Challenges and Opportunities in Utilizing Secondary Data for Health Research in Somalia: A Focus on Health Management Information Systems (HMIS)

Abstract

Somalia’s health system has been significantly weakened by decades of conflict, resulting in some of the world’s lowest health benchmarks and leaving women and children especially vulnerable. Despite substantial challenges, the introduction of DHIS2 in 2017 represented a pivotal step toward strengthening health data management, supported by Oslo University and the Global Fund. However, limited coverage, fragmented data reporting across sectors, and insufficient data from private healthcare providers persist. The challenges are further compounded by the Federal Ministry of Health’s failure to publish annual health statistics regularly reports or conduct equity analyses, despite DHIS2’s capability to disaggregate data by gender and geography. Additionally, the absence of a centralized health journal, repository, or database under the Ministry of Health hampers the systematic storage and access to data and published studies, limiting the availability of reliable resources for research and evidence-based policymaking. Despite these limitations having hindered the secondary use of data, Somalia now has two national frameworks—EPHS (2020) and HSSP III (2022-2026)—that offer a unified strategic approach to enhancing the Health Management Information System (HMIS). Both frameworks prioritize the standardization and integration of data, as well as the effective reuse of routine health information for research, monitoring, evaluation, and policymaking. Transitioning to a learning health system is critical for addressing Somalia’s health challenges. By expanding DHIS2 to include detailed data on individual health cases and private healthcare facilities, enhancing capacity building, and creating a centralized health data repository under the Somali National Institute of Health, Somalia can improve the quality, accessibility, and utilization of health data. This, in turn, would lead to more effective monitoring, resource allocation, and responsive health interventions that align with Learning Health System (LHS) goals and promote health equity. Opportunities in harnessing digital innovations, piloting data integration within urban private hospitals, and establishing decentralized data hubs that enable local health authorities to utilize data more effectively. Enhancing interoperability between DHIS2 and systems for disease surveillance or logistics will be crucial for creating a cohesive health information ecosystem. The paper underscores the importance of investing in health information systems and collaborating internationally to build a robust health infrastructure capable of advancing public health and fostering sustainable improvements in Somalia’s healthcare landscape.