Quality and Utilisation of DHIS2 data for health decision making and advocacy in Kenya: A Qualitative Study

Reliable health information systems (HIS) are critical for effective decision-making in the delivery of Primary Health Care and Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition (PHC/RMNCAH+N) services. In Kenya, the District Health Information Software 2 (DHIS2) platform serves as the primary HIS for tracking health indicators. This study explored perceptions of DHIS2 data quality and use for decision-making among PHC/RMNCAH+N stakeholders across 15 counties in Kenya. A qualitative study design was used, incorporating interviews with 88 key informants who were PHC/RMNCAH+N stakeholders in 15 counties in Kenya, to explore experiences, barriers, and facilitators of DHIS2 data use. Thematic network analysis was employed to identify recurrent themes and generate insights into the utility of DHIS2-generated information. Sociotechnical challenges included limited technical capacity among health staff, inadequate analytical skills, and reliance on a small pool of Health Records Information Officers (HRIOs), which hindered effective use of DHIS2 data. However, positive practices emerged, such as the use of DHIS2 dashboards and user-friendly outputs, which were valued for supporting evidence-based decision-making and advocacy, particularly at higher levels of health management. In some counties, visual displays of data, including scorecards and performance trends, facilitated budget advocacy and community engagement. Contextual barriers, such as disparities in access to data collection tools post-devolution, human resource shortages, and limited integration of private sector data, contributed to incomplete reporting. These challenges underpinned perceived inaccuracy of DHIS2 data, hindering the complete reliance on DHIS2 data for planning and decision making. The study highlights the need for targeted investments to improve DHIS2 data quality and use through stronger stakeholder coordination, enhanced data synthesis skills, and fostering a culture of data ownership both at the county and health facility levels. Addressing these gaps will contribute to improvement in DHIS2 data quality, enhanced ownership and reliance on DHIS2 data by PHC/RMNCAH+N stakeholders for decision making in Kenya.