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Beyond Training: Systems Framework for Sustainable Health Informatics Investment in Africa
Eric Nzirakaindi Ikoona1, Lucy Namulemo2,3, Ronald Kaluya2
1National Public Health Agency, 42A Main Motor Road, Wilberforce, Freetown, Western Area, 232, Sierra Leone, 232 076680085.
JMIR Public Health and Surveillance
|June 1, 2026
Summary
Sustainable health information systems (HISs) in Africa require more than just training health informaticians. Investment must also strengthen institutions, governance, and infrastructure for lasting health data capacity.
Area of Science:
- Health Informatics
- Public Health Systems
- Digital Health Infrastructure
Background:
- Africa has invested in national health information systems (HISs) with platforms and digital infrastructure.
- Health informatics capacity remains fragile due to workforce attrition, disrepairing platforms, and disconnected data systems.
- A misaligned investment logic concentrates resources on training informaticians, neglecting the institutional and infrastructural support needed for their effectiveness.
Purpose of the Study:
- To argue for a holistic investment approach to sustainable health informatics capacity in Africa.
- To propose a framework for building a functioning HIS ecosystem based on four interdependent pillars.
- To highlight the critical role of institutional, governance, and infrastructure support alongside workforce development.
Main Methods:
- A viewpoint grounded in direct implementation experience across sub-Saharan Africa.
- Analysis informed by published literature on health information systems and informatics.
- Development of a four-pillar framework for sustainable health informatics capacity.
Main Results:
- Sustainable health informatics capacity depends on an interdependent ecosystem comprising workforce development, institutional strengthening, governance and data standards, and interoperable infrastructure.
- Weakness in any single pillar actively undermines the others.
- The proposed framework uniquely emphasizes the interdependence of pillars and treats the enabling environment as a core investment requirement.
Conclusions:
- Investment in health informatics must address the entire HIS ecosystem, not just training.
- Strengthening all four pillars—workforce, institutions, governance, and infrastructure—is essential for durable health information systems.
- Policy recommendations and a readiness checklist are provided for stakeholders to foster sustainable health informatics capacity.
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