Transforming Health Data Use in Ethiopia: How Hardware Upgrades Can Drive Reporting Success

Technology upgrades in Ethiopia are increasing data use and saving lives. Photo: JSI Ethiopia

Digitizing health data enables instant access to accurate records, bolstering informed decision-making and reducing medical errors. Digital health improves health outcomes and service delivery by strengthening data management across the system, paving the way for smarter, safer, and more person-centered care. Digitization, however, requires robust infrastructure and advanced communication technology tools that can capture and exchange high-quality data across various health structures within a country.

As part of Ethiopia’s Information Revolution agenda, JSI supports health data digitization by leading the Gates Foundation-funded Ethiopia Data Use Partnership (DUP), which works to strengthen the data infrastructure of local health facilities and institutions.

Since 2016, in collaboration with the Ministry of Health and regional health bureaus, DUP made significant strides toward improving data management and use. A key milestone of this effort involved removing a critical bottleneck in health data reporting by upgrading computer system memory to enhance capacity and improve performance.

The Challenge

When Ethiopia adopted DHIS2 version 40 in 2024, health care providers encountered significant challenges due to outdated computer hardware. Nearly 70 percent of computers used for offline data reporting were equipped with only 4 GB of RAM, far below the system’s minimum requirement of 8 GB. The hardware limitation significantly affected data availability, leading to a decline in reporting rates and consistency.

The Solution

In October 2024, DUP worked with the Somali Regional Health Bureau to upgrade the hardware capacity of computers in health facilities, improving health data reporting across the Somali region. In the pilot, conducted in the Fafan Zone, reporting rates increased from 16 percent to an impressive 70 percent one day after the RAM upgrade. Health facilities reported fewer technical issues, improved system performance, and greater ease in managing data. The pilot’s success prompted a call for broader rollout to 11 other zones in the region.

This targeted initiative upgraded the RAM of 129 systems from 4 GB to 8 GB, equipping them to meet the demands of the upgraded DHIS2 version and improve their data reporting capabilities. Procuring and installing an equivalent number of new computers with required specifications in this zone alone could have cost the government an estimated USD $100,000, but the hardware upgrade only amounted to $3,000, making it a highly cost-efficient and effective investment model.

To ensure the success of the upgrades and recognizing resource limitations for onsite support, a team from the regional health bureau and DUP project conducted surveys to evaluate the current RAM specifications, closely monitored system performance post-upgrade, and engaged end-users and digital health staff to identify ongoing challenges. DUP also created user-friendly instructional videos in the local language that help users understand hardware needs and data reporting processes and help health information technician workers upgrade the computer hardware. This approach enhanced user engagement, leading to significant improvements in both data accessibility and the overall functionality of the region’s DHIS2 system.

Our old computer lacked the necessary resources to generate reports. However, once we upgraded the RAM, we were able to submit a complete report on time without any issues.” —Yusuf Nur Aw Ali, HMIS focal person for Tuliguled Woreda Health Office

Conclusion

The initiative’s effects were both immediate and transformative. Upgrading system memory in the Somali Region dramatically improved data reporting rates and consistency, resulting in enhanced quality of health service delivery. The initiative demonstrates a cost-efficient and scalable model for resource-limited settings. DUP’s localized and context-sensitive approach in the region highlights how tailored solutions can optimize data exchange at all levels, strengthening the health system.