Health Data Use, Analytics Capacity, and Digital Systems Supporting Sub-National Health Decision-Making in Ethiopia.

<ns5:p>Background A consistent health information system is the foundation of decision-making across all health system. Health systems are effectively using timely, high-quality data to improve decision-making, strengthen health systems, and enhance accountability. Objectives to strengthen data analytics capacity and promote real-time HIV, TB, malaria, and Resilient and Sustainable Systems for Health (RSSH) data use for evidence-based decision-making at sub-national levels in Ethiopia. Methods A mixed-methods, cross-sectional study was conducted at 53 purposively selected health facilities and 10 woredas in six regions. The participants were data clerks, clinical service providers, and HMIS officers from health facilities and woreda health offices. A total of 62 respondents were selected for the quantitative, and 19 for the qualitative methods. Result The findings showed that 42% of available computers were used for data management, 42% of facilities had reliable internet, and 3.4% primary health care staff received data analytics training in the past year. Digital dashboards were available in 40% facilities, and interoperability across systems was a major issue at the health facility. 18% facilities did not conduct a data quality audit, and the average report timeliness was 89.8%. The qualitative findings identified frequent system downtime, staff turnover, and a weak data use culture as challenges. Conclusion and Recommendation Despite improvements in digital health system implementation, infrastructure, digital literacy, and routine data utilization, challenges remain critical at sub-national levels. Therefore, interventions should prioritize infrastructure development, ongoing training, and regular mentorship in data analytics, fostering a data-use culture through leadership engagement, and integrating digital systems.</ns5:p>