Gender and Sex Integration in Routine Health Information Systems in West Africa: Evidence from Senegal

Introduction: Gender and sex data are important for accessing health services and defining health problems. However, they are not effectively integrated into most routine health information systems in developing countries. The aim of this study is to examine the extent to which gender and sex data have been integrated into Senegal's routine national information system. Methods: This was a qualitative study. In-depth individual interviews were conducted with health personnel. These were implementers at the community level (data collectors and public and private service providers (health data managers in private and public health facilities) and strategic-level managers of the HIS in Senegal (head of the national health information system). A total of 43 people was included in the study. The data collected in local or French were transcribed and analyzed thematically using NVIVO 11 software. Results: Results show that while healthcare providers recognize the importance of the health information system for decision-making, there are substantial gaps in knowledge and understanding of gender concepts. Gender is frequently conflated with biological sex, and sex-disaggregated data are rarely analyzed or used to inform decisions. Furthermore, the DHIS2 reporting and analysis tools were perceived as insufficiently gender-sensitive, limiting their ability to capture gender-related disparities in access to healthcare services. As a result, gender considerations remain marginal in routine data analysis and coordination meetings. It was also noted that the DHIS2 tool, which is the main IT tool for reporting and processing health information, was not sufficiently gender-sensitive. Conclusion: This study has shown that there is a gap in knowledge and training in gender concepts among healthcare providers involved in the management of Senegal's routine HIS. It also highlights the gender insensitivity of the collection, reporting and processing tools used in the routine health information system. Decision-makers should therefore take these shortcomings into account by initiating training for providers and by re-engineering the IT system to take gender into account.