Health information systems in developing countries: Case of African countries

Abstract Background: In developing countries, health information systems (HIS) is experiencing more and more difficult to produce quality data. The lack of reliable health information makes it difficult to develop effective health policies. In order to understand the organization of HIS in African countries, we undertook a literature review.Methods: Our study was conducted using the PubMed and Scopus bibliographic search engines. Our inclusion criteria were: (i) all articles published between 2005 and 2019, (ii) including in their titles the keywords "health", "information", "systems", "system", "africa", "developing countries", "santé", "pays en développement", "Afrique", (iii) written in English and French, (iv) dealing with organizational and technical issues of HIS in African countries.Results: Fourteen articles out of 2492 retrieved were included in the study, of which 13 (92.9%) were qualitative. All of them dealt with issues related to HIS in 12 African countries. All 12 countries (100.0%) had opted for a data warehouse approach to improve their HIS. This approach, supported by the DHIS2 application, had provided them with reliable data. However, 11 of the 12 countries (92.0%) were aligned with donor strategies and lacked a national strategy. Conclusion: This study helped us to understand that the lack of a national health information management strategy will always be a threat to HIS performance in African countries. Ideally, rigorous upstream thinking to strengthen HIS governance should be undertaken by defining and proposing a coherent conceptual framework to analyze and guide the development and integration of digital applications into HIS over the long term.