Quality, Usability, and Trust Challenges to Effective Data Use in the Deployment and Use of the Bangladesh Nutrition Information System Dashboard: Qualitative Study

Abstract

Background: Evidence-based decision-making is essential to improve public health benefits and resources, especially in lowmiddle-income countries (LMICs), but the mechanisms of its implementation remain less straightforward. The availability of high-quality, reliable, and sufficient data in LMICs can be challenging due to issues such as lack of human resource capacity and weak digital infrastructure, among others. Health information systems (HIS) have been critical for aggregating and integrating health-related data from different sources to support evidence-based decision-making. Nutrition Information Systems (NIS), which are nutrition-focused HIS, collect and report on nutrition-related indicators to improve issues related to malnutrition and food security -and can assist in improving populations' nutritional statuses and the integration of nutrition programming into routine health services. Data visualization tools (DVT) such as dashboards have been recommended to support such evidencebased decision-making, leveraging data from HIS/NIS. The use of such DVTs to support decision-making has largely been unexplored within LMIC contexts. In Bangladesh, the Mukto dashboard was developed to display and visualize nutrition-related performance indicators at the national and sub-national levels. However, despite this effort, the current use of nutrition data to guide priorities and decisions remains relatively nascent and under-utilized. Objective:The goal of the study is to better understand how Bangladesh's NIS has been utilized and areas for improvement to facilitate its use for evidence-based decision-making towards ameliorating nutrition-related service delivery and health status of communities in Bangladesh.Methods: Primary data collection was conducted through qualitative semi-structured interviews with key policy-level stakeholders (n=24). Key informants were identified through purposive sampling and were asked questions around how the experiences and challenges with the NIS and related nutrition dashboards.