Grand challenges of public health: How can health information systems support facing them?

Objectives: Achieving Universal Health Coverage (UHC) and establishing robust Civil Registration and Vital Statistics (CRVS) systems are two urgent priorities and grand challenges of global health, especially in Low and Middle Income Countries (LMICs). It is argued that addressing both these priorities requires strong supportive Health Information Systems (HIS), which to date have been elusive to develop. Methods: Two case studies are presented and discussed. The first concerns an Indian state's effort to implement a UHC HIS in primary health care while the second relates to the efforts of the Tajikistan national ministry to develop a HIS for CRVS. Results: UHC and CRVS can benefit by learning from the domain of information systems research and practice, especially relating to the design of large-scale and complex systems. From this perspective, key areas of concern in strengthening UHC and CRVS include: the role of primary health care, the role of existing systems and practices, and the fragility of technical infrastructure in LMICs. Conclusion: Implications for policymakers can be found on three levels: anchoring HIS in primary health care, renewing what already exists, and adopting hybrid rather than fully Internet-dependent systems. (C) 2018 Fellowship of Postgraduate Medicine. Published by Elsevier Ltd. All rights reserved.