African countries have made significant progress in collecting information and monitoring their health systems, but none has achieved sustainable capacity to translate that evidence into policies and action.
According to a new World Health Organisation (WHO) report exposes major weakness in Africa's health information systems, where countries are increasingly able to generate and review data but continue to struggle to use it to guide investments, improve healthcare services and respond to the health needs of their populations.
Dubbed ‘Health Data Systems and Capacity in Africa’, the report based on the global SCORE 2025 assessment was presented during the first Africa Health Data Forum, which opened in Nairobi on Today.
While making the presentations, WHO Regional Director for Africa Dr Mohamed Yakub Janabi said the 2024 assessment gave the region an overall health information system maturity score of 59 out of 100.
“That reflects real progress in collecting and managing health data, but the same assessment points to weakness in financing, governance, digital systems, and analytical capacities,” Janabi said.
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The assessment, covering 52 African countries, found that 49 an equivalent of 94 per cent, had attained well-developed or sustainable capacity to review progress and performance in their health systems.
However, none had reached sustainable capacity in the effective use of data and evidence for policy and action.
Only 14 countries, representing 27 per cent, had well-developed capacity in this area, while 31 (60 per cent) had moderate capacity and seven (13 per cent) had limited capacity.
Janabi said the challenge extended beyond collecting information to ensuring that countries could interpret and apply it.
“But access to data is only half the task. Interpretation is the most important,” he said.
The gap raises questions about the value of investments in health information systems if the information generated does not translate into decisions that improve service delivery.
The report also highlights persistent weaknesses in recording births, deaths and their causes, an essential component of determining population health needs and tracking preventable mortality.
During the presentation, Janabi challenged countries to address the number of people who still lack death certificates.
“Do we really need to have citizens who don't have death certificates?” he posed, describing the issue as “homework for us”.
Despite improvements since the previous assessment, 34 of the 52 countries, or 65 per cent had not attained well-developed capacity to count births, deaths and causes of death.
Only six countries had achieved sustainable capacity in this area, while just 21 per cent had sustainable civil registration and vital statistics systems, compared with the global average of 43 per cent.
The report warns that incomplete death registration makes it difficult for health authorities to identify leading causes of mortality, detect emerging health threats and determine where healthcare services need strengthening.
It also raises concerns about the sustainability of population health surveys, which provide information used to identify health inequalities and plan services.
Although 28 countries had well-developed capacity to survey populations and health risks, none had achieved sustainable capacity.
Thirty-three per cent of countries reported having no government funding for population-based surveys, while only six per cent said government financing accounted for at least 76 per cent of total survey funding.
The assessment further found that important health needs remain inadequately captured in population surveys, particularly mental health, non-communicable diseases and household healthcare expenditure.
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Only 31 per cent of countries included mental health disorders in their population-based surveys, while 16 per cent collected information on cataracts.
On disease surveillance, 75 per cent of countries had attained well-developed or sustainable capacity to monitor public health threats, with 25 per cent reaching sustainable capacity.
However, the report notes that sustaining these systems requires continued investment in infrastructure, skilled personnel and coordination.
Digital health systems also face challenges, with 38 per cent of countries reporting that they had no national digital health architecture or health information exchange.
Although 85 per cent had functional master health-facility lists, 62 per cent did not use national unique identifiers in their facility-based patient registries, potentially limiting the ability to connect patient information across health facilities.
The WHO assessment identifies domestic financing, stronger governance, investment in skilled health professionals and interconnected digital systems as key priorities for improving the use of health information.
It calls on governments and development partners to align investments and technical support with national priorities while strengthening country ownership of health information systems.
The report argues that the value of health data lies not merely in its availability but in how effectively it is used to identify risks, guide investments, improve healthcare services and protect lives.
