Table 3 Summary of current maturity status (2021), identified gaps, desired goals and improvement roadmap (2024) of the Ethiopian HIS

Leadership and governance

 Current maturity level = repeatable (2.47)

 Desired goal (2024) = 4.33

HIS strategic and M&E plans are not comprehensive, up-to-date and endorsed

There is no clear structure, process or specific mechanism to address noncompliance, no law enforcement to ensure adherence to organizational policies and procedures

HIS functions are not uniform across national and subnational levels, and there is no clear career path that serves for all concerned levels

Senior management buy-in, endorsement and enforcement of HIS policies and legislation

Strengthening structures, processes and specific mechanisms for enforcement of policies

Inclusive coordination mechanisms

Management and workforce

 Current maturity level = defined (3.37)

 Desired goal (2024) = 4.67

Informatics and project management concepts are used only in limited settings (and only in a few projects at the national level) for developing, implementing and managing HIS activities and projects

Training and education programmes are not being reviewed on a regular basis by the designated authority to ensure sufficient HIS workforce and to align with the evolving HIS needs and technology

Financial planning is not done in a holistic way for the entire HIS implementation life cycle, and there is a lack of consideration of HIS investments for different healthcare priorities that include sustainability. The resource mobilization plan is not periodically reviewed/revised to accommodate financial requirements needed to support evolving HIS activities and emerging health sector needs at the appropriate level of implementation (national, subnational). At the same time, there is no or very limited private–public partnership for funding of HIS implementation

Mainstreaming the informatics concept—including in academia

Clear health information technology/HIS structure and incentive mechanisms

Tailored competency enhancement training and development programmes for HIS/digital health workforce

Assessing and deploying the HIS/digital health workforce to meet the growing demands

ICT infrastructure

 Current maturity level = repeatable (2.29)

 Desired goal (2024) = 4

Lack of an alternative power source and business continuity plan (BCP) related to power supply; lack of a responsible body that will consistently follow up on power failure issues in most of the health institutions

Poor engagement of the private sector in laying out network infrastructure at public health facilities

Poor coordination between internet service provider and health sector benefactors

Lack of national technical standard/specifications for hardware required for HIS implementation

Lack of regular network and internet connectivity assessment and reporting methods

Lack of standard BCP; the existing business plans are not documented

BCP/policy—particularly to address issues of sustainable power sources, connectivity infrastructure and hardware demands

Speeding up the pace of the HealthNet scale-up and maintenance

Creating strong collaboration with the service providers (particularly with private sector and telecom service providers)

Mobilizing resources to address the increasing hardware demands

Standards and interoperability

 Current score = 2.38

 Desired goal (2024) = 4.11

HIS data standards and guidelines are not endorsed

Data exchange standards are not developed; no exchange standards between commodity management and HIS are established, and such exchange is not integrated into the national HIS plan

Limited implementation and utilization of core registry services

Lack of a unique person identification system

Implementing secure data exchange, messaging and terminology standards

Defining the minimum national clinical data sets based on international standards

Implementing and utilizing core registry services (e.g. Master Facility Registry, Master Patient Index, Provider Index)

Coordinating and working with stakeholders (e.g. Immigration Nationality and Vital Events Agency [INVEA]) on unique person identification system

Data quality and use

 Current score = 2.99

 Desired goal = 4.72

Data reviews and audits are not conducted on a regular basis using automated and manual data quality assessment (DQA) processes to ensure defined levels of quality. Limited use of metrics reported on data quality issues for continuous improvement. DQA plan is not periodically reviewed by the coordinating body to meet the evolving data quality needs

No standard operating procedures for data management integrated with the national HIS plan

The data use strategy is not adapted to meet emerging decision-making needs of programme managers, policy-makers and providers interacting with HIS

Condition-specific order sets and documentation templates are not defined; knowledge-based systems are not implemented in some settings to support decision-making

The data systems/applications in use do not fully ensure reliable and appropriate access to data at all levels for authorized users; changes in reporting requirements cause significant disruptions to data availability

Data use competency development is not tracked by user type and is not level-based

Guidance on the design and use of information products is not up to date, implemented or monitored for compliance by an established governing body

Parameters for the measurement of the impact of data use are not well defined, implemented or monitored. Metrics on reporting and analysis capabilities are not used for continuous improvement

Regular/consistent data quality reviews and audits—and automating the process

Dynamic data use strategy to meet the emerging decision support needs at all levels—including data use competency mechanisms

Developing and managing data repositories and warehouse

Standardizing the design, use and dissemination of information products

Developing and using guidelines on data use impact