System Design Barriers to HIS Data Use in Low and Middle-income Countries: A Literature Review


The ability of low and middle-income countries (LMICs) to monitor and measure their progress toward sustainable development health goals is dependent on design, implementation and use of a robust national health information system (HIS). Improved health system performance is directly linked with the use and quality of routine data in a country’s HIS. However, studies have reported several types of barriers that hamper data quality and data use in a national health system of LMICs. To better understand these barriers, we have conducted a systematic review of the scientific literature. The objective of this literature review was to synthesize and summarize the system design-related research and implementation gaps affecting data quality and data use in decision-making. The review made an effort to answer two key questions: (i) what does the published literature tell us about HIS design barriers to data use in LMICs? (ii) What, if any, are the main research and implementation gaps?

The review methodology included a two-pronged search strategy. Under the first strategy, electronic searches were performed in the PubMed, Web of Science, Embase, and Global Health scientific databases. After removing duplicates and papers with no abstract, a total of 307 abstracts (Appendix I) were selected for detailed review. The second search strategy involved consultation with an expert from the MEASURE Evaluation project who has extensive experience on routine data use issues in LMICs. Based on the consultation with the expert and a review of abstracts from the electronic search, a total of 18 papers were selected for full-paper review (Appendix II).

This report provides a comprehensive bibliography of the references identified through the literature review. Future work will include an analysis of these findings and a discussion regarding any implications to HIS data use and design

University of North Carolina at Chapel Hill School of Information and Library Science Technical Report 2016-01