Introduction

The Health Information System (HIS) which refers to a structured mechanism for the collection, storage, analysis, dissemination, and utilization of health-related data to support decision-making at all levels of the healthcare system. It is one of the anchor pillars of a functional health system. A well-functioning Health Information System (HIS) is essential for monitoring and evaluating health sector progress, tracking disease trends, addressing health inequalities, and ensuring efficient resource allocation. It supports evidence-based decision-making, improves service delivery, and enhances overall health system performance.

Current challenges with HIS in the African Region:

Due to limited investment in national health information systems across most Member States in the WHO African Region, the systems face numerous challenges. As a result, data availability and quality remain insufficient in many Member States, and this hinders their ability to effectively use health data to improve health outcomes and support decision-making. For example, data collection and transmission efforts are often fragmented and heavily reliant on paper-based systems, which are inefficient, error-prone, and slow. The lack of widespread adoption and implementation of common data standards within and between countries makes it difficult to integrate and compare health data across regions and programs. 

Furthermore, many Member States face a shortage of skilled personnel and resources needed to effectively collect, analyze, interpret, and utilize health data. This is further exacerbated by weaknesses in HIS governance and inadequate infrastructure, including limited access to technology and digital platforms for data storage, transmission, and sharing. Many countries prioritize routine health information systems over other important data sources and lack up-to-date HIS strategic plans and policies, hindering progress in improving data availability, quality and use.

Impact of these challenges on the national health information system

In 2021, the World Health Organization (WHO) published the SCORE (Survey, Count of Births and Deaths, Optimization of Routine Health Information Systems, Review of Strategies and Plans, and Enabling Data Use) assessment report, which highlighted significant gaps in the capacity of national health information systems to produce the necessary health data and statistics. (Figure 1). For example, the report revealed that 30 out of the 47 countries in the WHO African Region (64%) lacked the capacity to accurately count and register births and deaths. Additionally, the ability to diagnose the cause of death was nearly absent in most of these countries.

The report also revealed a somewhat high availability of data for reproductive, maternal, and newborn health, as well as health systems data, while the availability of mortality and non-communicable disease data was notably low (Figure 2).

A follow-up assessment is currently being conducted to evaluate whether Member States have made progress in enhancing the capacity of their national health information systems.

The WHO recognizes the crucial role of Health Information Systems (HIS) in strengthening national health systems and improving health outcomes. In the WHO African Region, the WHO HIS program plays a central role in supporting Member States to enhance their national health information systems. Broadly, WHO’s HIS work in the African Region focuses on improving systems and capacities for a) governance of national health information systems; b) data generation, storage, and transmission; c) health data analysis and synthesis; and d) the communication and use of health data for decision-making. Since these four key areas of focus are inextricably linked, WHO supports Member States in ensuring their full functionality to produce high-quality, timely, and reliable data.

WHO's focus on HIS governance stems from the understanding that a robust governance system for HIS is essential for the long-term sustainability of national health information systems. The WHO HIS Program therefore supports countries to develop and implement HIS strategic plans and policies, along with their operational plans, monitoring and evaluation frameworks and costing. WHO also supports countries to implement common data standards (including the reference classifications in the WHO Family of International Classifications (WHO-FIC)), strengthen the HIS workforce, harmonize partners, and align partner resources with country priorities for HIS, and establish a coordinated and country-led mechanism for collaboration that ensures the full participation of all actors. 

WHO's support to the Member States for data generation, storage, and transmission focuses on utilizing various data sources and harnessing innovations in digital technology to improve the accuracy and speed of data collection and reporting as well as data safety and security. In this regard, WHO assists Member States in generating and using data from routine health information systems (data collected from patients receiving care in health facilities), civil registration and vital statistics (particularly data on births, deaths, and causes of death), population-level surveys, integrated disease surveillance programs, health facility assessment surveys, and administrative records related to human resources, health financing, medicines, and infrastructure. Each of these data sources is essential, as it offers a distinct dataset for a specific health measurement. 

Similarly, WHO prioritizes providing support to countries in data analysis and synthesis, interpreting results, generating information and evidence, and facilitating the use of evidence in decision-making. As a result, WHO helps Member States adopt various mechanisms for generating evidence and promoting its use, including institutionalizing data analysis knowledge and skills, utilizing open-access platforms for information dissemination, and engaging key stakeholders through policy dialogue events.