This community innovation has been accepted at the 2025 DHIS2 Annual Conference
Health Facility Level Digitalization
Background Digitalization of health information systems, such as DHIS2, is essential for data-driven decision-making in healthcare. However, adoption remains slow and uneven, particularly at the facility level. In Tanzania, DHIS2 HMIS data warehouse for reporting routine health service data was implemented in 2014, yet many facilities still rely on higher-level units for data reporting and decision-making. For example, in Dodoma and Bahi, 53 and 47 facilities, respectively, initially were not enough competent to perform self-data entry or analysis on DHIS2, highlighting significant adoption gaps. Challenges stem from center-periphery disparities, where facility-level digitalization is hindered by limited resources, minor roles, and top-down interactions. Methods Through a DoE project by HISP Tanzania and the University of Oslo, action research was conducted in Bahi and Dodoma. The study aimed to address digitalization gaps by empowering facilities. Data collection included interviews, observations, and workshops. Interventions included training on DHIS2 self-data entry, analysis, and customized dashboards tailored to facility needs. Results The interventions led to significant improvements, with all public facilities in Dodoma and Bahi now capable of self-reporting on DHIS2. The center-periphery framework revealed disparities in resource distribution, roles, and interactions. Facility digitalization is hindered by limited resources, lack of decision-making power, and top-down approaches, emphasizing the need for balanced engagement. Conclusion This study highlights the differential adoption of digitalization across hierarchical levels and the challenges of center-periphery imbalances. It offers actionable strategies, such as training and tailored tools, to accelerate facility-level digitalization, bridging the gap and strengthening healthcare systems.
Primary Author: Merina Marcellino
Keywords:
Digitalization, Health Information Systems (HIS), DHIS2, Tanzania, facility-level adoption, data-driven decision-making, center-periphery disparities, resource allocation, capacity-building, action research, self-reporting, customized dashboards, healthcare planning, data collection, top-down interactions, bottom-up engagement, training, healthcare systems, digital health transformation.
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