The health information system (HIS) makes up one of the pillars of the health system (HS) whose responsibility is the generation of data to facilitate the functioning of the other HS components: service delivery, health workforce, access to essential medicines, financing, and leadership (1). A good HIS ensures the availability of good quality data and its use to support the informed decision making process (2–4). This highlights the importance of both the production of quality data and the use of the data for decision making at every level of the health pyramid. However, RHIS of low-income countries has difficulties functioning at the globally expected standard, with respect to good data management and interpretation skills (5). These systems are characterised by either the production and use of poor-quality data or the non-use of good quality data by decision makers, which negatively influences the health service delivery and uptake (3, 5). Nevertheless, routine health information (RHI) availability permits a regular evaluation of the public health interventions both at the sub-national and national levels as well as an evaluation of HS strengthening interventions (6–7) even though this has not been a regularly practice in so many settings.
Since data generation is done at the level of the health facility, emphasis should be placed on the staff at this level through implicating them in the elaboration of RHI tools, planning, implementation and evaluation of RHIS interventions. In Benin, exhaustiveness of reporting increased from 16–89%, and the proportion of reports with sufficient data quality increased from 18.8–4.8% after implicating staff in the conception and elaboration of data collection tools (8). However, RHIS staff englobes a wider range of personnel, including clinical, administrative, support staff as well as other users from different sectors whose roles cannot be overlooked (9).
State-related factors that would affect the functioning of a RHIS include governance, planning, availability of material, financial and human resources, supportive supervision, information dissemination, and promotion of culture of information use (10). The development of indicators; elaboration of tools for data collection; and preparing procedural guides, mastery of hardware and software equipment for data processing and analysis constitute the technical factors (10). Behavioural determinants like HIS users’ demand, self-confidence, self-motivation, and competence to perform HIS tasks, have also greatly influenced on the HIS performance and which require appropriate consideration and management accordingly (10–12). Most or if not, all of these factors were also cited in People’s Region in Ethiopia, where roughly half of the HF accurately reported antenatal visits, post-natal visits, fully immunised children, total malaria cases, confirmed malaria cases, and sever acute malnutrition cases data (13).
Several African countries have sort to harmonise and facilitate the HI collection through the putting into place of an open source software platform. The most commonly solicited is the District Health Information System (DHIS) version 2, which has been shown to improve on the completeness of reporting (14).
Following the standardisation of data collection by the Cameroon Ministry of Public Health (MOPH) through the putting into place of DHIS 2 (15), there is a tendency of improved HI management. This is due to the fact that both public and private HFs have the obligation to report through DHIS 2, thus improving on completeness and timeliness of reporting. Though not yet evaluated, this tool facilitates not just complete and timely reporting, but also facilitates feedback. Nevertheless, lack of management support, lack of skills by users, lack of computers, poor internet and electricity coverage have been identified as potential challenges related with the efficient use of DHIS 2 (14).
Cameroon Health Sector Strategy (HSS) for the health information system (HIS) states: “By 2027, ensure the development of health research and the availability of quality health information system for evidence-based decision-making at all levels of the health pyramid” (15). HSS aims at attaining 90% of health facilities having a well organised system of data management (15). To reduce the hindrances in meeting the HSS objectives and other health-related Sustainable Development Goals (SDGs) target for HIS, it is not only important to ensure the availability of RHI but also its performance through quality health information and its evaluation. Following Tamfon et al. (16) who determine the inadequate functionality of the RHIS of the HFs in Yaoundé, this study aims at identifying associated factors to poor performance of the RHIS in Yaoundé; so as to guide targeted RHIS strengthening and enable the orientation of the limited strengthening resources.