Utilization of district health information system 2 among health professionals in resource-limited settings: A systematic review

Background District Health Information system 2 (DHIS2) has become a core digital platform for routine health information management. Although health systems use DHIS2 to strengthen reporting and support evidence-informed decision-making, the extent of its utilization varies across settings. This systematic review synthesized evidence on DHIS2 utilization and its determinants among health professionals in resource-limited settings. Methods We conducted a systematic review in accordance with the PRISMA 2020 guidelines. We searched PubMed, Scopus, Web of Science, African Journals Online (AJOL), Google Scholar, institutional repositories, and government databases. Two reviewers independently screened articles and extracted data, and any differences were resolved through discussion with a third reviewer. Methodological quality was assessed using the Newcastle–Ottawa Scale, and a narrative synthesis was used to summarize study characteristics, patterns of system use, and determinants of DHIS2 utilization. Results Sixteen studies involving 5,195 Health professionals were included. DHIS2 utilization varied widely, ranging from routine data entry and reporting to advanced applications such as planning, monitoring, and decision-making. Higher utilization was associated with supportive leadership, regular supervision, clearly defined roles, functional monitoring teams, digital skills, confidence, and perceived usefulness. Common barriers included inadequate infrastructure, unreliable electricity supply, and limited internet connectivity. Conclusion DHIS2 utilization is shaped by interactions among health professionals’ competencies, organizational support, and technological infrastructure. Addressing infrastructure gaps and strengthening capacity development may improve effective use of routine health information systems. Future research should use standardized measures to assess DHIS2 utilization and its impact on health system performance. PROSPERO registration: CRD4420251273313.