HMIS Support for Child Nutrition and Growth: Lessons Learned from Rwanda.

Introduction: Accurate and timely nutritional information plays a vital role in monitoring the progress of the Rwandan National Nutrition Program (NNP). However, the absence of a cohesive reporting system to monitor child growth and nutrition poses a challenge. This study focuses on analyzing health workers' utilization of health information management systems (HMIS) to identify areas for enhancement in program implementation. Methods: Our interview guide and group discussion questions were structured around the constructs of the Human, Organization, and Technology–Fit (HOT-Fit) framework. These guided discussions were conducted with health workers supporting the NNP children in primary health facilities across three districts in Rwanda. The subsequent data analysis involved importing the transcripts into NVivo for interpretation within the framework. Results: Health care providers, including community health workers and nutritionists, rely on paper registers for tracking and reporting nutritional data. Data managers store this information digitally, preferring HMIS for increased efficiency. They find use of digital entry and reporting faster and less cumbersome compared to paper-based systems. Respondents identified challenges with paper-based registration, noting repetitive entries and inconsistencies across registers. Nutrition information within HMIS faces obstacles such as a lack of nutritionists, suboptimal system use, limited internet access, and low digital literacy among staff. Conclusion: Addressing challenges such as documentation practices and staffing is crucial for enhancing user satisfaction. The integration of routine recording systems can significantly improve data utilization. This study underscores the importance of tailored digital health interventions to enhance the HMIS supporting the National NNP.