A Quantitative Capability and Needs Assessment Across 12 African Health and Demographic Surveillance Systems under the INSPIRE Initiative

BackgroundHealth and demographic surveillance systems (HDSS) provide essential longitudinal population data in contexts where civil registration and administrative systems are incomplete. Despite their importance, HDSS data systems vary substantially in infrastructure, governance, and analytic capacity. As part of the Implementation Network for Sharing Population Information from Research Entities (INSPIRE) 2.0 program, we conducted a comprehensive capability and needs assessment across 12 African HDSS in 10 countries to document current data ecosystems, capability maturity, and training needs. MethodsA quantitative needs assessment was conducted between April - June, 2025 using a REDCap-based survey completed by HDSS technical staff, including site leads, data managers, and data analysts. The survey captured standardized metrics across four data management domains, namely, site characteristics, data ecosystem, capability maturity, and workforce training needs. Data were analyzed descriptively in R, with cross-site comparisons used to identify patterns, gaps, and priority areas for investment. ResultsAcross the 12 sites, the assessment revealed strong adoption of electronic data collection tools but persistent reliance on hybrid paper-digital workflows at one-third of sites. Metadata standards, interoperability mechanisms, automation pipelines, and cloud infrastructures were inconsistently implemented. Capability maturity varied widely across data management, governance, platforms, and user culture. Training needs were substantial across all seven domains, especially in research and methodology, technology and infrastructure, and data analytics. The analysis identified systemic gaps in coding capacity, metadata standards, governance monitoring, ETL automation, cloud readiness, and advanced analytics. ConclusionsHDSS platforms in Africa maintain robust operations but require significant capacity strengthening in governance, automation, metadata management, and analytics to achieve higher data capability maturity. Workforce development must be prioritized through structured, bilingual training programs aligned with INSPIRE 2.0. These findings provide a critical baseline for designing targeted interventions and guiding harmonization of HDSS data systems in Africa.