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Anti-corruption, transparency, and accountability in health management information systems

Exploring the potential of the District Health Information Software 2 (DHIS2)

Health management information systems have untapped potential to advance anti-corruption in the health sector. However, strong data governance is needed to ensure that data collection, management, and use is ethical and equitable, protects vulnerable populations, and helps promote evidence-based decision making in health. The District Health Information Software 2 (DHIS2), an open-source platform, offers a low-cost tool to strengthen countries’ capacity to collect, manage, and use health data effectively, especially in low-resource settings.

19 September 2022
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Main points

  • Health information management systems (HMIS) are central to the digitalisation of the health sector, especially in low-income settings. HMIS are promoted with the promise of improved efficiency and accountability of resources and services. However, their performance often falls short due to limitations in digital infrastructure, regulations, and operational capacities, making them susceptible to corruption and fraud.
  • The District Health Information Software 2 (DHIS2) was designed to address the many difficulties low- and middle-income countries face in setting up strong HMIS. It has shown potential to foster a better decision-making culture, strengthen transparency, and promote participation. While HMIS such as DHIS2 are still vulnerable to corruption, they can also play a role in preventing and mitigating it.
  • HMIS can help detect fraud and corruption through data analytics, improving public expenditure tracking, and enhancing social accountability and citizen participation. However, shortage of human resources, slow internet connectivity, inadequate technical support, and frequent changes to the software are among the reasons why some countries have struggled to use DHIS2 sustainably.
  • Other obstacles to using HMIS as an anti-corruption tool include the limited pace of digitisation of health data, political and administrative incentives to keep information undisclosed, lack of or weak open data policies, lack of institutional incentives, and shrinking progressive civic space. As the value of data increases, there is growing need for anti-corruption considerations to be integrated into the development and deployment of HMIS.
  • Strong data governance is needed to make HMIS work with integrity. With the proper regulations and policies in place, data governance processes could ensure that data collection, management, and use are ethical and equitable, do not cause harm to vulnerable populations, and help promote better decision making in the health sector. To realise this potential, one must first improve the quality and protection of data, the interoperability among systems, and data sharing between institutions. When all these conditions are met, HMIS have the potential to play a strategic role in anti-corruption efforts in the health sector.

Cite this publication


Sejerøe Hausenkamph, D.; Cepeda Cuadrado, D.; Aarvik, P.; Kirya, M.; (2022) Anti-corruption, transparency, and accountability in health management information systems. Bergen: U4 Anti-Corruption Resource Centre, Chr. Michelsen Institute (U4 Issue 2022:9)

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About the authors

Daniel Sejerøe Hausenkamph is a U4 adviser and public health professional with an interest in anti-corruption, health systems, and digitalisation.

Daniela Cepeda Cuadrado is a U4 anti-corruption adviser, working with donor agencies and multilateral organisations to mainstream anti-corruption efforts in the health sector. Daniela is a policy analyst and researcher with experience working with UN agencies, civil society, and academia in the fields of anti-corruption, health, and sustainable development.

Per Aarvik

Per is an independent writer on applied digital technology for humanitarianism, development, governance and anti-corruption. Social media data, satellite imagery, geographical information systems, and applied artificial intelligence are among his interests. He holds a Master's degree in Democracy Building from the Department of Comparative Politics, University of Bergen, Norway. His thesis focused on the potential of crowdsourced civil society election monitoring as a tool to combat election fraud. His background is from journalism, advertising, and higher design education – as a practitioner, educator, and in managerial roles. In recent years, he has led digital humanitarian work during disasters and in democracy projects.

Monica Kirya is a lawyer and Senior Adviser at the U4 Anti-Corruption Resource Centre. She coordinates the themes on mainstreaming anti-corruption in public service delivery and integrating gender in anti-corruption programming.

Disclaimer


All views in this text are the author(s)’, and may differ from the U4 partner agencies’ policies.

This work is licenced under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International licence (CC BY-NC-ND 4.0)

Keywords


health sector, open government, open source data, accountability, transparency, anti-corruption tools, e-government

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