A scoping review of DHIS2 implementation in the National Health Management Information System of the Democratic Republic of Congo

Abstract The Democratic Republic of Congo (DRC) continues to face major challenges in establishing a reliable National Health Management Information System (HMIS), largely due to its vast geography, limited infrastructure, and complex disease burden. The adoption of District Health Information Software 2 (DHIS2) was intended to reduce fragmentation, standardize routine reporting, and strengthen data-driven decision-making. This study synthesizes peer-reviewed and grey literature published between 2009 and 2025 to examine the implementation process, system performance, and broader implications of DHIS2 in the DRC. A structured scoping review was conducted using a PRISMA-ScR-informed search and screening process. Relevant scholarly literature was identified through PubMed, ScienceDirect, SpringerLink, and Google Scholar, supplemented by targeted searches of institutional repositories and grey-literature sources including the Ministry of Health, DHIS2, MEASURE Evaluation, HISP, Data for Impact, and IMA World Health. The synthesis was guided by a PRISM-informed socio-technical framework that organized evidence into technical, organizational, and behavioral domains. Fourteen sources met the inclusion criteria. The literature shows that the DRC moved from a fragmented paper-based HMIS toward a nationally deployed DHIS2 platform through a phased implementation process that included pilot, scale-up, and completion stages. Reported gains include improved reporting completeness, greater standardization, better data visibility, and expanded use of DHIS2 for surveillance and program monitoring. However, the evidence also shows persistent constraints related to infrastructure, human resource capacity, interoperability, data quality, and weak data-use culture. Quantitative indicators reported in the literature include HMIS performance improving from 59% to 64% between 2009 and 2015, national reporting completeness reaching 86.3% in early 2017, and TB reporting completeness reaching 92.8% in 2020. DHIS2 has become an important backbone of the DRC health information system, but its full value depends on sustained investment in infrastructure, workforce development, interoperability, governance, and routine data use. The evidence supports a cautious interpretation: DHIS2 has improved data availability and system coordination, but transformation of health outcomes remains incomplete.