Towards Integrated Digital Health Systems for Nutrition and Food Security in Uganda: A Cross-Sectional Survey

Abstract

Abstract Despite robust policy frameworks, Uganda’s digital health landscape is characterised by fragmentation—often termed “Pilotitis”—where stand-alone applications impede the integrated delivery of health, nutrition, and food security services. As part of the IGNITE project, this study mapped existing digital health systems (DHSs), identified systemic gaps, and explored opportunities and resource requirements for sustainable integration of existing Health, Nutrition and Food security data systems. The IGNITE project adopted a mixed-methods design; however, this paper reports findings from the first phase—a national cross-sectional survey conducted in Uganda. The survey mapped digital health, nutrition, and food security systems, identifying gaps, resource needs, and potential actions. Stakeholders from government, NGOs, academia, UN agencies, and frontline health workers were included using purposive and snowball sampling. Data were collected online and through field support. Of 134 respondents, 110 with ≥70% survey completion was included in the analysis. While 93% of respondents utilise digital tools (predominantly DHIS2 and mobile apps), only 20% reported full automated integration with national platforms. Critical barriers to interoperability included a lack of technical expertise (90%), insufficient DHIS2 training (82%), different data formats (77%), and infrastructure constraints (75%). Respondents identified workforce development (56%) and DHIS2 use and adoption (29%) as primary opportunities. Immediate priorities include staff training and provision of mobile hardware, while long-term strategies focus on standardised data formats (78%) and formalised governance frameworks for Integrated platforms (64%) and automated data exchange (56%). Uganda possesses a vibrant but disconnected digital ecosystem. Transitioning from isolated “data islands” to a cohesive system requires addressing the massive technical capacity gap and establishing mandated interoperability guidelines. The findings provide a data-driven roadmap for the Ministry of Health and partners to optimise digital health adoption, ensuring that nutrition and food security interventions are supported by a unified, evidence-informed digital architecture Author Summary Uganda uses many digital tools to track health and nutrition, but these systems often do not “talk” to one another. This creates “data islands” where important information about a child’s health or a family’s food security is trapped in one system and cannot be seen by other sectors. We wanted to map these systems to understand why they are fragmented and how to fix them. We surveyed 110 professionals, including government officials, international partners, and community health workers. We asked them what digital tools they use, what stops them from sharing data, and what resources they need to work more effectively. Most people use digital tools, but only 1 in 5 systems is fully connected to the national database. The biggest hurdles are a lack of technical skills, poor internet in rural areas, and different data formats that don’t match. Most workers feel they haven’t been trained well enough to manage these complex digital systems. To improve digital systems for health, nutrition and food security data in Uganda, we must move past small “pilot” projects and build one connected system. This requires urgent investment in training workers, providing tablets for data collection, and setting strict rules that require all new digital tools to be compatible with national systems.