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Abstract Background Health data is one of the most valuable assets in health service delivery yet one of the most underutilized in especially low-income countries. Health data is postulated to improve health service delivery through availing avenues for optimal patient management, facility management, and public health surveillance and management. Advancements in information technology (IT) will further increase the value of data, but will also call for capacity readiness especially in rural health facilities. We aimed to understand the current knowledge, attitudes and practices of health workers towards health data management and utilization. Methods We conducted key informant interviews (KII) for health workers and data staff, and focus group discussions (FGD) for the village health teams (VHTs). We used both purposive and convenience sampling to recruit key informants, and convenience sampling to recruit village health teams. Interviews and discussions were audiotaped and transcribed verbatim. We manually generated the codes and we used thematic analysis to identify the themes. We also developed a reflexivity journal. Results We conducted a total of 6 key informant interviews and 3 focus group discussions of 29 participants. Our analysis identified 7 themes: One theme underscored the health workers’ enthusiasm towards an optimal health data management setting. The rest of the six themes resonated around working remedies to the systemic challenges that grapple health data management and utilization at facilities in rural areas. These include: Building human resource capacity; Equipping the facilities; Improved coordination with partners; Improved data quality assurance; Promotion of a pull supply system and Reducing information relay time. Conclusion Our findings reveal a plethora of systematic challenges that have persistently undercut optimal routine health data management and utilization in rural areas and suggest possible working remedies. Health care workers express enthusiasm towards an optimal health management system but this isn’t matched by their technical capacity, facility readiness, systems and policy willingness. There is an urgent need to build rural lower facilities’ capacity in health data management and utilization which will also lay a foundation for exploitation of information technology in health.