Ensuring the Sustainability of Health Information System Changes in Ethiopia

Executive Summary Despite significant advancements in Ethiopia's Health Information System (HIS), particularly through initiatives like the Capacity Building and Mentorship Program (CBMP), sustaining these improvements remains a critical challenge. Growing financial constraints compel both the government and development partners to prioritize sustainable outcomes, demanding that HIS investments deliver lasting, measurable improvements rather than short-term fixes. While existing policies have enhanced HIS transformation, they lack robust institutional mechanisms to ensure sustainability beyond project lifecycles. Evidence suggests that without a structured approach to monitor and reinforce sustainability, progress is vulnerable to reversal due to gaps in local ownership, capacity retention, and accountability. Our findings reveal moderate overall sustainability of HIS changes, with foundational areas posing significant challenges. Specifically, infrastructure and the stability of partnerships and funding emerged as critical weaknesses hindering long-term sustainability. Furthermore, the sustained effectiveness of HIS is hampered by a lack of consistent leadership engagement and robust support mechanisms. To secure recent gains in Ethiopia’s HIS, this policy brief recommends a comprehensive, evidence-based strategy. Key recommendations include: integrating sustainability tracking metrics into implementation, prioritizing essential HIS supplies, institutionalizing dedicated financing, and strengthening leadership engagement and partnerships. Emphasis is placed on fostering local ownership through targeted training, motivation, and robust accountability systems to ensure long-term impact."