Macharia Peter M, Beňová Lenka, Ray Nicolas, Semaan Aline, Musau Moses M, Kipterer John Kapoi, Herringer Mark, Snow Robert W, Okiro Emelda A
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
Population and Health Impact Surveillance Group, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya.
BMC Med. 2025 Apr 7;23(1):211. doi: 10.1186/s12916-025-04023-z.
Healthcare service provision, planning, and management depend on the availability of a geolocated, up-to-date, comprehensive health facility database (HFDB) to adequately meet a population's healthcare needs. HFDBs are an integral component of national health system infrastructure forming the basis of efficient health service delivery, planning, surveillance, and ensuring equitable resource distribution, response to epidemics and outbreaks, as well as for research. Despite the value of HFDBs, their availability remains a challenge in sub-Saharan Africa (SSA). Many SSA countries face challenges in creating a HFDB; existing facility lists are incomplete, lack geographical coordinates, or contain outdated information on facility designation, service availability, or capacity. Even in countries with a HFDB, it is often not available open-access to health system stakeholders. Consequently, multiple national and subnational parallel efforts attempt to construct HFDBs, resulting in duplication and lack of governmental input, use, and validation.
In this paper, we advocate for a harmonized SSA-wide HFDB. To achieve this, we elaborate on the steps required and challenges to overcome. We provide an overview of the minimum attributes of a HFDB and discuss past and current efforts to collate HFDBs at the country and regional (SSA) levels. We contend that a complete HFDB should include administrative units, geographic coordinates of facilities, attributes of service availability and capacity, facilities from both public and private sectors, be updated regularly, and be available to health system stakeholders through an open access policy. We provide historical and recent examples while looking at key issues and challenges, such as privacy, legitimacy, resources, and leadership, which must be considered to achieve such HFDBs.
A harmonized HFDB for all SSA countries will facilitate efficient healthcare planning and service provision. A continental, cross-border effort will further support planning during natural disasters, conflicts, and migration. This is only achievable if there is a regional commitment from countries and health system stakeholders to open data sharing. This SSA-wide HFDB should be a government-led initiative with contributions from all stakeholders, ensuring no one is left behind in the pursuit of improved health service provision and universal health coverage.
医疗服务的提供、规划和管理依赖于一个具备地理位置信息、最新且全面的卫生设施数据库(HFDB),以充分满足人群的医疗需求。卫生设施数据库是国家卫生系统基础设施的一个组成部分,构成了高效卫生服务提供、规划、监测以及确保公平资源分配、应对流行病和疫情爆发以及开展研究的基础。尽管卫生设施数据库具有重要价值,但在撒哈拉以南非洲(SSA),其可用性仍然是一项挑战。许多撒哈拉以南非洲国家在创建卫生设施数据库方面面临挑战;现有的设施清单不完整,缺乏地理坐标,或者包含有关设施指定、服务可用性或容量的过时信息。即使在拥有卫生设施数据库的国家,卫生系统利益相关者通常也无法开放获取该数据库。因此,多个国家和次国家层面的并行努力试图构建卫生设施数据库,导致重复建设,且缺乏政府的投入、使用和验证。
在本文中,我们主张在整个撒哈拉以南非洲建立一个统一的卫生设施数据库。为实现这一目标,我们详细阐述了所需步骤以及要克服的挑战。我们概述了卫生设施数据库的最低属性,并讨论了过去和当前在国家和区域(撒哈拉以南非洲)层面整理卫生设施数据库的努力。我们认为,一个完整的卫生设施数据库应包括行政单位、设施的地理坐标、服务可用性和容量的属性、公共和私营部门的设施,应定期更新,并通过开放获取政策供卫生系统利益相关者使用。我们在审视关键问题和挑战(如隐私、合法性、资源和领导力)时提供了历史和近期的示例,要实现这样的卫生设施数据库,必须考虑这些问题和挑战。
为所有撒哈拉以南非洲国家建立一个统一的卫生设施数据库将促进高效的医疗规划和服务提供。一项大陆层面、跨境的努力将进一步支持在自然灾害、冲突和移民期间的规划。只有当各国和卫生系统利益相关者作出区域承诺进行开放数据共享时,这一目标才能实现。这个全撒哈拉以南非洲的卫生设施数据库应该是一项由政府主导、所有利益相关者共同参与的倡议,确保在追求改善卫生服务提供和全民健康覆盖方面不让任何一个人掉队。