Information Revolution Booklet - June 2021 - FINAL
Information Revolution Booklet - June 2021 - FINAL
I
REVOLUTION
INFORMATION
FIVE YEAR PROGRESS REPORT
CONTENTS
Contents
BACKGROUND INFORMATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Background
DATA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DATA QUALITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Connected Woreda
GOVERNANCE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
eHEALTH ARCHITECTURE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Data
ELECTRONIC REGULATORY INFORMATION SYSTEM. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Governance
MASTER FACILITY REGISTRY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
eHealth Architecture
HUMAN RESOURCE INFORMATION SYSTEM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
HEALTHNET . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 eRIS
CAPACITY BUILDING. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
LESSONS LEARNED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
FUTURE PRIORITIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Future Priorities
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FIVE YEAR PROGRESS REPORT
BACKGROUND INFORMATION
Contents
The Information Revolution (IR) led by Ethiopia’s Ministry of IR Roadmap (2016-2020) identifying two pillars of focus
with actionable and measurable interventions: (1) enhance
Background
Health (MOH) was one of four key transformation agendas in the
first Health Sector Transformation Plan (HSTP). The IR agenda the culture of information use for decision making, and (2)
was launched in response to increasing demands for health implementation and scale-up of prioritized health information
information and opportunities to leverage advancements systems (HIS) and tools The IR agenda continues to be a major
in information and communications technology (ICT). To priority in HSTP-2 to bring fundamental cultural changes and
advance the IR objectives, the MOH developed a national accelerate the process of data use within the health sector.
Connected Woreda
Ethiopia IR
IR PILLARS
Data
Enhance the culture PILLAR PILLAR
of information use for
decision making. 1 2 Implementation and scale-up of
prioritized HIS and tools.
Governance
HIS Governance
eHealth Architecture
Improving performance of
the health system Enable equitable access to high
quality health care services
eRIS
Lesson Learned
This is a summary of the IR Roadmap Booklet highlighting key accomplishments and learnings from the last five years, as well as recommendations
Future Priorities
for the next five years. More detailed information is available in the IR Roadmap Booklet. Information provided in the IR Roadmap Booklet and this
summary IR Progress Report is intended to be used by the federal government, donors, partners and other stakeholders supporting the health
sector.
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FIVE YEAR PROGRESS REPORT
Contents
The Connected Woreda Strategy is Ethiopia’s program to support and implement the IR agenda
and HTSP priorities at the woreda level. The program aims to:
• Improve the quality and transformation of health information at all levels.
• Improve the culture of using health information for decision at all levels.
Background
• Strengthen HIS infrastructure through improved connectivity and digitization of health
information system tools.
• Strengthen IR implementation and expansion to all regions.
A woreda that has established a data use culture and is taking advantage of digital tools at 90% of
Connected Woreda
the facilities within the woreda are credited as Model Facilities.
Data
Typical Profile
• Facilities working to • Facilities have basic M&E • Highest-performing • Model Facilities
improve core Measure infrastructure in place, facilities • Can access and share data
& Evaluation (M&E) but have room to improve • Score over 90% on
infrastructure and in data quality, and
Governance
assessment criteria
practices across the board administration and clinic
data use. • Can access and share data
• Score less than 65% on offline (e.g., paper, flash
assessment criteria • Score between 65% and drive)
90% on assessment
criteria
eHealth Architecture
M&E Systems & • Capacity building • Targeted support for • Document Model Facility • Same as Model Facility
Capacity to strengthen HIS lower-performing best practices • May demonstrate
infrastructure and facilities. (Assumes • Provide a site to test, how digital tools
supportive supervisions M&E infrastructure is demonstrate and diffuse complement processes
mostly in place at this data-use best practices at Model Facility levels
level.)
• May demonstrates how • May include
• Capacity building for • Targeted support for digital tools complement demonstrations of
Data Quality data completeness lower-performing processes at Model Facility tools such as Electronic
and timeliness, and facilities. (Assumes levels, such as: Medical Records (EMR)
performance of Lot most facilities are • Fully functional
»»IVR/SMS for monthly/
Quality Assurance meeting data quality HealthNet
PHEM reporting
eRIS
HMIS Health Management Information System • HEWs use standard processes (i.e., non-standard
Graphic acronyms processes may not function correctly with eCHIS)
IVR Interactive Voice Response
PHEM Public Health Emergency Management • Minimum training requirements met by relevant health
SMS Short Message Service workers and administrators
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FIVE YEAR PROGRESS REPORT
DATA
Contents
Health and health-related data in Ethiopia are gathered through different institutions and
processes, including surveys and surveillance systems to improve evidence-based decisions
making at all levels. Over the last five years, updated and new survey and surveillance data
Background
were collected in alignment with the IR agenda.
2016
Connected Woreda
Emergency Obstetric and
Newborn Care Survey
conducted on maternal and
newborn services in the
country 2016 - 2017
Data
2016 - 2018
Governance
facility-based surveys
2017 - 2018
eHealth Architecture
2017 - 2018
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FIVE YEAR PROGRESS REPORT
DATA QUALITY
Contents
Improving data quality and promoting the culture of information use are the center of the IR
agenda. The following graphic provides information on the quality assurance.
Background
Data Quality Assurance – Timeline
Connected Woreda
2016 2017 2018 2019 2020
Data
Annual assessment (MOH/RHB) Annual DQR Annual DQR Annual DQR
Quarterly assessment by RHBs Routine DQA Routine DQA Routine DQA Routine DQA Routine DQA
Governance
Monthly self assessment by LQAS LQAS LQAS LQAS LQAS
health facilities
Graphic acronyms • Annual Data Quality review (DQR) • Performance of Routine Information System Management (PRISM)
• Data Quality Assessment (DQA) • Regional Health Bureaus(RHBs)
eHealth Architecture
• Lot Quality Assurance Sampling (LQAS) • Woreda Health Office (WoHO)
GOVERNANCE
document HIS governance functions, principles, and structures in a consultative process with
stakeholders.
LAUNCHED
HIS governance framework approved an HIS Steering Committee led by the Minister
Lesson Learned
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FIVE YEAR PROGRESS REPORT
Contents
eHEALTH ARCHITECTURE
The eHealth Architecture is a blueprint for Ethiopia’s health information needs, software and hardware
requirements to coordinate IT choices, ensuring appropriate resource utilization, and facilitating access
and integration of data. The MOH made progress over the last five years developing and refining the
Background
eHealth Architecture blueprint and making investments in the components.
Shared Services Institution-Based HIS & Data Sources Population-Based Analytics &
Acronyms
Connected Woreda
HIS & Data Sources Business Intelligence
LEGEND:
Facility Surveys Analytics and BI
Client Registry (EMPI) (SPA+)
Development not started
Health Insurance /
eHIRIS IDSR / ePHEM CRVS
eHNIIS Under Development
Master Facility Registry eLMIS/HCMIS eRIS Surveys Data Warehouse Functional Application
Data
Health Data Dictionary eHMIS/DHIS 2 HGIS Census EHDAP
External Systems
Interoperability Service
Authentication • Encryption • Routing • Transformation • Queuing • Validation • Translation IFMIS
Governance
Agriculture
eHealth Architecture
eHealth Architecture Governance, Principles, Processes and Standards
Shared Services
• MFR system customization completed
• Data about health facilities collected from different sources and being reconciled
• A plan to generate an authoritative list of all health facilities by the end of the current fiscal year
eRIS
• National Health Data Dictionary (NHDD) is up and running and National Classification of Diseases
(NCoD) is loaded; indicators are loaded into NHDD.
• A mobile app to access the data dictionary
• Develop client registry and shared health records in the later years of the project
Lesson Learned
Interoperability Services
• Data exchange between different systems being demonstrated
• Additional priority use cases have been identified and planned to be implemented
• eHealth Architecture (eHA) and interoperability academy established at Mekelle University
eHealth Architecture
Future Priorities
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FIVE YEAR PROGRESS REPORT
Contents
Deployed the Ethiopia Digital Health Projects Inventory System to
register and conduct inventory registry digital health projects
Background
Tested data exchange between the MFR and DHIS2
Accomplishments
Connected Woreda
Leveraged DHIS2 for case-based COVID-19 surveillance and data
exchange with the lab information system on lab orders and results
Data
HEALTH INFORMATION TECHNOLOGY SYSTEM
STANDARDS & INTEROPERABILITY
Governance
HIS and ICT standards promote collection, exchange, use and reuse of health data across
unaffiliated organizations and technologies, reducing fragmentation. The MOH advanced
guidelines and protocols supporting HIS standards over the past five years to advance
interoperability of health data.
eHealth Architecture
eRIS
Lesson Learned
the NHDD as the authoritative NHDD Pocket, a mobile app of National data to develop EMR standards (i.e., minimum
source for indicators and HIS the NHDD to enable access to dictionary data sets, functionalities, technical
standards practitioners requirements)
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FIVE YEAR PROGRESS REPORT
Contents
National Health ICT Infrastructure
alth Record
Background
LEGEND:
Facility Surveys Analytics and BI
stry (EMPI) (SPA+)
Planned Activities: Development not started
Connected Woreda
automatic synchronization to i-License and i-Register
Dictionary eHMIS/DHIS 2 HGIS Census EHDAP
• Implement i-License (health facilities ) in 100 woreda level offices to register all
public and private facilities
External Systems
eRIS is the umbrella system at Ethiopia Food and Drug Administration (EFDA) comprised of multiple
Interoperability Service
sub-systems
Authentication • Encryption •which
Routing •work together:
Transformation • Queuing • Validation • Translation IFMIS
i-Register
Agriculture is used to manage the
i-License enables entities to apply food, medicines and medical devices
Point of Service HIS
for a certificate of competence to
Data
registration
Metrology processes when an
eLIS register and
Surveillance IVRimportEMR
products. Patient Portal applicant seeks to register those
products
Education
in Ethiopia for later import.
Governance
eHealth Architecture
i-Verify is used to verify and check
i-Import is used to manage the
the authorization status of medicines
import process, once registered in
by EFDA and monitor the movement
Ethiopia.
of medicines from manufacturer to
the point of issue.
eRIS
SCA
N
Lesson Learned
SCAN
Future Priorities
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FIVE YEAR PROGRESS REPORT
Contents
An HMIS supports routine collection, aggregation, analysis, presentation and utilization of health and
Background
health related data for evidence-based decisions by health workers, managers, policy makers and
others. Since launching the IR Roadmap, Ethiopia deployed the electronic DHIS2 to support HMIS
activities.
Connected Woreda
Shared Services Standardized indicator
Institution-Based HIS & Data Sources Populatio
HIS & Data
definitions
Shared Health Record
Facility Surveys
Client Registry (EMPI) (SPA+)
Health Insurance /
eHIRIS IDSR / ePHEM CRVS
eHNIIS
Accomplishments
Data
Master Facility Registry eLMIS/HCMIS eRIS Surveys
Governance
Interoperability Service
Authentication • Encryption • Routing • Transformation • Queuing • Validati
DEPLOYED DHIS2
3,605 1,600 7,000 4,000
system consolidating two
ONLINE OFFLINE DATA WORKERS DATA WORKERS
systems into one for HMIS
trained on Point ofon
trained Service
DHIS2 HIS
data
data collection, analysis
DHIS2 access sites DHIS2 use analytics tools
and reporting
eHealth Architecture
Nutrition eLIS Surveillance IVR EMR
eCHIS
DHIS2
Future Priorities
EVIDENCE-BASED
DECISIONS BY
HEALTH WORKERS
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Shared Health Record
FIVE YEAR PROGRESS REPORT
LEGEND:
Facility Surveys Analytics and BI
Client Registry (EMPI) (SPA+)
Health Insurance /
eHIRIS IDSR / ePHEM CRVS
eHNIIS
SYSTEM (eCHIS)
Under Development
Contents
Master Facility Registry eLMIS/HCMIS eRIS Surveys Data Warehouse Functional Application
Background
sites. Interoperability Service
Authentication • Encryption • Routing • Transformation • Queuing • Validation • Translation IFMIS
Agriculture
Connected Woreda
Nutrition eLIS Surveillance IVR EMR Patient Portal
Education
eCHIS
eCHIS
•eHealth
Development ofGovernance,
Architecture Principles,
eCHIS to support Processes
agrarian, and Standards
urban and pastoralist
communities
• Implementation of eCHIS in agrarian, urban, and pastoralist health posts
• Develop and implement eCHIS governance protocols and standard
operating procedures (SoPs )
Data
ACHIEVEMENTS: • Provide optimization and server side tech support
1,250
Governance
FAMILY FOLDER, RMNCH and COMMUNICABLE HEALTH POSTS
DISEASES (TB and MALARIA) health posts using eCHIS acoss 4
modules for eCHIS development completed agrarian regions
eHealth Architecture
eCHIS Components
FAMILY FOLDER
SERVICES
SETTING
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FIVE YEAR PROGRESS REPORT
Contents
The MFR is a platform for collecting, storing and sharing authoritative information on health
facilities in the country. The MFR data can be used by public and private sector stakeholders
Background
to align their systems and programs.
Connected Woreda
Deployed the MFR National Health ICT Infrastructure Developed MFR
with a public portal Institution-Based HIS & Data Sources HIS
Shared Services data accuracy
Population-Based Analytics & and
approval protocols
& Data Sources Business Intelligence
Data
Shared Health Record
LEGEND:
Facility Surveys Analytics and BI
Client Registry (EMPI) (SPA+)
Development not started
Health Insurance /
eHIRIS IDSR / ePHEM CRVS
eHNIIS Under Development
Governance
Master Facility Registry eLMIS/HCMIS eRIS Surveys Data Warehouse Functional Application
External Systems
An EMR is a digital version of a paper chart or register created and managed by health
eHealth Architecture
services providers at a health organization to capture Interoperability Service
and store patient health information.
Authentication • Encryption • Routing • Transformation • Queuing • Validation • Translation IFMIS
Agriculture
470
Lesson Learned
ACHIEVEMENTS:
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FIVE YEAR PROGRESS REPORT
Contents
An HRIS enables users to manage human capital and track the health workforce. In recognition of
the need to better track and manage the health workforce, the MOH made strides in planning for an
electronic HRIS.
Background
National Health ICT Infrastructure
Connected Woreda
HIS & Data Sources Business Intelligence
• Complete the
Shared Health Record
development of the
human resource LEGEND:
Facility Surveys Analytics and BI
Client Registry (EMPI) (SPA+) administration,
Development not started
development, and
Health Insurance /
eHIRIS
eHIRIS IDSR / ePHEM licensureeHNIIS
modules CRVS
Under Development
health departments
Data
Health Data Dictionary eHMIS/DHIS 2 HGIS
(ZHDs), WoHOs and HFs PLANNING
Census FOR DEPLOYMENT OF IHRIS SOFTWARE
EHDAP
AT THE NATIONAL AND SUB-NATIONAL LEVELS
External Systems
Interoperability Service
Authentication • Encryption • Routing • Transformation • Queuing • Validation • Translation IFMIS
Governance
Agriculture
SYSTEM
eCHIS (PHEM) Education
eHealth Architecture
eHealth Architecture Governance, Principles, Processes and Standards
The MOH deployed the country’s PHEM in 2018 to capture and analyze public health
emergency data.
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FIVE YEAR PROGRESS REPORT
Contents
Across the globe, digital health has been brought to the forefront as a crucial
tool to combat the COVID-19 pandemic. In Ethiopia, critical digital tools were
developed and implemented to mitigate the effects of the pandemic:
Background
Critical Item Availability
Connected Woreda
a system to enable the EFDA to monitor and Simplified process to expedite licensing
control hand sanitizer quality and registration of COVID-19 supplies
Data
National COVID-19 surveillance and Port-of-entry health declaration for
tracking system: COVID-19 case surveillance program:
supports the enrollment and tracking of an application that travelers use
suspected cases; captures symptoms, to record personal identification
demographics, risk factors, and exposures; information including phone number;
creates lab requests; links confirmed cases travel history; illness symptoms; and
Governance
with contacts; and monitors patient outcomes their place of residence
eHealth Architecture
suspects and contacts of confirmed cases who
will be followed for 14 days
Community house-to-house
Toll-free recording app: screening app:
an app which records and stores data a mobile application for Health Extension
from individuals who call 8335 and 994 Workers that helps in data collection and
short codes to report their COVID-19 serves as job aid for nationwide door-to-
status and/or concerns door COVID-19 screening campaigns
to support users on health queries or concerns and developed for community members self-
direct them to accurate information sources reporting when they have COVID-19 symptoms
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FIVE YEAR PROGRESS REPORT
HEALTHNET
Contents
The MOH has been working with Ethio Telecom to provide internet connection to all health
facilities and health administration units across the country via HealthNet, a Virtual Private
Network (VPN) service. HealthNet allows these sites to access digital tools such as DHIS2 to
Background
timely enter data and submit reports.
Connected Woreda
Internet
Data
systems using HealthNet
3,605
Governance
HEALTH INSTITUTIONS
have been connected
to HeathNet
eHealth Architecture
Key benefits of HealthNet
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FIVE YEAR PROGRESS REPORT
Contents
Ethiopia deployed and enhanced a suite of interoperable ICT systems for managing health
system supply chain information in support of the IR agenda.
Background
Vitas is an enterprise level mBrana is a Dagu is an inventory Fanos is a supply
procurement, inventory and mobile inventory management system chain dashboard for
warehouse management management system for health commodities decision making
technology system for vaccines at the facility level
Connected Woreda
Data
EXPANDING FUNCTIONALITY DAGU IS BEING REDESIGNED DEPLOYED mBrana
on Vitas to support Global Standards 1 to be interoperable with Vitas to track distribution of bed-nets in
(GS1) enabled tracking of select program and Fanos malaria risk areas
commodities and online ordering
Governance
Health SystemNational
Supply Health
Chain Information
ICT Infrastructure
Shared Services Institution-Based HIS & Data Sources Population-Based Analytics &
HIS & Data Sources Business Intelligence
eHealth Architecture
LEGEND:
Facility Surveys Analytics and BI
Client Registry (EMPI) (SPA+)
Development not s
Health Insurance /
eHIRIS IDSR / ePHEM CRVS
eHNIIS Under Developmen
External Syste
Agriculture
Lesson Learned
Suppliers
Hospital Clinic Health Posts
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FIVE YEAR PROGRESS REPORT
Contents
Through additional supportive policies, laws, regulations, and guidelines, the MOH enhanced the
enabling environment for health information systems to operate.
Background
HIS governance Data access and
framework sharing directive
Connected Woreda
and governance mentorship
protocol guidelines
Woreda-based health
HMIS indicator sector planning
reference guide guidelines
Data
NHDD standard eHealth Architecture
operating procedures
Governance
CAPACITY BUILDING
Ethiopia launched several capacity building programs to enhance the knowledge and skills of
eHealth Architecture
the health workforce to increase use of health information for decision making.
30 8
across 6 universities participated
informatics programs using the
in an implementation research and
nationally harmonized, Ministry of
capacity building workshop in 2019, to
Education approved bachelor’s level
PARTICIPANTS identify priority learning questions. UNIVERSITIES health informatics curriculum.
Lesson Learned
6 UNIVERSITY
GRANTEES
implemented the Capacity Building & Mentorship
Program to support woredas and health facilities
10 2,000 6PHD
43
MASTERS
Future Priorities
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FIVE YEAR PROGRESS REPORT
LESSONS LEARNED
Contents
The following key lessons were learned through the implementation of the IR agenda
between 2016-2020:
Background
Connected Woreda
Engaging stakeholders at different levels of the health
system increased buy-in for the IR agenda, and
mobilized resources to advance key priorities.
Data
Investing in capacity building programs to enhance
workforce knowledge and skills improved data use
practices.
LESSONS
Governance
Prioritizing data for decision making, maximized the
use of limited human and financial resources.
eHealth Architecture
Integrating the transformation agenda into the
health system improved the overall performance
and health outcomes.
eRIS
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FIVE YEAR PROGRESS REPORT
FUTURE PRIORITIES
Contents
Accomplishments and lessons from the past five years
Background
have helped shape future priorities. Looking forward, the
IR strategic objectives outlined in HTSP 2 are as follows:
Connected Woreda
structure
→→ Establish learning and knowledge management system at national and
subnational levels
→→ Improve confidence on the quality of the data generated through
routine sources by instituting sustained and comprehensive
implementation of data quality assurance techniques at all levels in the
health system
Data
→→ Create awareness and build capacity of health workers on data quality
and information use through continuous training. Mentorship, and
The MOH in
coaching
collaboration with
other health sector →→ Strengthen initiatives to improve the culture of use of data for action at
stakeholders will point of service delivery and administrative levels
Governance
work to coordinate, →→ Create model Woredas and hospitals on improved data quality and
collaborate, invest in information use
and advance these key →→ Advance data analytics approaches and practices from the routine
priorities. descriptive and exploratory analytics to big data, predictive data
modeling, data mining, and machine learning to respond to the
eHealth Architecture
growing demand to generate evidences to solve complex public health
problems
→→ Generation and translation of evidence to policy and action by
triangulating data from routine, survey, surveillance, and research
→→ Advance the eHealth Architecture and interoperability framework
→→ Develop standards and guidelines for selection, development and use
of digital health solutions
eRIS
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FIVE YEAR PROGRESS REPORT
Contents
Background
Connected Woreda
Data
INFORMATION REVOLUTION
FIVE YEAR PROGRESS REPORT
Governance
eHealth Architecture
eRIS
Lesson Learned
Disclaimer:
Future Priorities
This Booklet is made possible by the support of the American people through the United States Agency for International Develop-
ment (USAID). The contents are the sole responsibility of the Ministry of Health of Ethiopia and do not necessarily reflect the views
of USAID or the United States Government.
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