Assessing the functionality of the routine health information system in health facilities of Yaoundé, Cameroon: a cross-sectional study

Abstract Background Functional Routine Health Information Systems (RHIS) are essential for evidence-based decision-making, performance monitoring, and attaining Universal Health Coverage and Sustainable Development Goals. Despite substantial investment in health information infrastructure in Cameroon, gaps in RHIS functionality persist. This study assessed the functionality of the RHIS in health facilities (HFs) of Yaoundé, Cameroon. Methods A cross-sectional study was conducted from November 2024 to July 2025 in 88 HFs selected from six health districts. The MEASURE Evaluation RHIS rapid assessment tool was used to evaluate performance of RHIS domains and subdomains. RHIS functionality was quantified as a percentage score at the subdomain, domain, and global levels, and dichotomised as good (≥ 60%) or poor (< 60%). Pearson Chi-square and Fisher's Exact tests (when necessary) were used to establish associations between categorical variables. A p-value < 0.05 was considered statistically significant. Results RHIS domains functioned at 46% (Data Collection and Processing), 44% (Data Analysis, Dissemination and Use), 39% (Data and Decision Support Needs), and 29% (Management and Governance). Subdomain scores ranged from 20% (Human Resources) to 54% (Data Demand and Use). Of the surveyed HFs, 65.9% demonstrated good functionality and varied significantly across health District (p < 0.001) with Efoulan (100%), Nkolndongo (9‌1.3%), and Biyem-Assi (84.2%) showing good functionality, while N‌kolbi⁠sso⁠n (50.0%), Djoungolo‌ (22‍.7%), and Cité Verte (20.0%⁠) recording poor scores. Conclusion RHIS functionality in Yaoundé is constrained by weaknesses in governance, and human resources. Strengthening these organisational determinants is essential for sustainable system performance.