Using Routine Health Information Data for Research in Low- and Middle-Income Countries: A Systematic Review

Background: Routine health information systems (RHISs) support resource allocation and management decisions at all levels of the health system, as well as strategy development and policy-making in many low- and middle-income countries (LMICs). Although RHIS data represent a rich source of information, such data are currently underused for research purposes, largely due to concerns over data quality. Given that substantial investments have been made in strengthening RHISs in LMICs in recent years and the growing demand for more real-time data from researchers, this systematic review builds upon the existing literature to summarize the extent to which RHIS data have been used in peer-reviewed research publications. Methods: Using terms ‘routine health information system’, ‘health information system’, or ‘health management information system’ and a list of LMICs, four electronic peer-review literature databases were searched from inception to February 20 2019: PubMed, Scopus, EMBASE, and EconLit. Articles were assessed based on pre-determined eligibility criteria. Identified characteristics were extracted using a piloted data extraction form. Results: We identified 132 studies that met our inclusion criteria in 37 different countries. Overall, the majority of the studies identified were from Sub-Saharan African countries and were published in the last five years. Malaria and maternal health were the most commonly studied health conditions, although a number of other health conditions and health services were also explored. Conclusions: Our study identified an increasing use of RHIS data in research with many studies applying rigorous study designs and analytic methods to advance program evaluation, monitoring and assessment of services, and epidemiology in LMICs. RHIS data represent an underused source of data and should be further embraced by the research community to gain insights from LMIC health systems.