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BACKGROUND Every organization, especially healthcare-related ones, must have access to high-quality data. In reality, quality data enables any healthcare system to adhere to and analyze its specified objectives in order to meet the needs of its users. Therefore, it is essential that the processes used to generate these data are well-structured and effective. In so many sub-Saharan African nations, the data management processes are limited, resulting in a quality issue in the collected data in the healthcare sector (such as the low levels of completeness, low levels of accuracy, and low levels of responsiveness). This is becoming increasingly common, and it undermines the accuracy of the intervention decisions made by the management of any healthcare system. OBJECTIVE To evaluate the performance of Gabon's health information system, we conducted a study of the procedures used to collect high-quality data. METHODS This qualitative study followed a five-step methodology (identification of indicators in the data collection process, specification of data allowing the calculation of indicators, design of the data collection questionnaire, collection of data and health information system performance evaluation). We have opted to rely on the qualities (criteria) of three factors that contribute to data quality (data recording and storage, verification of data accuracy and data processing and analysis). RESULTS 58% of the structures do not appear to satisfy all the criteria that encourage the capture and storage of data, 53% do not appear to meet all the criteria that promote the verification of the data's accuracy, and 56% do not appear to meet all the criteria that promote good data processing and analysis. CONCLUSIONS Despite the fact that the characteristics employed to evaluate the quality of the data in our study are not exhaustive, they have the advantage of characterizing the performance level of the healthcare information system in Gabon. We notice from this study that Gabon's healthcare information system has constraints that prevent it from producing trustworthy data to support strategic decisions, and the results of this study may serve as a basis for considering the enhancement of the current health information system.

BACKGROUND Effective health information systems support decision-making. In some sub-Saharan African countries, including Gabon, there is a problem with data quality. Indeed, the tools supporting the data collection process in health facilities are limited and tend to favour manual data processing. OBJECTIVE This study presents the conceptual approach of an information system model for health decision support in resource-limited countries and the results of the evaluation's model. METHODS The study was conducted in three phases. First, the design and development of a platform based on the analysis of the different processes of data production and indicator generation. Secondly, the implementation of the platform in the health structures in Gabon. Finally, an evaluation of the platform with users. RESULTS A total of 14 users were interviewed, with an average experience of 12 years in health data management. The results show that the use of the proposed model significantly improves the completeness, timeliness and accuracy of data compared to the traditional system. Respectively, 93% versus 12% (p CONCLUSIONS The proposed model contributes significantly to the improvement of health data quality in Gabon.

Background In developing countries, health information system (HIS) is experiencing more and more difficulties to produce quality data. The lack of reliable health related information makes it difficult to develop effective health policies. In order to understand the organization of HIS in African countries, we undertook a literature review. Methods Our study was conducted using the PubMed and Scopus bibliographic search engines. The inclusion criteria were: (i) all articles published between 2005 and 2019, (ii) articles including in their title the keywords "health", "information", "systems", "system", "africa", "developing countries", "santé", "pays en développement", "Afrique", (iii) articles that are written in English or French, (iv) which deals with organizational and technical issues about HIS in African countries. Results Fourteen retrieved articles out of 2492 were included in the study, of which 13 (92.9%) were qualitative. All of them dealt with issues related to HIS in 12 African countries. All 12 countries (100.0%) had opted for a data warehouse approach to improve their HIS. This approach, supported by the DHIS2 system, has enabled providing reliable data. However, 11 out of the 12 countries (92.0%) frameworks were aligned with funding donors’ strategies and lacked any national strategy. Conclusion This study suggests that the lack of a national health information management strategy will always be a threat to HIS performance in African countries. Ideally, rigorous upstream thinking to strengthen HIS governance should be undertaken by defining and proposing a coherent conceptual framework to analyze and guide the development and integration of digital applications into HIS over the long term.

Objective: The need for an efficient and reliable health information system motivated Gabon, with the support of the World Bank, to finance a project to reinforce its health information system. An audit of this system was required to report on the reality of the existing system and tools. Methods: Over the course of two periods, May to September 2016 and April to May 2018, information was collected using both qualitative and quantitative approaches. In this framework, were carried out successively: participative workshops including health actors in Gabon, a survey of health care workers, an analysis of reference documents relating to national health policies, and an analysis of the strengths, weaknesses, opportunities, and threats to the system. Results: In total, 171 health care professionals participated in the different workshops, and 770 others were questioned among 150 health care establishments from 10 health care regions of the country. At the end of this research work, organizational and technical problems were noted at the level of the health information system of Gabon, notably the absence of a judicial framework defining the roles and responsibilities of the different actors of the system, weak data management, a stovepipe information system, several non-interoperable IT applications, and weak completeness rate, at 30%. Among the 770 health care professionals surveyed, 539 (70%) were favorable to a new information system. As for the main assets, we noted the existence of computing equipment and acceptable internet coverage, 31.5% of the health care establishments are connected via cable. Conclusion: This research sheds light on the existing health information system and should enable the implementation of a new system.; Objectif : Le besoin de disposer d’un système d’information sanitaire efficient et fiable a motivé le Gabon, avec l’appui de la Banque mondiale, pour qu’il financer un projet visant à renforcer son système d’information sanitaire. En amont, un audit de ce système s’imposait pour rendre compte de la réalité des dispositifs et des outils existants.Méthode : Les informations ont été recueillies sur deux périodes allant respectivement de mai à septembre 2016 et d’avril à mai 2018 pour la seconde en utilisant des approches qualitative et quantitative. Dans ce cadre, ont été réalisés successivement des ateliers participatifs incluant des acteurs de santé au Gabon, une enquête menée auprès de professionnels de santé, une analyse des documents de référence relatifs à la politique de santé nationale et une analyse des forces, faiblesses, opportunités et menaces du système.Résultats : Au total, 171 professionnels de santé de santé ont participé aux différents ateliers, et 770 autres ont été interrogés parmi 150 structures de soins issues des 10 régions sanitaires du pays. Au terme de ce travail, des problèmes organisationnels et techniques ont été relevés au niveau du système d’information sanitaire du Gabon, notamment l’absence de cadre juridique définissant les rôles et responsabilités des différents acteurs du système, une faible pratique de la gestion des données, un système d’information en silo, plusieurs applications informatiques non interopérables et un taux de complétude faible, à 30 %. Parmi les 770 professionnels de santé enquêtés, 539 (70 %) étaient favorables à la mise en place d’un nouveau système d’information. Comme principaux acquis, nous avons noté l’existence d’un parc informatique et une couverture Internet acceptables, 31,5 % des structures de soins étant connectées via le câble.Conclusion : Ce travail apporte des éclaircissements sur le système d’information sanitaire existant et permet de mieux envisager la mise en œuvre du nouveau système.