This community innovation has been accepted at the 2026 DHIS2 Annual Conference as a digital poster.
A Sustainability Framework for DHIS2 Systems
Many digital health initiatives are successfully deployed but struggle to be sustained over time, specially when donor funding or external technical support declines. Weak governance, limited local technical capacity, and fragmented operational ownership often undermine long-term impact. As countries increasingly adopt DHIS2 as national digital public infrastructure, sustainability must be deliberately embedded as a core design principle rather than treated as a post-implementation concern. To develop and operationalize a practical sustainability framework that institutionalizes DHIS2 and strengthens long-term continuity across governance, financing, workforce, infrastructure, and user adoption domains. The WHO–ITU enabling environment model was adapted and extended with a “supporting environment” layer emphasizing usability, user trust, and operational resilience. Document reviews, stakeholder consultations, and structured assessments were conducted across Sri Lanka’s national DHIS2 implementations, including tracker-based individual-level systems. Key gaps included limited inter-agency coordination, dependence on project-based funding, insufficient digital skills, uneven infrastructure, weak institutionalization, and low user confidence. Interventions included formal governance structures, sustainable financing, organized training programs, responsive user support, comprehensive documentation, standardized system maintenance, and strengthened data quality practices. These actions improved system usability, strengthened institutional ownership, reduced external dependency, and increased data user at national and sub-national levels. Sustainable DHIS2 implementations require institutional, human, and technical investments alongside software deployment. Embedding governance, capacity building, and operational ownership from the outset enables transition from donor-supported projects to resilient, government-led digital public infrastructure. The framework offers a practical and replicable model for other countries seeking long-term sustainability.
Primary Author: Priyanga Senanayaka
Keywords:
DHIS2, sustainability, digital public infrastructure, health information systems, digital health, operational ownership, LMIC health systems, public health informatics