From data collection to data use: How Ghana and Nigeria are strengthening health systems through rapid-cycle analytics
Reliable, timely data is critical to ensuring that health systems can meet the needs of women, children, and adolescents — but only when that data is actively used to inform decisions. Both Nigeria and Ghana have invested in national health information systems to measure the quality and equity of primary health care, yet data reporting has not always translated to improved Reproductive, Maternal, Newborn Child, Adolescent Health and Nutrition (RMNCAH-N) health outcomes.
Recent data use reviews by Results for Development (R4D), the Global Financing Facility for Women, Children, and Adolescents (GFF) and country partners revealed progress as well as bottlenecks that hinder routine use of data in health decision-making. Persistent barriers include — unclear ownership of data collection and reporting, limited skills in data analysis and interpretation, unreliable internet connectivity, incomplete records, missing paper forms, and heavy workloads — leading to delays, errors, and mistrust in the data. As a result, costly and infrequent national surveys often remain the default source for decision-making.
A different approach to health data
Frequent assessments can reveal health system weaknesses and enable targeted, data-driven action. To fill this gap, GFF’s Frequent Assessment and Systems Tools for Resilience (FASTR) initiative aims to accelerate improvements in RMNCAH-N outcomes by increasing the systematic use of data for decision-making — ensuring that data is not only collected with regular frequency, but that it is analyzed and used routinely to improve performance.
In 2024, FASTR expanded to Ghana and Nigeria through a partnership led by R4D and the GFF, with support from the World Bank and Gates Foundation. Working with Nigeria’s Federal Ministry of Health and Social Welfare (FMoH&SW), Ghana Health Service (GHS) and other stakeholders, partners assessed existing systems, co-created locally adapted tools, and strengthened country capacity to translate data into health decisions.
Co-developing the approach in Ghana and Nigeria
Strengthening data use requires an accurate diagnosis of where data is needed, when, why, and by whom to translate results into action. In Nigeria, a review of Nigeria’s National Health Management Information System (NHMIS) identified areas where FASTR could add value, including:
- Fitting into national reform priorities: Aligning with National Health Sector Renewal Investment Initiative (NHSRII) and the Sector-Wide Approach (SWAp) so analysis could feed directly into timely reform monitoring
- Turning incomplete data into usable data: Applying statistical approaches to adjust for Nigeria’s persistent reporting challenges to ensure data quality is not a barrier to use
- Getting data in front of decision-makers: Integrating FASTR into existing platforms such as the MSDAT and RMNCAH scorecards
- Closing the loop on decisions: Tracking and documenting decisions informed by FASTR, improving accountability in the health system
- Building skills that stick: Strengthening stakeholders’ capacity to analyze and use data
Meanwhile, in Ghana, we co-designed FASTR’s rapid-cycle approaches to serve three use cases where timely and frequent assessments and stronger feedback loops across all levels of the health system are needed to improve performance:
- Keeping a pulse on frontline care: Regular monitoring RMNCAH-N performance at primary care facilities
- Making subnational data work harder: Strengthening data quality and use at regional, district, and sub-district levels by integrating data analysis into the existing subnational data quality validation cycle
- Steering a major new program in real time: Monitoring the roll-out of the new Free PHC program, informing course correction and program improvement
Across both countries, FASTR emphasizes iteration and learning through user friendly analytical tools, analytical coaching, mentoring and change management — embedding a culture of data-driven decision-making.
The work in action
FASTR now supports both countries through workshops, coaching and institutionalization of analysis and results into national and subnational decision-making forums. Stakeholders have agreed on a set of key RMNCAH-N indicators for FASTR in alignment with national health strategies and are tracking these on a quarterly basis.
In Nigeria, Ministry participants are now generating quarterly RMNCAH-N performance assessment reports using DHIS-2 data, culminating in the Joint Annual Review of the Health Sector Statistical Book and Nigeria’s Annual State of Health Report. In tandem, remote health facility phone surveys, also quarterly, are providing real-time insight into facility performance.
“We are using the FASTR analytical tool to analyze data for informed decisions, because our program needs to be evidence based and so we are using the FASTR analytical tool to improve programming for policy formulation and decision-making” – Joy Kalu, Department of Family Health, FMoH&SW
“The advent of the FASTR analytical tool has helped us do a lot of data cleaning to ensure that whatever we have on our DHIS-2 platform is of good quality for informed decision-making” – Oyedele Malumba, Chairman of the HMIS Officers
In Ghana, Ghana Health Service designed a roadmap at national and subnational levels aligned with their country’s goals. Regular analytic labs and coaching sessions provide staff with opportunities to share lessons across national and regions and jointly interpret data.
“The country will benefit from improved analytical capacities when it comes to inferences that we have to draw from the data and to understand which areas of the data we should do further research […] so that we improve our programs” – Dr. Ayim, PPME GHS
Group picture from Ghana’s co-creation event
4 lessons from Nigeria and Ghana, and the road ahead
Nigeria and Ghana illustrate how the FASTR initiative can be adapted to different contexts. What have we learned so far?
- Design for data use from the beginning: In both Nigeria and Ghana, FASTR conducted data use landscape assessments to map existing information flows, identify where data is collected but not acted upon, and surface the structural, technical, and human barriers that prevent routine use in decision-making. These assessments help form a country-specific plan to strengthen data use at every level of the health system, ensuring that the tools and approaches FASTR introduces are built around what decision-makers need and not what data systems happen to produce.
- Stakeholder engagement matters: Inclusive co-creation builds trust and ensures that analysis focuses on what matters most.
- Context shapes priorities: Nigeria is focusing on integration of continuous monitoring into national reforms and improving the reliability of reporting, while Ghana emphasizes strengthening district- and facility-level data quality and use.
- Capacity is central: Continuous training and coaching help staff transition from data entry validation to data use. Empowering national stakeholders as data coaches for subnational staff reinforces ownership and sustainability. As one Ghanaian participant emphasized, “Staff need continuous support and coaching to move from data entry to data use.”
Strengthening data use is a gradual process requiring national leadership, inclusive dialogue, and sustained investment. New applications of artificial intelligence (AI) in the FASTR analytics platform are also accelerating the pace of capacity building and ensuring that intelligence lives in a system for sustainability.
Though embedding frequent assessment into routine practice takes time, FASTR is already helping Ghana and Nigeria take tangible steps toward stronger, more resilient health systems — improving outcomes for women, children, and adolescents.
This is what sustainable data use looks like in practice
Ghana and Nigeria are showing what it looks like when health data is used to drive decisions. That shift doesn’t happen because of a tool or a program — it happens because country leaders and frontline staff commit to a different way of working.
Importantly, this work is not designed as a one-off analytical exercise but as an embedded, repeatable learning system. Through quarterly review cycles, agreed indicators, capacity strengthening, and institutionalized dialogue platforms, the approach supports continuous reflection, adaptation, and improvement. With sustained political commitment and investment, both countries have strong potential to develop durable national data-use mechanisms that enhance service delivery and contributes to improved RMNCAH-N outcomes across both countries.
R4D thanks the following officials and individuals for their contributions to this story: Dr. Chris Opoku Fofie (Ghana Health Service Family Health Department), Dr. Salamatu Attah Nantogma (Ghana Health Service PPME), Dr. Anthony Adoghe (Federal Ministry of Health Department of Health Planning, Research, and Statistics), Dr. Kamil Shoretire (Federal Ministry of Health Department of Health Planning, Research, and Statistics), Umma Yaradua (Global Financing Facility for Women, Children, and Adolescents), Pearl Adwoa Opoku Youngmann (Global Financing Facility for Women, Children, and Adolescents).
