Interventions to improve district-level routine health data in low-income and middle-income countries: a systematic review

Background Routine health information system(s) (RHIS) facilitate the collection of data at all levels system allowing estimates disease prevalence, treatment and preventive intervention coverage, risk factors to guide control strategies. This core pillar remains underdeveloped in many low-income middle-income countries. Efforts improve RHIS quality timeliness were launched over 10 years ago. Methods A systematic review was performed across 12 databases literature search engines for both peer-reviewed articles grey reports on interventions. Studies analysed three stages: (1) categorisation components processes; (2) comparison component effectiveness (3) whether post-intervention outcome improved above WHO integrated surveillance response framework standard 80% or above. Results 5294 references screened, resulting 56 studies. Three key performance determinants—technical, organisational behavioural—were proposed as critical strengthening. Seventy-seven per cent [77%] studies identified addressed determinants. The most frequently implemented ‘providing training’ ‘using an electronic management systems’. Ninety-three [93%] pre–post controlled trial showed improvements one more outputs, but after applying a threshold >80% post-intervention, this number reduced 68%. There observed benefit multi-component interventions that either conducted training improvement multiple processes determinants RHIS. Conclusion Holistic address should be continuously practised strengthening with clearly defined pragmatic outcomes are required future These accompanied by qualitative cost analyses understand which investments needed sustain high-quality