The Nigerian health information system policy review of 2014 : the need, content, expectations and progress.

BACKGROUND: Nigeria's national health information system (HIS) data sources are grouped into institutional and population based data that traverse many government institutions. Communication and collaboration between these institutions are limited, fraught with fragmentation and challenges national HIS functionality. OBJECTIVES: The objective of this paper was to share insights from and the implications of a recent review of Nigeria's HIS policy in 2014 that resulted in its substantial revision. We also highlight some subsequent enactments. REVIEW PROCESS AND OUTCOMES: In 2013, Nigeria's Federal Ministry of Health launched an inter-ministerial and multi-departmental review of the National Health Management Information System policy of 2006. The review was guided by World Health Organization's 'Framework and Standards for Country Health Information Systems'. The key finding was a lack of governance mechanisms in the execution of the policy, including an absent data management governance process. The review also found a multiplicity of duplicative, parallel reporting tools and platforms. CONCLUSION: Recommendations for HIS Policy revisions were proposed to and implemented by the Federal Government of Nigeria. The revised HIS policy now provides for a strong framework for the leadership and governance of the HIS with early results.

Data for decision making: using a dashboard to strengthen routine immunisation in Nigeria.

Availability of reliable data has for a long time been a challenge for health programmes in Nigeria. Routine immunisation (RI) data have always been characterised by conflicting coverage figures for the same vaccine across different routine data reporting platforms. Following the adoption of District Health Information System version 2 (DHIS2) as a national electronic data management platform, the DHIS2 RI Dashboard Project was initiated to address the absence of some RI-specific indicators on DHIS2. The project was also intended to improve visibility and monitoring of RI indicators as well as strengthen the broader national health management information system by promoting the use of routine data for decision making at all governance levels. This paper documents the process, challenges and lessons learnt in implementing the project in Nigeria. A multistakeholder technical working group developed an implementation framework with clear preimplementation; implementation and postimplementation activities. Beginning with a pilot in Kano state in 2014, the project has been scaled up countrywide. Nearly 34 000 health workers at all administrative levels were trained on RI data tools and DHIS2 use. The project contributed to the improvement in completeness of reports on DHIS2 from 53 % in first quarter 2014 to 81 % in second quarter 2017. The project faced challenges relating to primary healthcare governance structures at the subnational level, infrastructure and human resource capacity. Our experience highlights the need for early and sustained advocacy to stakeholders in a decentralised health system to promote ownership and sustainability of a centrally coordinated systems strengthening initiative.

Building Strong Health Supply Chain Systems: The Visibility and Analytics Network approach to improving the Nigeria Immunization Supply Chain.

BACKGROUND:  Health supply chain managers are unable to effectively monitor the performance of the Immunization supply chain in Nigeria. As a result, they are unable to make effective, data-driven decisions. This results in poor vaccine availability at some service delivery points. A lack of reliable data for evidence-based decision making is a significant contributor to this challenge. METHOD: The Visibility and Analytics Network ("VAN") principles were introduced to enable end-to-end visibility in the immunization supply chain and logistics (ISCL) system and make more accurate data available to health supply chain managers. RESULTS:  The application of the VAN principles has led to improved data collection, real-time stock visibility, enhanced data analytics framework. This enhanced visibility has promoted a culture of accountability and data-driven decision-making previously unattainable. Health supply chain managers are now equipped with better skills and tools to promote effective operation of the immunization supply chain. CONCLUSION:  The introduction of VAN principles has been an effective approach to improving data visibility and creating incremental improvements in the ISCL in Nigeria.