African HIE Maturity Assessment


The Africa CDC developed a strategic plan to develop and strengthen information systems to support public health strategies in Africa. It also sets a strategic objective of designing and implementing a continental data-sharing platform for Member States. To achieve this objective, Africa CDC has drafted an African Union (AU) Health Information Exchange (HIE) Policy and Standard document for Member States to exchange health information. The document outlines HIE policy and standard recommendations that can be adopted and used by the AU Member States to leverage interoperable digital health systems. It also specifies the information flows starting from a facility-level health information system of Member States to Africa CDC, WHO, and African regional bodies such as Regional Collaborating Committees (RCC) and Regional Economic Communities (REC). To successfully implement the document, the development of an HIE maturity model is crucial to guide the assessment and progress evaluation of the current digital capacity of AU Member States. Understanding the HIE maturity level of Member States could help to identify bottlenecks and critical factors for the successful implementation of AU HIE Policy and Standards.

The AU HIE Policy and Standard document recommends an initial HIE maturity assessment in terms of human resources, infrastructure, governance, and finance to successfully implement HIE policy and standards for digital health systems. The HIE maturity assessment could be used to determine the maturity level of Member States in relation to health data exchange starting from facility level to Africa CDC, WHO, African regional bodies (RCC and REC), partners, and other Member States, as described in the continental HIE architecture of the AU HIE Policy and Standards document. The assessment will help the smooth implementation of the AU HIE policy and standards for digital health systems.

HIE maturity assessment is increasingly important to realize the potential benefits of interoperability and data exchange across the continent. The assessment is essential to describe the current maturity level of HIE. It is also useful to set objectives and plan for future maturity levels of HIE among digital health systems. A recent review paper stated that a proven way of developing a systematic roadmap to achieving full maturity is developing and adopting a maturity model. Hence, the primary rationale for developing an HIE maturity model is to assist Member States and stakeholders in achieving HIE maturity through a systematic and stepwise approach. It provides the different maturity levels and the required steps necessary to achieve them. Through a maturity assessment, Member States can understand where they are and where to go in terms of HIE.


The main objective of this proposal is to develop an HIE maturity model and conduct HIE maturity assessments among Member States in terms of HIE governance, skilled human resources, ICT infrastructure, interoperability, and data sharing

Activities and Deliverables

Within digital health systems, several maturity models have been developed, although these models are still at an early stage of development. These models will be critically reviewed and adapted to the context of HIE. Some of the maturity models for review include the Digital Health Investment Review Tool, Global Digital Health Index, Health Information System Stages of Continuous Improvement Toolkit, and HIS Interoperability Maturity Toolkit.

This work will be mainly guided by the recent review paper that outlined the components of maturity model development. The components include defining the scope, designing the maturity model, developing and validating constructs, presenting results, deployment and evaluation, and systematic documentation.

The first step in developing a maturity model is to define the scope of the model. To achieve it, existing models will be critically reviewed. The second step is to design the architecture of the maturity model which includes the audience, method, and driver of the application, respondents, and application. After the definition of scope and design for the constructs of the model will be developed and validated. In this case, domains and components will be developed, and the ways to measure them will be determined through an extensive literature review. Next, the model will be presented to the audience either through publications or conferences. Then, the model will be tested and evaluated using actual data. Finally, the process of the maturity model development will be documented and communicated through appropriate channels to stakeholders.

Generally, the following activities will be carried out to conduct HIE maturity assessment among Member States:

  •    An exhaustive and comprehensive desk/ literature review of all regional and national HIS and relevant documents to identify components and sub-components of the HIE maturity model and how each component and sub-component is measured, including measurement scales. A key informant interview will also be used to collaborate on the information and collect other relevant key digital health features and indicators to develop the model.
  • Draft an HIE maturity model based on the framework derived from the literature review and key informant interviews.
  •  Conduct a review/ validation workshop among subject-matter experts to critically review the components and sub-components of the drafted maturity model.
  •   Develop a digital platform used to assess the maturity level of HIE of a country
  •   Conduct a desk review to understand the HIE ecosystem and stakeholders that should be included in the assessment.
  •   Conducting HIE maturity assessments in five selected Member States (Data collection through survey, interview, and/or workshop)
  •   Analyze the data and write the results
  •   Write the discussion, conclusions, and recommendations
  •  Write the final report and submit it to Africa CDC

  • African Union Members

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