Managers’ perspectives on using routine health information systems for effective child healthcare programmes in Namibia

Abstract

Background: Routine health information systems (RHISs) are critical for evidence-based child health programme management, yet limited research exists on healthcare managers’ experiences with RHIS implementation in resource-constrained settings.
Objectives: This study explored healthcare managers’ perspectives on using RHISs to enhance child healthcare programme effectiveness in Namibia.
Method: A qualitative case study design employed semi-structured interviews with 24 healthcare managers. Purposive sampling ensured representation across management hierarchies, and Braun and Clarke’s six-stage thematic analysis guided data analysis.
Results: Three themes emerged: RHIS implementation challenges, capacity and governance gaps, and pathways for sustainable development. Namibia’s hybrid paper-digital system creates inefficiencies, with poor connectivity and technical glitches undermining data reliability. While managers demonstrated conceptual understanding of RHIS importance, significant disparities existed in practical data management skills and DHIS2 access. Despite data availability, strategic planning remained constrained by political influences, absent policy frameworks, and fragmented parallel systems lacking interoperability. Managers primarily used routine data for operational decisions rather than strategic planning.
Conclusion: Effective RHIS implementation requires simultaneously addressing technical infrastructure, human capacity, and institutional governance. Priority interventions should target system reliability, practical data competencies, and legislative frameworks mandating evidence-based planning.
Contribution: This study provides a new understanding of the complex technical, capacity and governance factors that influence the effectiveness of RHISs in resource-constrained settings.