A Strategic Framework for Data Governance in Curative Health Information Systems in Low-Resource Settings

In many healthcare systems, allopathic services provide both preventive and curative care. With the growing adoption of Health Information Management Systems (HIMS) in the curative sector, the need for robust data governance is increasingly evident. However, comprehensive frameworks remain limited, and existing literature lacks depth. This study explores key domains and strategies for implementing effective data governance in curative sector HIMS, particularly in resource-constrained settings. A mixed-method approach was used in three phases. Phase 1 involved a literature review to identify existing data governance domains and strategies. Phase 2 employed qualitative interviews with 15 purposively selected stakeholders (medical administrators, clinicians, informaticians, nurses, and healthcare assistants) in the Western Province to uncover current data governance challenges. Phase 3 used the Nominal Group Technique with six experts to validate and refine the framework based on earlier findings. The literature review revealed eight domains and 50 strategies. Thematic analysis of interviews identified seven critical data governance issues in clinical systems. Expert validation confirmed 49 strategies as essential, leading to the development of a comprehensive framework for data governance in Sri Lanka’s clinical HIMS. The proposed framework addresses all key components of data governance and is adaptable for use in other low- and middle-income countries. The study highlights a significant knowledge gap among stakeholders and the presence of information silos, suggesting a need for targeted training and further investigation. Future studies should incorporate patient perspectives to enrich the framework.