An EHO operates in hard-to-reach, conflict-affected area providing primary health care services and public health awareness sessions. Until last year, data from service delivery were collected using paper-based systems. Key challenges are seen in data quality, report timeliness, data usage, data fragmentation to gather meaningful insights from data and many more.
The EHO launched a digital transformation initiative in HIS system to promote HIS improvements.
Key activities include:
HIS system assessment – Using various tools to gather information about strengths and areas of improvement in current HIS.
Stakeholder advocacy – Advocacy sessions are conducted to get stakeholder buy-in.
Standardization of forms/formats – Paper forms/formats which were previously diverse depending on various donor and project requirements are standardized. This helped the organization readiness for smoother digital transformation.
The variables included in the forms are chosen by cross-checking minimum donor requirements, selected health system indicators and by reflecting current implementation activities.
Development of Data Management and data flow SOP – to streamline the data flow and data management procedures from data sources, data collection, data collation, data analysis, reporting and data usage.
The SOP includes data flow maps, selected health system indicators, roles and responsibilities, standardized forms/formats, detailed process throughout the data lifecycle including data storage, data privacy and data security.
Capacity building to staff – HIS focal points and related staff are trained on digital skills and HIS software.
Pilot testing – The digitalized HIS was tested for three months followed by review meetings and modifications of the process according to the users’ feedback.
We finally aim to integrate HIS with LMIS & HRIS to foster data usage and data-informed decision-making. Regular reviews and modifications will be needed to enhance the adoption and success of the transformative change.
Key barriers are:
Limited digital literacy – field staff have limited digital capacity and high staff turnover rate leads to loss of trained staff. We introduced training in basic digital skills first, to enhance staff readiness.
Resistance to change – some senior staff are accustomed to legacy paper-based system, and we need to conduct sessions of advocacy to get buy-in.
Digital infrastructure and internet connectivity – basic digital infrastructure and internet connectivity is an important issue in remote and conflict-affected areas.
Sustainable financing for system transformation and system maintenance – long-term financing and technical support remains a challenge.
Data security and privacy issues – for legal, ethical and reputational risks.
Improving HIS and driving digital transformation in an EHO setting can significantly strengthen service delivery, outbreak detection, accountability, and strategic planning. However, success depends not only on technology but also on people, processes, financing, leadership, and governance. Anticipating barriers—such as limited digital skills, infrastructure gaps, sustainability risks, and weak data culture—and addressing them through phased implementation, strong capacity building, and institutional ownership is critical for long-term impact.