Managing health systems depends on having information on the supply and quality of health services available. As countries scale up efforts for improved health coverage and response against major diseases, good data are needed to track the progress and performance of the health system. However, few developing countries have up-to-date data to assess and monitor service quality or to conduct annual review of health services in the public and private sector for the population . Public health decision-making depends greatly on timely availability of good data .
The World Health Organization (WHO) encourages countries to develop a comprehensive Master Health Facility List (MHFL) as an initial step towards strengthening performance monitoring at the facility level, which feeds into regional, national, and international monitoring systems . A MHFL is a complete listing of all public and private health facilities in an administrative area. A MHFL should include information about administration and health services provided at each facility . Many countries have several health facility lists with non-standardized norms for identifying and updating the facilities. A MHFL should be standardized with an established unique identifier for each facility, and be linked to other data sources such as the health management information system (HMIS) and logistics management information system (LMIS) to allow information to be compared across time and across data sources.
For many years, Nigeria had different non-standardized health facility lists created for various purposes and development projects. With the growing adoption of information technology in routine health information management, the Nigerian Federal Ministry of Health (FMOH) initiated efforts in 2010 to compile an updated and standardized MHFL. This effort produced a harmonized list in 2013. After the compilation of the list, facilities were assigned unique identifiers, using codes that conveyed information for the states and local government areas (LGAs), but the parameters did not include geo-coordinates [3,4,5]. In 2017, the FMOH established the national health facility registry (HFR) to update the MHFL via an online platform. The HFR serves as a hub for connecting different information systems, eliminating duplication of health facility lists to enable authorities plan for the establishment of new health facilities .
The MHFL does not have a code for the lowest administrative level, the Ward, in its unique identifier .. Some facilities have been renamed, relocated, or upgraded, but because the MHFL has not been updated since its creation in 2013, these changes are not reflected in the MHFL. New health facilities constructed after the establishment of the MHFL are also not on the District Health Information Systems version 2 platform (DHIS2), a web-based version of the National Health Management Information System (NHMIS).
In 2016, the US Centers for Disease Control and Prevention (CDC), in collaboration with the Nigeria National Malaria Elimination Program (NMEP), established a 3-year intervention project, Malaria Frontline Project (MFP), with the objectives of strengthening the technical capacity of LGA-level health workers, improving malaria surveillance and facilitating evidence-based decision-making. The project was implemented in Kano and Zamfara States in the Northwest geopolitical zone of Nigeria. During the project implementation, some deficiencies in the list of facilities in DHIS2 and MHFL became obvious. New facilities were submitting monthly data but their data could not be entered into DHIS2 because the facility was not on the list of facilities in DHIS2. Facilities not on the MHFL do not appear on the DHIS2 platform. It became apparent that the analyses and reporting from DHIS2 for the project states did not capture all functional health facilities and non-functional facilities were not identified.
To overcome this problem and improve data reporting and analyses in support of health system surveillance and management at the LGA level, the MFP team together with the State Ministry of Health (MoH) updated the existing MHFL in the project areas in Kano and Zamfara States. In 2017, MFP staff conducted this health facility assessment and submitted the results to the State MoH.