supports **routine EPI** and **special campaigns** (HPV, TCV, Hajj meningitis).
+
+* **Q:** Do parents need to register for every campaign?
+  **A:** **No.** VaxEPI is **single-time registration**; campaigns reuse the same **Health ID**.
+
+* **Q:** How is identity verified?
+  **A:** Via **Birth Registration Number (BRN)**; then linked to **SHR** to issue a **Unique Health ID**.
+
+* **Q:** How are vaccination events captured?
+  **A:** Vaccinator **scans the QR card** and records details; the system posts to VaxEPI and **HIE**.
+
+* **Q:** Where can I get the vaccination certificate?
+  **A:** From the **VaxEPI portal** at [https://vaxepi.gov.bd](https://vaxepi.gov.bd), updated after each dose.
+
+* **Q:** What if a dose was recorded incorrectly?
+  **A:** There is a **void/correction** process with full **audit trail**.
+
+---
+
+## 14) Abbreviation Glossary
+
+* **BRN:** Birth Registration Number
+* **DGHS:** Directorate General of Health Services
+* **EHR:** Electronic Health Record
+* **EPI:** Expanded Programme on Immunization
+* **HIE:** Health Information Exchange
+* **HPV:** Human Papillomavirus vaccine (campaign)
+* **MoHFW:** Ministry of Health and Family Welfare
+* **QR:** Quick Response code
+* **SHR:** Shareable Health Record
+* **TCV:** Typhoid Conjugate Vaccine
+
+---
+
+## 15) One-Paragraph Summary (for fallback retrieval)
+
+VaxEPI (launched 2024 by DGHS/MIS) is Bangladesh’s integrated portal for vaccine registration and vaccination information, covering routine EPI and special campaigns (HPV, TCV, Hajj meningitis). Registration is verified by BRN; each child is issued a Unique Health ID from the national Shareable Health Record (SHR). Vaccinators give doses and scan a QR-coded vaccine card to update the record; events sync to the Health Information Exchange (HIE). Families can download an up-to-date digital vaccination certificate from the [VaxEPI portal](https://vaxepi.gov.bd). VaxEPI’s single-time registration, SHR linkage, and QR-based point-of-care updates make it a cornerstone of Bangladesh’s digital health implementation.