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. 2023 Sep 21;13(9):e071616.
doi: 10.1136/bmjopen-2023-071616.

Health data ecosystem in Pakistan: a multisectoral qualitative assessment of needs and opportunities

Sana Mahmood  1   2   3 , Ali Aahil Noorali  4   5 , Afshan Manji  4   5 , Noreen Afzal  1 , Saadia Abbas  4 , Javeria Bilal Qamar  4 , Sameen Siddiqi  2 , Zahra Hoodbhoy  6 , Salim S Virani  4 , Zulfiqar A Bhutta  3   7 , Zainab Samad  8   5   9
Affiliations

Health data ecosystem in Pakistan: a multisectoral qualitative assessment of needs and opportunities

Sana Mahmood et al. BMJ Open. .

Abstract

Objective: Data are essential for tracking and monitoring of progress on health-related sustainable development goals (SDGs). But the capacity to analyse subnational and granular data is limited in low and middle-income countries. Although Pakistan lags behind on achieving several health-related SDGs, its health information capacity is nascent. Through an exploratory qualitative approach, we aimed to understand the current landscape and perceptions on data in decision-making among stakeholders of the health data ecosystem in Pakistan.

Design: We used an exploratory qualitative study design.

Setting: This study was conducted at the Aga Khan University, Karachi, Pakistan.

Participants: We conducted semistructured, in-depth interviews with multidisciplinary and multisectoral stakeholders from academia, hospital management, government, Non-governmental organisations and other relevant private entities till thematic saturation was achieved. Interviews were recorded and transcribed, followed by thematic analysis using NVivo.

Results: Thematic analysis of 15 in-depth interviews revealed three major themes: (1) institutions are collecting data but face barriers to its effective utilisation for decision-making. These include lack of collection of needs-responsive data, lack of a gender/equity in data collection efforts, inadequate digitisation, data reliability and limited analytical ability; (2) there is openness and enthusiasm for sharing data for advancing health; however, multiple barriers hinder this including appropriate regulatory frameworks, platforms for sharing data, interoperability and defined win-win scenarios; (3) there is limited capacity in the area of both human capital and infrastructure, for being able to use data to advance health, but there is appetite to improve and invest in capacity in this area.

Conclusions: Our study identified key areas of focus that can contribute to orient a national health data roadmap and ecosystem in Pakistan.

Keywords: PUBLIC HEALTH; QUALITATIVE RESEARCH; Quality in health care.

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Conflict of interest statement

Competing interests: Dr ZS reports research grant support from the NIH-Fogarty International Center for the AKUPI-NCDs Research training program (Project Number 5D43TW011625-02) and UZIMA DS (U54TW012089); the NIHR, UK for the Centre for IMPACT (NIHR203248); Bill & Melinda Gates Foundation (INV 021944 & INV 050389); and Duke University. Dr SV MD, PhD, FACC, FAHA, FASPC Research support: U.S. Department of Veterans Affairs, National Institutes of Health, World Heart Federation, Tahir and Jooma Family; Honorarium: American College of Cardiology American College of Cardiology (Associate Editor for Innovations, acc.org); Associate Editor (Current Atherosclerosis Reports, Current Cardiology reports, Journal of Clinical Lipidology). Dr ZB MBBS, FRCPCH, FAAP, PhD Executive Director of NCD Child.

Figures

Figure 1
Figure 1
An overview of the methodological framework of the studyparticipant cohorts, process of interview preparation, conductance and analysis.
See this image and copyright information in PMC

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