Understanding how community level health data and information are utilized to strengthen health systems and improve decision making in Nigeria

Abstract

Strengthening Health Management Information Systems (HMIS) at all levels of the health system, including the community level is vital for optimizing evidence-based decision-making. However, there is limited knowledge on how data and information on health are collected, stored, and used at the community level or linked to higher levels, such as the primary healthcare level. This study assessed the overall data and information system practices within communities. The study was conducted in Kano, Anambra, and Akwa Ibom states, Nigeria. Two local government areas (LGAs) were purposively selected from each state to represent urban and rural settings. Data was collected through 62 in-depth interviews and was analyzed thematically, guided by the Health Information System Strengthening Model. Formal healthcare providers were central to data collection and transmission at the community level but faced challenges due to the absence of dedicated data managers. Informal healthcare providers contributed minimally to data collection due to limited training and their perceived irrelevance. Community-based groups supported data collection and mobilization but lacked formal recognition and resources. Despite limited data transmission to higher levels, it was hardly used for decision-making. Overall, the constraining factors to collection and use of data on health were infrastructure challenges, fragmented data systems, poor integration into national platforms, and limited feedback from higher-level stakeholders. There should be investments in the collection and use of health data that are generated at the community level, especially those collected from outside primary healthcare facilities to enhance the effectiveness of HMIS for evidence-based decision making.