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Background: Health information management (HIM) is at the core of health organisations, providing essential information. In Malawi, there is a substantial deficit of qualified personnel, specifically health information managers, who can properly manage health information in electronic and paper-based formats. The nation has no higher education institution offering an academic programme in HIM. Objective: To investigate the need for HIM professionals in Malawi government health facilities, to determine the kinds of data managed by data users; competencies of HIM workers and challenges associated with the current HIM system. Method: A cross-sectional research design was adopted, with a qualitative approach to gather data from data users and key informants, using two focused interview guides. Data were collected from 13 participants from 6 government health facilities representing the primary, secondary and tertiary healthcare delivery levels. Data were analysed thematically. Results: Data users handled a diverse range of data, the majority having moderate skills in HIM. Both data users and key informants reported experiencing challenges in dealing with the existing HIM system. Findings also revealed key challenges associated with the absence, or inadequacy, of a well-trained HIM professional workforce in Malawi health facilities. Conclusion: Introducing a training programme in HIM would improve data management in health facilities in Malawi. Well-managed data would improve the delivery of health care services.