How Can Routine Health Information Systems Improve Health Systems Functioning in Low- and Middle-Income Countries? Assessing the Evidence Base

PURPOSE: Health system performance depends on production and use of quality health data and information. Routine health information systems (RHIS) are defined as systems that provide information at regular intervals of a year or less to meet predictable information needs. These include paper-based or electronic health records and facility- and district-level management information systems. RHIS are receiving increasing attention as an essential component of efficient, country-owned, integrated national systems. To guide investment decisions on RHIS, evidence is needed on which types of RHIS interventions work and which do not. DESIGN/METHODOLOGY/APPROACH: This chapter is a systematic review of the literature on the evaluation of RHIS interventions in low- and middle-income countries, starting from the premise that investments in RHIS could be better understood and so produce greater benefits than they currently do. FINDINGS: We describe the conceptual literature on the determinants of RHIS performance and its role in improving health systems functioning, discuss the evidence base on the effectiveness of strategies to improve RHIS performance, provide an overview of RHIS evaluation challenges, and make suggestions to improve the evidence base. ORIGINALITY/VALUE: The goal is to help ensure that (a) RHIS interventions are appropriately designed and implemented to improve health systems functioning and (b) resulting RHIS information is used more effectively.