By Gregory T. Okere
Health Information Systems (HIS) constitute a crucial building block of any country’s health system. Underperforming HIS renders national planning and other management decision-making functions in the health system inefficient.
Nigeria’s National Health Management Information System Policy (NHMIS) introduced in 2006 was increasingly not producing improvements at a pace expected by national health planners. Thus, it called for a review which was triggered by a realisation by leading health planners that the problems that the NHMIS was meant to address were not being achieved. For example, data availability and its use for decision making were poor.
Also, adequate cross collaboration by various contributors to the national HIS was not taking place. Consequently, in 2013, the Federal Ministry of Health (FMOH) instituted a review of the policy to better diagnose its shortcomings and in turn optimise for a more optimally functioning Health Information System. The review gave birth to the Nigeria Health Information System Policy, produced by the Federal Ministry of Health in September, 2014. The new 2014 Nigerian Health Information System (HIS) policy explicitly emphasises data standards that will enable a systematic integration and interoperability of sub-systems in an ICT driven environment. Governance structures for a national HIS architecture must incorporate institutions that contribute data to the system. Political will and funding are critical for the HIS to achieve its goals. Information is a critical resource for the management of the health system. The right to seek, receive and impart information and ideas concerning health issues should be optimally utilized for the promotion of health care, especially for preventive health services.
The FMoH has established its national health management information software (DHIS 2) for routine health information. However, progress in integrating the various versions of the software by disease programmes and partners is slow. The review and harmonization of the data reporting tools was carried out in 2013; but compliance and implementation are still low with reporting rates varying across states. Overall completion rate in the national DHIS 2 database is just over 60%. The Integrated Disease Surveillance and Response (IDSR) system has been successful in detecting outbreaks, but the response capacity is still inadequate.
There are still challenges with the quality of data, with various values for selected indicators. Routine analysis of data with provision of timely feedback is inadequate. As a result, efforts in data use for policy making are deficient. There is often more success in translating the results of surveys to policy. The quality of data is still sub-optimal, and data quality assessments are not regularly and consistently conducted.
There is often large variation in the values of indicators from different data sources. Other challenges related to health information systems include very weak capacity for HIS at sub-state level e.g.,LGA, facilities, untimely production/reporting of routine data, inadequate use of available data for planning and decision making, limited information from the private sector and little or no operational research activities.
Fund allocation by the government to the health information system is inadequate and unable to meet the needs. This has made the government unable to take the lead in directing partners on the landscape, causing more fragmentation. It is time for Nigeria to improve her Health Information Systems and data
Okere writes from Centre for Social Justice, Abuja