The state of community health information systems in West and Central Africa
Background The proliferation of siloed community-based reporting systems in developing countries has been observed to be inadequate in supplying communi-ty stakeholders and governments with the information they desire. There is a clear need for community-based reporting systems to feed into a single centralized, government owned information system. Here we assess the status of centralized, government owned community health information system (CHIS) in 17 West and Central African Countries.
Methods A comprehensive, 58 questions, CHIS macro self-assessment was devel-oped. The assessment requires stakeholder engagement from all levels including community health workers (CHW) and community stakeholders. The assessment was conducted in 17 West and Central African Countries.
Results, both qualitative and quantitative, were collected during direct observations of three assessments and during a one-week CHIS workshop in March 2018 where all countries were represented.Results The assessment approach proved effective at gathering honest and valu-able information about the state of the CHIS across all 17 countries as well as bringing in all range of stakeholders. The CHIS assessment has shown that the need and desire is high among countries to have a CHIS that harmonizes the frag-mented landscape of CHW reporting tools and populates data into the national health management information system (HMIS).
Conclusions Countries face significant budget limitations to the development, de-ploy, and sustain a CHIS. Additional major challenges are CHIS governance, ad-herence to SOPs and system design. System administrators reported little prior di-rect engagement with CHW’s and community stakeholders. Likewise, data feedback to CHW’s and stakeholders is largely lacking. Infrastructure, access to cell phones, reliable electrical power supply, and mobile network, clearly continue to be a prin-cipal limitation to community information systems. Complex and expensive in-teroperability layers between mHealth apps and the CHIS will be unsustainable to Ministries given their financial constraints.