"Without good information, there can be no good policy or planning." -- Professor Eyitayo Lambo, Former Minister of Health (2003-2007)
Strengthening health systems is critical for achieving universal health coverage in Nigeria and globally. However, reliable information on the people, institutions, and resources that make up the system is essential to achieving this goal.
The primary goal of a Health Information Management System (HIMS) is to ensure that accurate and complete patient information critical for health system policy development and implementation, health service delivery, human resources development and others, is available to individuals, healthcare providers and policymakers, when and where it is needed.
A HIMS enables the collection, analysis, and dissemination of health data. It provides decision-makers with evidence-based information, allowing them to develop policies that improve the quality and accessibility of healthcare services, leading to better health outcomes for all.
One of the six building blocks of the World Health Organization's (WHO) Health Systems Strengthening framework is Health Information Systems (HIS). It refers to a system designed to manage health data and is a broader concept encompassing all healthcare information management aspects, including HIMS. When the Health Information Management System is ineffective, policymakers, health professionals, and researchers are deprived of critical information necessary to make evidence-based decisions and strengthen a country's health system.
Overview: Nigeria's Health Information System (HIS) Policy
In 2013, the Federal Ministry of Health (FMoH) reviewed the National Health Information Management System (NHIMS) policy of 2006. The revised Health Information System Policy aims to strengthen the country's health information system by improving data quality, timeliness, and use for decision-making at all healthcare system levels.
The objectives of the policy were to,
The HIS Policy also made provisions for at least 2% of the annual health and health-related institutions budget at all levels, to be allocated for HIS and at least 1% of the annual health and health-related institutions budget at all levels to be provided for data management governance as part of the efforts to strengthen HIS and improve health outcomes for all Nigerians.
Achieving an effective and efficient National HIMS in Nigeria
Nigeria has made modest progress towards implementing an effective Health Information Management System. The adoption of the District Health Information System 2 (DHIS2) platform in 2016 and the implementation of the Nigeria Health Information System Strategic Plan (NHISSP) 2014 -2018 were necessary steps towards establishing systems that facilitate the collection, analysis, and distribution of health data across all levels of the healthcare system. The DHIS2 platform has played a critical role in improving healthcare outcomes, facilitating the tracking of disease trends and planning and implementing effective health interventions.
However, more work is needed to ensure that Nigeria's health information systems are fully optimised and utilised to improve health outcomes for all Nigerians.
Several issues have been attributed to the subpar performance of Nigeria's Health Information System. According to a study conducted to understand the status of HIMS in Nigeria, common challenges of the HIMS include,
Most of these issues are at the national level, and until these issues are re-addressed, full implementation remains a mirage even at the subnational and national levels.
Towards an effective and efficient National Health Information Management System in Nigeria
To sustain the current gains and progress in the implementation of an efficient Health Information Management System, several steps can be taken to ensure that Nigeria's HIS is fully optimised and utilised to improve health outcomes.
These steps include:
- increase funding to upgrade technology, ensure adequate internet connectivity across the country, and address the issue of inadequate human resource for health.
- strengthen the capacity of health workers by focusing on improving ICT skills, proper data collection methods, data analysis, and data use at all health system levels. Healthcare workers should also be trained in the use of the HIMS and its various components, including disease surveillance, patient record management, and health planning.
- improve data quality through regular training and supervision for data collectors, use of standardised data collection tools, and establishment of data quality assurance mechanisms.
- strengthen partnerships and collaborations between different stakeholders, including the government, healthcare providers, and patients, to ensure that the HIMS effectively meets the population's health needs.
- maintain efficient use of technology and investment in ICT infrastructure and devices, improve internet access, and promote the use of mobile technologies for data collection and analysis.
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Moreover, the current Health Information System (HIS) Policy, signed in 2014, is overdue for revision. As such, the Federal Ministry of Health and other relevant stakeholders should prioritise a review of the existing policy, taking into account changes in policy context, legal and regulatory requirements, emerging.
