Strategic analysis of the health information system for communicable disease control in Afghanistan

A well-functioning Health Information System (HIS) is a foundational component for controlling communicable diseases (CDs), especially in fragile and conflict-affected settings like Afghanistan. However, Afghanistan’s HIS suffers from structural, technical, and political challenges that compromise its ability to deliver real-time, accurate, and integrated health data. This study aims to conduct a strategic SWOT analysis of Afghanistan’s HIS in managing CDs and to propose targeted solutions to improve its performance and responsiveness. This qualitative study used the Framework Method to explore perceptions of the Afghan health information system’s HIS performance in managing CDs, guided by the World Health Organization HIS framework and SWOT analysis. Forty-nine semi-structured interviews with diverse health stakeholders were conducted, analyzed inductively and deductively to identify key themes. Rigor was ensured through triangulation, independent coding, and reflexive analysis. The study identified 11 strengths, 20 weaknesses, 9 opportunities, 12 threats, and 22 solutions. Key strengths included the availability of digital tools (e.g. DHIS2) and well-established surveillance programs. However, systemic weaknesses such as lack of real-time reporting, underreporting from the private sector, limited research on CDs, technical staff shortages, and low community awareness persist. Opportunities include donor support and digital innovations, while threats like political interference, funding cuts, and brain drain severely hinder HIS functionality. Afghanistan’s HIS has a solid foundation but faces operational challenges. To enhance its effectiveness in CDs control, national efforts should prioritize infrastructure upgrades, workforce capacity-building, digital integration, and localized innovations. Implementing these targeted solutions can help Afghanistan transition toward a more resilient, reliable and real-time health information system.