Advancing National Health Information Systems Maturity: Lessons Learned on Implementing the Informatics-Savvy Health Organization (Isho) Assessment and Action Planning Framework for Health Leaders in Zambia

Abstract

BackgroundAs the global information revolution continues, countries must navigate the digitization of health data to impact public health practice and improve population health outcomes. Informatics-Savvy Health Organization (ISHO) is an action-planning framework for planning and implementing a country’s health information system (HIS) vision and strategic priorities.ObjectiveThe ISHO assessment identifies strengths and weaknesses in the informatics capacity of HIS across three pillars: 1) vision, policy, and governance; 2) informatics workforce; and 3) effective information systems and informs an action-oriented informatics roadmap. This paper outlines lessons learned from conducting an ISHO assessment in Zambia and its contribution to action planning for HIS strengthening.MethodsThe ISHO assessment process involved participatory methods to self-assess health facilities at the above-site and site levels. Assessment included key informant interviews and focus group discussions using standardized ISHO maturity score questionnaires. From 25 facilities in five provinces, 151 health workers assessed the HIS maturity, developed a roadmap, and provided feedback on the assessment process and tools. Data analysis used Microsoft Excel Plus 2019 Version 1808.ResultsWorking partners' engagement, collaboration, dedicated assessment team, communication, focused HIS system, and use of electronic tools are essential to successful implementation. Zambia ISHO assessment strengths were engagement and collaboration. Assessment process yielded a roadmap of priority actions aligned with Zambia's digital strategic goals, aiming to advance the HIS from a "managed" to a "defined" maturity state.ConclusionIn Zambia, ISHO took a participatory, inclusive approach to assessment, interpretation of strengths, gaps, and road map priorities, fostering local governance of the national HIS. Zambia’s ISHO assessment and planning experience is a model for other countries planning ISHO assessments in their own HIS contexts. If used at repeated intervals, ISHO assessments can help track HIS maturity over time, ensuring informatics roadmaps are responsive to the situation and national priorities.

Keywords: Informatics-Savvy Health Organization, health information systems, maturity models, Health Information systems strengthening, participatory self-assessments, Zambia