Intergovernmental Learning Exchange to Advance Data-Driven Decision Making: Experiences from Nigeria.

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Oaiya" }, { "@type": "Person", "name": "Oludare Onimode" }, { "@type": "Person", "name": "Olaposi Olatoregun" }, { "@type": "Person", "name": "Gibril Gomez" }, { "@type": "Person", "name": "Bashorun Adebobola" }, { "@type": "Person", "name": "Christopher Isokpunwu" }, { "@type": "Person", "name": "Oladejo Folasade" }, { "@type": "Person", "name": "Balogun Olufunke" }, { "@type": "Person", "name": "Herman Tolentino" }, { "@type": "Person", "name": "Brianna Musselman" }, { "@type": "Person", "name": "Sam Wambugu" } ], "publisher": { "@type": "Organization", "name": "F1000Research", "logo": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 480, "width": 60 } }, "image": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 1200, "width": 150 }, "description": " Background Nigeria has strategically invested in digital health to achieve HIV/AIDS epidemic control, meet SDG health targets, and advance towards UHC. Despite progress, challenges persist. This paper details Nigeria’s commitment, in collaboration with PEPFAR, CDC, and other agencies, to address Health Information System (HIS) challenges through participation in the Intergovernmental Learning Exchange to Advance Data-Driven Decision Making (I-LEAD) programme. Methods The i-LEAD programme followed a 3-phase approach: 1) conducted an expedited Informatics-Savvy Health Organisation (ISHO) assessment to identify critical national HIS challenges; 2) enhanced informatics capabilities of selected Nigerian delegates, including a purpose-fit session, Bring Your Own Difficult Decision (BYODD), involving SMEs to collaboratively refine, contextualise and guide the localised development of actionable solutions for the national HIS challenges; and 3) outlined the nation’s approach to implementing the HIS solutions Results The expedited ISHO assessment identified 5 HIS challenges: governance, interoperability, data security, Electronic Medical Record (EMR) centralisation, and funding. Participating in the i-LEAD programme strengthened Nigeria’s leadership technical capacity in informatics, particularly in strategic visioning and planning, with the BYODD sessions resulting in the collaborative development of localised solutions to address the 5 HIS challenges. In the post-i-LEAD phase, efforts focused on 2 activities for the HIS solutions. These activities are 1) improving data quality through harmonisation of value data sets, and 2) decentralising I-LEAD learning and building the capacity of Public Health Informatics (PHI) technical groups through progressive levels of Growing Expertise in E-Health Knowledge and Skills (GEEKS) training. These activities were selected because of their potential to deliver the maximum impact within the HIS ecosystem. Conclusion Nigeria’s active participation and commitment through the I-LEAD programme have strengthened its digital health agenda, leveraging health informatics to enhance healthcare delivery and achieve broader health goals. This approach can serve as a model for other developing nations facing similar health informatics hurdles. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/14-759/v1", "name": "Intergovernmental Learning Exchange to Advance Data-Driven Decision..." } } ] } Home Browse Intergovernmental Learning Exchange to Advance Data-Driven Decision... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Oaiya AI, Onimode O, Olatoregun O et al. Intergovernmental Learning Exchange to Advance Data-Driven Decision Making: Experiences from Nigeria. [version 1; peer review: 1 approved, 1 not approved] . F1000Research 2025, 14 :759 ( https://doi.org/10.12688/f1000research.166773.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Intergovernmental Learning Exchange to Advance Data-Driven Decision Making: Experiences from Nigeria. [version 1; peer review: 1 approved, 1 not approved] Agbonkhese I. Oaiya https://orcid.org/0000-0002-7327-2870 1 , Oludare Onimode 2 , Olaposi Olatoregun https://orcid.org/0000-0002-2058-5400 2 , [...] Gibril Gomez 2 , Bashorun Adebobola 3 , Christopher Isokpunwu 4 , Oladejo Folasade 5 , Balogun Olufunke 6 , Herman Tolentino 7 , Brianna Musselman 8 , Sam Wambugu 8 Agbonkhese I. Oaiya https://orcid.org/0000-0002-7327-2870 1 , Oludare Onimode 2 , [...] Olaposi Olatoregun https://orcid.org/0000-0002-2058-5400 2 , Gibril Gomez 2 , Bashorun Adebobola 3 , Christopher Isokpunwu 4 , Oladejo Folasade 5 , Balogun Olufunke 6 , Herman Tolentino 7 , Brianna Musselman 8 , Sam Wambugu 8 PUBLISHED 01 Aug 2025 Author details Author details 1 PATH, FCT Abuja, FCT Abuja, Nigeria 2 APIN Public Health Initiative/Public Health Information Surveillance, Systems and Solutions (PHIS3), FCT Abuja, FCT Abuja, Nigeria 3 National HIV/AIDS, Hepatitis and STIs Control Programme (NASCP), Federal Ministry of Health, FCT Abuja, FCT Abuja, Nigeria 4 Health Planning, Research and Statistics, Federal Ministry of Health, FCT Abuja, FCT Abuja, Nigeria 5 Federal Ministry of Women Affairs, FCT Abuja, FCT Abuja, Nigeria 6 Nigeria Ministry of Defence, FCT Abuja, FCT Abuja, Nigeria 7 University of Illinois Chicago, Chicago, Illinois, USA 8 PATH, Seattle, USA Agbonkhese I. Oaiya Roles: Conceptualization, Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Oludare Onimode Roles: Conceptualization, Methodology, Writing – Review & Editing Olaposi Olatoregun Roles: Conceptualization, Methodology, Writing – Review & Editing Gibril Gomez Roles: Conceptualization, Methodology, Writing – Review & Editing Bashorun Adebobola Roles: Conceptualization, Methodology, Supervision, Writing – Review & Editing Christopher Isokpunwu Roles: Conceptualization, Methodology, Supervision, Writing – Review & Editing Oladejo Folasade Roles: Conceptualization, Methodology, Writing – Review & Editing Balogun Olufunke Roles: Conceptualization, Methodology, Writing – Review & Editing Herman Tolentino Roles: Conceptualization, Methodology, Project Administration, Supervision, Writing – Review & Editing Brianna Musselman Roles: Conceptualization, Methodology, Project Administration, Supervision, Writing – Review & Editing Sam Wambugu Roles: Conceptualization, Methodology, Project Administration, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS This article is included in the Health Services gateway. Abstract Background Nigeria has strategically invested in digital health to achieve HIV/AIDS epidemic control, meet SDG health targets, and advance towards UHC. Despite progress, challenges persist. This paper details Nigeria’s commitment, in collaboration with PEPFAR, CDC, and other agencies, to address Health Information System (HIS) challenges through participation in the Intergovernmental Learning Exchange to Advance Data-Driven Decision Making (I-LEAD) programme. Methods The i-LEAD programme followed a 3-phase approach: 1) conducted an expedited Informatics-Savvy Health Organisation (ISHO) assessment to identify critical national HIS challenges; 2) enhanced informatics capabilities of selected Nigerian delegates, including a purpose-fit session, Bring Your Own Difficult Decision (BYODD), involving SMEs to collaboratively refine, contextualise and guide the localised development of actionable solutions for the national HIS challenges; and 3) outlined the nation’s approach to implementing the HIS solutions Results The expedited ISHO assessment identified 5 HIS challenges: governance, interoperability, data security, Electronic Medical Record (EMR) centralisation, and funding. Participating in the i-LEAD programme strengthened Nigeria’s leadership technical capacity in informatics, particularly in strategic visioning and planning, with the BYODD sessions resulting in the collaborative development of localised solutions to address the 5 HIS challenges. In the post-i-LEAD phase, efforts focused on 2 activities for the HIS solutions. These activities are 1) improving data quality through harmonisation of value data sets, and 2) decentralising I-LEAD learning and building the capacity of Public Health Informatics (PHI) technical groups through progressive levels of Growing Expertise in E-Health Knowledge and Skills (GEEKS) training. These activities were selected because of their potential to deliver the maximum impact within the HIS ecosystem. Conclusion Nigeria’s active participation and commitment through the I-LEAD programme have strengthened its digital health agenda, leveraging health informatics to enhance healthcare delivery and achieve broader health goals. This approach can serve as a model for other developing nations facing similar health informatics hurdles. READ ALL READ LESS Keywords i-LEAD, GEEKS, HIV/AIDS, EMR, NDR, Governance, Public Health Informatics, Digital Health, Informatics Savvy Health Organisation (ISHO), Nigeria. Corresponding Author(s) Agbonkhese I. Oaiya ( [email protected] ) Close Corresponding author: Agbonkhese I. Oaiya Competing interests: No competing interests were disclosed. Grant information: This activity was funded by the U.S Centres for Disease Control and Prevention (CDC) under "The Technical Assistance Platform (TAP)" project through a cooperative agreement. The contents of this publication are solely the responsibility of the authors and do not necessarily reflect the views of the U.S. Government. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Copyright: © 2025 Oaiya AI et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Oaiya AI, Onimode O, Olatoregun O et al. Intergovernmental Learning Exchange to Advance Data-Driven Decision Making: Experiences from Nigeria. [version 1; peer review: 1 approved, 1 not approved] . F1000Research 2025, 14 :759 ( https://doi.org/10.12688/f1000research.166773.1 ) First published: 01 Aug 2025, 14 :759 ( https://doi.org/10.12688/f1000research.166773.1 ) Latest published: 23 Feb 2026, 14 :759 ( https://doi.org/10.12688/f1000research.166773.2 )  There is a newer version of this article available. Suppress this message for one day. Introduction Globally, the widespread integration of digital technology has transformed how various industries operate, including those in the healthcare sector. Digital technology in health increases the accessibility to medical information, telemedicine, electronic health records, and cutting-edge diagnostics, resulting in more efficient, personalised, accessible, and improved delivery of quality healthcare services. 1 It is expected that the widespread adoption of these technologies in health would increase the potential for global connectedness by growing countries’ progress towards bridging the digital divide within their respective health systems, developing informatics-savvy groups to secure and sustain these interoperable systems, and achieving improved quality of healthcare for all. 1 , 2 Nigeria is one such developing country that has made significant investments in the digital health space to bridge the digital divide to achieve Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) epidemic control and achieve its vision to be a nation free from the Acquired Immune Deficiency Syndrome (AIDS) disease, meet the 2030 agenda by accelerating progress across the health-related Sustainable Development Goals (SDG), and ultimately, advance towards Universal Health Coverage (UHC) for her populace. 3 Nigeria’s digital health sector has witnessed remarkable growth and transformation in recent years. The country has recognised the pivotal role of digital technology in improving healthcare access and delivery, especially in the diagnosis, treatment and management of HIV/AIDS disease, which is a known contributor to national mortality rates. Presently, the Nigerian digital health ecosystem comprises several global health technologies that have been adapted and implemented to enhance patient care and streamline healthcare management. 3 – 6 These technologies include Health Information Systems (HIS) like the National Health Management Information System (NHMIS) driven by the District Health Information System (DHIS2), the National Health Workforce Registry (NHWR) that is based on the iHRIS Manage Software, Electronic Medical Records (EMR) based on OpenMRS and other platforms, and a National Data Repository (NDR), leveraging popular Free and Opensource solutions. 3 – 7 In addition, the government of Nigeria, in partnership with global organisations like the United States’ President’s Emergency Plan for AIDS Relief (PEPFAR), has also initiated numerous programs aimed at optimising digital healthcare governance and enhancing the infrastructure base, and there has been remarkable achievement. 8 – 10 The country has also adopted a national eHealth strategy and policy framework to oversee the incorporation of technology into the healthcare sector, encouraging the seamless exchange of data among healthcare institutions. However, some challenges persist. Digital eHealth governance in Nigeria is not fully functional when compared to the global benchmark. 6 While there is an eHealth strategy in place, complete with a monitoring and evaluation framework, it faces challenges when it comes to practical implementation. Various digital technological solutions have been developed independently, often without adherence to the recommended health information standards for data exchange, transmission, and messaging, as well as security, privacy, and hardware. These siloed and isolated initiatives limit the smooth exchange of data among them, consequently affecting the quality of healthcare services rendered at the various points of care and impeding collaborative efforts in reducing the epidemic impact of HIV/AIDS. Additionally, there are concerns regarding financing digital health in the country. 6 Finding a sustainable funding model remains a challenge for many projects and programs, and, notably, the absence of a workforce proficient in informatics to effectively plan for, manage and sustain the digital health sector further complicates the landscape. This paper outlines the measures taken by the Government of Nigeria, spearheaded by the Federal Ministry of Health (FMoH) through the National AIDS, Viral Hepatitis and STI Control Programme (NASCP), along with other ministries such as the Federal Ministry of Women Affairs (FMoWA) and the Nigerian Ministry of Défense (NMoD) and in collaboration with key international partners. These efforts were supported by the United States’ President’s Emergency Plan for AIDS Relief (PEPFAR) and its implementing agencies, including the Centres for Disease Control and Prevention (CDC), the Department of Defense (DoD), and the United States Agency for International Development (USAID). Together, these diverse stakeholders worked to identify and address common national HIS challenges, with a focus on optimising and operationalising the national digital health governance, enhancing the coordination of HIV/AIDS disease programme areas to attain epidemic control, and, more importantly, cultivating an informatics-savvy workforce able to sustain the Nigerian digital health ecosystem. These were achieved through participation and commitment to the I-LEAD programme. The I-LEAD programme aims to empower leaders, managers, and technical experts engaged in public health informatics in envisioning the digital health landscape, formulating effective strategies to realise their vision, and successfully implementing and sustaining these strategies. This becomes especially valuable for Nigeria, as the nation endeavours to harness digital investments and solutions to enhance healthcare delivery, achieve a nation free of AIDS, and ultimately attain UHC for its population. Methods Setting the context It has been nearly four decades since the outbreak of Nigeria’s first HIV/AIDS cases. Since then, the government of Nigeria, with support from international partners such as PEPFAR, has been actively involved in the fight against HIV/AIDS to attain epidemic control and achieve an AIDS-free Nigeria, with zero new infections, zero discrimination and stigma and zero AIDS-related deaths. 11 Recently, the Nigerian government has taken significant steps towards optimising the management of patient health information, elevating data quality, and fostering a more efficient and coordinated approach to healthcare services, particularly within the realm of HIV/AIDS programme management. To support this paradigm shift, PEPFAR, through its agency partners; CDC, USAID and DoD, and in-country technical partner, Public Health Information Surveillance, Systems and Solutions (PHIS3), partnered with the government of Nigeria in institutionalising relevant eHealth technologies in alignment with the recommended National Health Information Architecture. As of December 2023, EMRs have been deployed across a total of 2,439 health facilities in all states in Nigeria, including the Federal Capital Territory Abuja. In addition, a central repository of de-identified patient-level data aggregated from these service delivery points, called the National Data Repository (NDR), has also been deployed with over 1.9 million patients actively in treatment as of the same date. 12 Apart from implementing these eHealth technologies, a series of multifaceted and phased capacity-building sessions was also conducted to drive ownership and sustainability post-donor support. Some of these learning and development workshops were designed to align with the various administrative structures of the government, emphasising broad health informatics-related activities such as strategy development. Other sessions delved into the practical implementation of these strategies by building capacity for the relevant actions and procedures needed to translate these strategic goals into actionable activities. Additionally, some workshops focused on the effective utilisation of institutionalised digital tools within the context of HIV/AIDS care. Nevertheless, challenges were encountered in establishing the crucial link between formulating a robust national digital health vision, creating comprehensive cross-cutting strategies that spanned all disease and health areas, and effectively translating these long-term and medium-term strategies into operational actions to foster the growth of the digital landscape in Nigeria. Intergovernmental Learning Exchange to Advance Data-Driven Decision Making (I-LEAD) The Intergovernmental Learning Exchange to Advance Data-Driven Decision Making, which is commonly referred to as I-LEAD, is a programme that aims to empower diverse country-level leaders beyond decision-making and policy formulation capacities, managers and technical experts in the public health informatics space. The programme supports these nationally diverse stakeholders in envisioning the digital health landscape, formulating effective strategies to realise their vision, and successfully implementing and sustaining these strategies for impact. To ensure effective planning, implementation, and sustainability of national digital health solutions and their impact on ensuring the delivery of care, PHI professionals in leadership and managerial capacities should cultivate proficiency across four fundamental dimensions: Vision, Strategy, Operations, and Tactics (VSOT). 13 The I-LEAD programme primarily focuses on the initial two components of this framework. Completing I-LEAD includes an additional learning event called Growing Expertise in E-Health Knowledge and Skills (GEEKS). GEEKS focuses on the other two dimensions: operations and tactics. Together, the synergy of combining these learning programs, I-LEAD and GEEKS, results in a collective strengthening of the proficiency of a diverse spectrum of PHI stakeholders. The combined approach, which addresses all four VSOT framework dimensions, guarantees that national entities, including PHI leaders and decision-makers or policy formulators, managers, and technical experts, who are essential in conceiving the digital health landscape and developing strategies to realise it, are better prepared to realise their vision, and effectively execute and maintain these strategies. The I-LEAD programme is conducted on a per-demand basis, and the frequency depends on the requests received from countries that are expected to commit to the programme requirements. One crucial commitment involves following through with the roadmap as an integral part of the post I-LEAD phase. Nigeria, through the FMoH/NASCP and its PEPAR partners, expressed their interest in attending the 2023 edition, which also included representation from other countries in the eastern African region. Establishing a core technical team To ensure Nigeria’s active involvement in the I-LEAD programme, a core technical team was established, comprising representatives from FMoH-NASCP, PHIS3, and the Technical Assistance Platform (TAP) - a CDC-supported project driven by PATH that aims to assist Nigeria in harnessing and implementing sustainable digital health technologies. This core team had two primary responsibilities, with the first securing Nigeria’s participation in the I-LEAD event. The core team collaborated with the I-LEAD organisers, notably staff from the CDC headquarters in Atlanta, to provide orientation on the prerequisites and processes for attending the I-LEAD event. This orientation also covered Nigeria’s commitment post I-LEAD. The second core team’s responsibility was to coordinate the Nigerian delegates attending the event in completing the I-LEAD preparatory activities. One such activity was leveraging an evidence-based method, the ISHO assessment framework, to identify national HIS challenges to bring to the event. Formulating the Nigerian delegates to participate in the I-LEAD The technical core team identified and selected 17 delegates to represent Nigeria. The Nigerian delegation included government representatives from the Federal Ministry of Health and NASCP, Federal Ministry of Women Affairs (FMoWA), and Nigerian Ministry of Defence (NMoD), as well as individuals from various inter-agency organisations such as the CDC, DoD, USAID, APIN Public Health Initiatives/PHIS3, Palladium Group/Data.Fi, and PATH. With support from the I-LEAD organisers and the core technical team, the delegates underwent a comprehensive orientation that covered various aspects of the I-LEAD process in optimising country HIS ecosystems. This included a detailed explanation of the prerequisites for participation and a thorough understanding of Nigeria’s commitment to the post I-LEAD activities. In addition, the delegates were trained to enhance their capacities in utilising the ISHO framework in assessing national informatics systems readiness, identifying HIS gaps across key health system domains impacting healthcare service delivery, and using those insights to inform strategic planning activities and health system strengthening initiatives. Notably, identifying these national HIS gaps must be done empirically through the conduct of an ISHO assessment. This is a fundamental requirement for participating in the I-LEAD programme. Conducting an ISHO assessment ISHO stands for Informatics-Savvy Health Organisation. 14 , 15 The ISHO toolkit was originally developed by the Public Health Informatics Institute (PHII) to guide governments, agencies, or any organisation in assessing their informatics readiness and capabilities, to develop e-Health strategies, information systems, electronic health information exchanges, and ensure the availability of an informatics-savvy workforce to achieve a digital public health future. 14 The ISHO toolkits consist of 2 types of tools: an above-site and site level. Both tools achieve their goal by assessing informatics capabilities across three strategic pillars. The first pillar, “Vision, Policy, and Governance”, focuses on the existing digital health governing structures, delving into the implementation status of current digital health policies, strategies, and costed plans. The second is “Skilled Workforce”, which examines the structures that ensure the continuous supply and availability of informatics-savvy health workers. The last pillar is “Effective Information Systems”, which evaluates the technological aspects of the current information technology capabilities. 15 – 21 Using the above site ISHO tool, the Nigerian delegates conducted an expedited ISHO assessment at the national level in Nigeria. Each delegate, representing key government ministries including the FMoH and NASCP, the FMoWA, the NMoD, and implementing partners supporting the Nigerian government HIV/AIDS response, played a key role in conducting the assessment. The goal of the evaluation was to determine national HIS strengths, as well as identify informatics challenges, towards establishing a national baseline. Furthermore, completing this stage is a prerequisite for taking part in a BYODD session during the I-LEAD event. This interactive session provides the platform where critical HIS challenges in participating countries are collectively addressed with support from global public health informatics experts. The completed above-site ISHO tools were collated, after which the Nigerian delegates convened multiple times to collectively review and analyse each completed above-site tool. Responses from each completed above-site tool were aggregated in a structured format to identify recurring patterns across the different evaluated domains, synthesise emergent themes and collectively shortlist the HIS challenges for presentation in the I-LEAD’s BYODD session. Prioritising national HIS gaps The national HIS gaps identified after conducting the expedited above-site ISHO assessment were further shortlisted. This was done after several consultative meetings with the government of Nigeria and health informatics Subject Matter Experts (SME) internally and externally, from the CDC headquarters. A selection criterion was developed, and factors such as implementation impact in the digital health space, required resources such as human resources for health (HRH) and cost of implementation, as well as the anticipated timelines, were used to rank and prioritise HIS challenges. Results ISHO assessment findings Several health informatics challenges were identified following the analysis of the expedited above-site ISHO assessment and presented in Figure 2 . Issues around HIS governance and coordination were a notable challenge. Others revolved around data security, systems interoperability, EMR centralisation and strategies for improvement of data quality, data management and use, sustainability, and funding. Further discussions were held amongst the delegates attending the I-LEAD and health informatics SME from the government of Nigeria and PEPFAR to distil the identified gaps into five (5) that would be addressed at the I-LEAD event. The foremost informatics gap centred on (1) governance, while others revolved around (2) information system interoperability, (3) data security, (4) EMR centralisation to address the availability of 3 fully established EMRs in Nigeria, and (5) securing digital health funding. Outputs from I-LEAD’s BYODD sessions The Nigerian delegate’s capacity was built across various aspects in envisioning, conceptualising, and developing country-level informatics strategies using multiple evidence-based problem-solving methodologies. Specific to the BYODD sessions, it consisted of numerous iterative sessions with SMEs. During these sessions, the HIS challenges specific to Nigeria were presented, rigorously examined, leveraging different problem-solving methodologies, other country experiences, all tailored to the unique local context. The Nigerian HIS challenges were subsequently addressed and redefined, and 5 solutions are presented in Table 1 below. Of the 5 proposed solutions, 4 were HIS governance-related. These were proposed due to the peculiarities of our multi-stakeholder environment, ensuring coordination and focused intervention to achieve considerable impact with modest resource requirements through efficient implementation planning. Table 1. Redefined HIS challenges after BYODD sessions. HIS challenge domain Activity Description Priority * HIS Governance and Systems Interoperability Improving data quality through harmonisation of value data sets Improve data exchange between all EMRs in Nigeria, NigeriaMRS, LAMISPlus and ViVa, with the NDR through harmonisation of value data sets * High (5) Knowledge Sharing and Sustainability Decentralise I-LEAD learning and/or build the capacity of PHI technical groups by convening a TIER 1 and 2 GEEKS training This activity focuses on harnessing the benefits of the VSOT framework by combining the I-LEAD and GEEKS programmes. This activity shall foremost decentralise the knowledge gained during the I-LEAD and then plan for and conduct a GEEKS programme for technical experts * High (5) HIS Governance Digital Health Strategy Implementation and Use Operationalise and monitor the implementation of the revised Nigeria Digital Health Strategy to enhance the effectiveness of streamlined healthcare operations High (4) HIS Governance Addressing digital health data standards challenges through TA for the Digital Health Standards Subcommittee Technical assistance (TA) to support digital health standards subcommittees of the National Digital Health Technical Committee (NDHTC) High (4) HIS Governance (Security) Conduct security vulnerability and risk assessment on EMR and NDR systems Identifying and addressing potential security vulnerabilities and risks within the EMR and NDR Medium (3) * Activity selected for implementation by the Nigerian delegates as part of the post I-LEAD phase. The first HIS governance streamlined activity focused on improving data quality through the harmonisation of value data sets across all EMRs in the country. The second activity identified from the broader HIS governance challenges focused on the existing Nigerian digital health strategy, specifically, on its implementation and role in supporting interoperability across key information systems to optimise healthcare service delivery. This included activities related to operationalising and monitoring the rollout of the revised strategy. Addressing digital health data standards challenges through technical assistance for the Nigerian digital health standards subcommittee and conducting a security vulnerability and risk assessment on health information systems involved in HIV/AIDS, EMRs, and NDR systems were the third and fourth streamlined activities. The fifth and last activity was on knowledge transfer to promote ownership and sustainability post-donor support. This focused on decentralising the knowledge gained from the I-LEAD, harnessing the fullness of the VSOT framework by conducting a progressive GEEKS event. A detailed roadmap outlining the various tasks to be undertaken across the streamlined activities presented in Table 1 was created and is provided in Appendix I. Finally, as part of the Nigerian government’s commitment to the I-LEAD programme, two activities were prioritised for implementation. These included improving data quality through harmonisation of value data sets and decentralising I-LEAD learning and building the capacity of PHI technical groups by convening a tier 1 and 2 GEEKS training. Discussion In preparation for the I-LEAD programme, the Nigerian delegates engaged in activities to identify common national HIS gaps. This emerged through an evidence-based approach by conducting an expedited above-site ISHO assessment. Following the assessment, multiple consultative meetings and discussion sessions were held to prioritise identified HIS challenges with the highest priority. Overall, 5 HIS challenges were selected for the I-LEAD event after consultative meetings with the Nigerian technical team and delegates, with support from PHI SMEs in-country and externally from supporting donors and implementing partners. Participating in the I-LEAD demonstrated successful resolution of the shortlisted HIS gaps. Five (5) practicable strategies with the most significant potential to address the identified national HIS issues were generated based on criteria that were unique to our locality, and these were presented in Table 1 above. Furthermore, two (2) of these strategies were selected and earmarked for implementation by the Nigerian delegates as part of the post I-LEAD commitment. These activities were selected based on criteria such as impact on the digital health space, availability of existing structures or some level of previous work to build on, and the resources required. The first activity cuts across two domains of the Nigerian digital health space: governance and system interoperability. Its objective is to enhance data exchange among all EMRs in Nigeria; NigeriaMRS, LAMISPlus and ViVA EMR, with the NDR through harmonisation of value data sets. The second activity focused on knowledge dissemination and harnessing the benefits of the VSOT framework through participating in the I-LEAD programme. This initiative sought to decentralise I-LEAD learnings, specifically focusing on the first two components of the VSOT framework: vision and strategy. Additionally, it is also aimed to enhance the capabilities of the internal PHI technical groups by organising tier 1 and 2 GEEKS training, with the GEEKS training specifically addressing the last two components of the VSOT framework: operation and tactics. There was a limitation in the I-LEAD approach presented in Figure 1 . The limitation was the expedited above-site ISHO assessment conducted to identify and shortlist HIS gaps taken to the I-LEAD event. The evaluation was a rapid one and limited in scope. Although the technical core team embarked on multiple consultative meetings with PHI SMEs locally and externally to mitigate this, we recommend conducting a more comprehensive ISHO assessment, one that encompasses both above-site and site level evaluations. This expanded assessment would provide a more thorough understanding of HIS challenges and better inform strategies for future improvements. Figure 1. Overview of the Nigeria I-LEAD experience across 3 phases: preparatory activities, the I-LEAD main event, and post I-LEAD activities. Abbreviations: AI, Artificial intelligence; BYODD, Bring Your Own Difficult Decision; CDC, US Centers for Disease Control and Prevention; DoD, United States Department of Defense; FHIR, Fast Healthcare Interoperability Resources; GEEKS, Growing Expertise in E-Health Knowledge and Skills; GoN, Government of Nigeria; HIS, Health information system; I-LEAD, Intergovernmental Learning Exchange to Advance Data-Driven Decision Making; ISHO, Informatics-Savvy Health Organization; PEPFAR, United States President’s Emergency Plan for AIDS Relief; PHIS3, Public Health Information Surveillance, Systems and Solutions; USAID, United States Agency for International Development; TAP, Technical Assistance Platform; VSOT, Vision, Strategy, Operations, and Tactics. Figure 2. National HIS challenges identified after expedited above-site ISHO assessment. Conclusion In conclusion, I-LEAD adopts an evidence-based methodology for shaping policies to tackle health informatics challenges countries face. This approach differs significantly from the conventional approach most developing countries use, which is often ineffective and lacks widespread impact in the broader health sector. The I-LEAD approach employs an empirical strategy in determining national health informatics-related challenges. It incorporates a series of capacity-building activities to reinforce PHI’s leadership and management skills. This approach helps in envisioning long-term informatics-related objectives and provides tailored approaches to address challenges to the specific needs of the locality. For the Nigerian delegation led by the FMoH, engaging in the I-LEAD program resulted in numerous significant advantages. This initiative served as a valuable platform for advancing their proficiency in health policy and governance, focusing particularly on key areas such as data sharing, data security, innovative financing, and sustainability. The program also addressed essential knowledge domains like data integration, interoperability, FHIR and Terminology Standards, as well as Machine Learning and Generative Artificial Intelligence. Additionally, it encompassed strategies for enhancing workforce recruitment, development, and retention within the informatics realm. Furthermore, the I-LEAD program facilitated direct interaction with experts in the health informatics field, enabling the delegation to harness evidence-based techniques for addressing identified PHI challenges in Nigeria. Lastly, the FMoH’s commitment to implementing the refined PHI solution was solidified through their participation in the program, establishing the groundwork for bridging the digital divide in the country. Implications for policy & practice The findings and interventions outlined in this report bear significant implications for policy and practice in Nigeria’s healthcare landscape. Firstly, the identification of national health informatics challenges, particularly in governance, interoperability, data security, EMR centralisation, and funding, emphasised the necessity for a thorough and well-coordinated digital health strategy. This will guide policymakers to prioritise establishing, implementing, and monitoring robust governance frameworks to facilitate the smooth integration of various digital health initiatives in Nigeria. Furthermore, the commitment to address these challenges through the I-LEAD programme signifies a shift towards evidence-based policymaking. The I-LEAD programme incorporated BYODD sessions, which harnessed the expertise of global PHI experts to refine and streamline Nigeria’s HIS challenges into actionable activities with the broadest impact across multiple health domains. Finally, the emphasis on improving data exchange between EMRs as part of the post I-LEAD phase demonstrates the Nigerian government’s commitment to building a skilled workforce and ensuring the integrity and confidentiality of health data. This phase opens the path for better data-driven decision-making and more efficient healthcare operations. Policymakers can utilize this model to shape future initiatives, creating a robust and responsive digital health ecosystem and acting as a model for other countries facing similar difficulties. Disclaimer The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of any affiliated agency of the authors. Data availability Underlying data All data supporting the results are included within this article and its related files. Figshare: iLEAD Experience in Nigeria: Supplementary Data: https://doi.org/10.6084/m9.figshare.29345027 . 22 This project contains the following data: • Figure 1. jpg - Overview of the Nigeria I-LEAD Experience across 3 phases: preparatory activities, the I-LEAD main event, and post I-LEAD activities. • Figure 2. jpg - National HIS Challenges Identified After Expedited Above-Site ISHO Assessment. • Table 1 – Redefined HIS Challenges After BYODD Sessions. • Appendix 1 - Nigeria I-LEAD Roadmap.xlsx. • ISHO Expedited Assessment Templates and Completed Tools. Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0). Acknowledgements We would like to express our heartfelt gratitude to the organisers of the I-LEAD 2023 edition for the East and West African region. Special thanks go to the following persons: 1. Herman Tolentino 2. Sri Wilmore 3. Tadesse Wuhib 4. Neranga Liyanaarachchige 5. Maria Jolly 6. Jan MacGregor 7. Daniel Rosen 8. Julianna Kohler 9. Nega Gebreyesus 10. Katy Handley Sincere thanks also go to the following persons, who were part of the Nigerian delegates. 11. Dalhatu Ibrahim 12. Isah Abbas 13. Richard Ugbena (Deceased, January 2025) 14. Onime David 15. Ogorry Otse 16. Mathew Adegbite 17. Nwadike Chukwuka Livinus 18. Ogbonna Ifeanyichukwu Charles 19. Okoye Ifeanyichukwu References 1. World Health Organization: Global Strategy on Digital Health.2021; 57 . Publisher Full Text 2. United Nations General Assembly: Transforming our world: the 2030 Agenda for Sustainable Development.2017; 16301 : 467–490. Publisher Full Text 3. Federal Ministry of Health Nigeria: National Health ICT Strategic Framework.2016. 4. PATH: Digital Square Global Goods.2019. 5. World Health Organization (WHO): Global Digital Health Monitor World Health Organisation. WHO; 2023. 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Publisher Full Text Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 01 Aug 2025 ADD YOUR COMMENT Comment Author details Author details 1 PATH, FCT Abuja, FCT Abuja, Nigeria 2 APIN Public Health Initiative/Public Health Information Surveillance, Systems and Solutions (PHIS3), FCT Abuja, FCT Abuja, Nigeria 3 National HIV/AIDS, Hepatitis and STIs Control Programme (NASCP), Federal Ministry of Health, FCT Abuja, FCT Abuja, Nigeria 4 Health Planning, Research and Statistics, Federal Ministry of Health, FCT Abuja, FCT Abuja, Nigeria 5 Federal Ministry of Women Affairs, FCT Abuja, FCT Abuja, Nigeria 6 Nigeria Ministry of Defence, FCT Abuja, FCT Abuja, Nigeria 7 University of Illinois Chicago, Chicago, Illinois, USA 8 PATH, Seattle, USA Agbonkhese I. Oaiya Roles: Conceptualization, Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Oludare Onimode Roles: Conceptualization, Methodology, Writing – Review & Editing Olaposi Olatoregun Roles: Conceptualization, Methodology, Writing – Review & Editing Gibril Gomez Roles: Conceptualization, Methodology, Writing – Review & Editing Bashorun Adebobola Roles: Conceptualization, Methodology, Supervision, Writing – Review & Editing Christopher Isokpunwu Roles: Conceptualization, Methodology, Supervision, Writing – Review & Editing Oladejo Folasade Roles: Conceptualization, Methodology, Writing – Review & Editing Balogun Olufunke Roles: Conceptualization, Methodology, Writing – Review & Editing Herman Tolentino Roles: Conceptualization, Methodology, Project Administration, Supervision, Writing – Review & Editing Brianna Musselman Roles: Conceptualization, Methodology, Project Administration, Supervision, Writing – Review & Editing Sam Wambugu Roles: Conceptualization, Methodology, Project Administration, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information This activity was funded by the U.S Centres for Disease Control and Prevention (CDC) under "The Technical Assistance Platform (TAP)" project through a cooperative agreement. The contents of this publication are solely the responsibility of the authors and do not necessarily reflect the views of the U.S. Government. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Article Versions (2) version 2 Revised Published: 23 Feb 2026, 14:759 https://doi.org/10.12688/f1000research.166773.2 version 1 Published: 01 Aug 2025, 14:759 https://doi.org/10.12688/f1000research.166773.1 Copyright © 2025 Oaiya AI et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Oaiya AI, Onimode O, Olatoregun O et al. Intergovernmental Learning Exchange to Advance Data-Driven Decision Making: Experiences from Nigeria. [version 1; peer review: 1 approved, 1 not approved] . F1000Research 2025, 14 :759 ( https://doi.org/10.12688/f1000research.166773.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 01 Aug 2025 Views 0 Cite How to cite this report: Adoyo M. Reviewer Report For: Intergovernmental Learning Exchange to Advance Data-Driven Decision Making: Experiences from Nigeria. [version 1; peer review: 1 approved, 1 not approved] . F1000Research 2025, 14 :759 ( https://doi.org/10.5256/f1000research.183812.r402549 ) The direct URL for this report is: https://f1000research.com/articles/14-759/v1#referee-response-402549 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 03 Nov 2025 Maureen Adoyo , Kenya Medical Research Institute, Nairobi, Nairobi County, Kenya; Information Science, Health Records and Systems, Rongo University (Ringgold ID: 390296), Rongo, Migori County, Kenya Approved VIEWS 0 https://doi.org/10.5256/f1000research.183812.r402549 The paper is adequate in both form and content. The logical flow and documentation of processes are well executed and provide valuable insights that are worth sharing for adoption by countries facing similar HIS challenges. However, there are a few ... Continue reading READ ALL The paper is adequate in both form and content. The logical flow and documentation of processes are well executed and provide valuable insights that are worth sharing for adoption by countries facing similar HIS challenges. However, there are a few areas that require further elaboration and improvement to enhance clarity and practical applicability Regarding the VSOT framework and other approaches mentioned, please clarify whether they were developed during the implementation of the program or adapted from an existing source. If it is an original innovation, consider providing a visual presentation to facilitate adoption by other programs. If not, please acknowledge the source appropriately. Methodology It is important to clarify how the number of 17 delegates for participation in the I-LEAD programme was determined. Was this primarily influenced by a vailable resources, or were there other criteria e.g., expertise, institutional representation, or regional balance, that guided the decision? Additionally, provide details on the distribution of these delegates among the representative government bodies and agencies. Results Check the results section. The sentence “A detailed roadmap outlining the various tasks to be undertaken across the streamlined activities presented in Table 1 was created and is provided in Appendix 1” requires revision. Since the process has already been undertaken, I suggest using a reporting verb. Discussion I appreciate the flow-chart figure providing an overview of the Nigeria I-LEAD experience across three phases—preparatory activities, the I-LEAD main event, and post-I-LEAD activities. However, the multiple consultative meetings and discussion sessions mentioned in the discussion still need further elaboration. It is important to specify the number of these sessions and describe what each session achieved. Please also clarify whether the sessions were designed to address separate objectives or whether each session informed the next convening. This additional information should also be incorporated into the methodology section to guide countries that may wish to replicate the i-LEAD approach to strengthening HIS. Conclusion Looking at the conclusion and the stated aim of the I-LEAD programme aims to empower leaders, managers, and technical experts engaged in public health informatics in envisioning the digital health landscape, formulating effective strategies to realise their vision, and successfully implementing and sustaining these strategies” —it would strengthen the paper to highlight specific leadership attributes the program developed that are critical for revolutionizing the digital health landscape. Additionally, please indicate any strategies, for example, approaches to sustainable funding developed through this process. Key lessons or highlights in implementing effective and efficient public health informatics or advancing a robust digital health landscape would also provide valuable insights for replication and scale-up. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly References 1. Oaiya A, Onimode O, Olatoregun O, Gomez G, et al.: Intergovernmental Learning Exchange to Advance Data-Driven Decision Making: Experiences from Nigeria. F1000Research . 2025; 14 . Publisher Full Text Competing Interests: No competing interests were disclosed. Reviewer Expertise: Governance, Digital Health, Health Policy, Health System Surveillance for Emerging and Re-emerging Diseases, and Health Information Systems Strengthening. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Adoyo M. Reviewer Report For: Intergovernmental Learning Exchange to Advance Data-Driven Decision Making: Experiences from Nigeria. [version 1; peer review: 1 approved, 1 not approved] . F1000Research 2025, 14 :759 ( https://doi.org/10.5256/f1000research.183812.r402549 ) The direct URL for this report is: https://f1000research.com/articles/14-759/v1#referee-response-402549 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 23 Feb 2026 Agbonkhese Oaiya , PATH, FCT Abuja, Nigeria 23 Feb 2026 Author Response Firstly, we sincerely thank you for your thoughtful and encouraging review, and for recognising the manuscript’s overall quality, logical flow, and relevance to countries facing similar Health Information System challenges. ... Continue reading Firstly, we sincerely thank you for your thoughtful and encouraging review, and for recognising the manuscript’s overall quality, logical flow, and relevance to countries facing similar Health Information System challenges. The following are our responses to the comments raised: The VSOT framework was not developed during the Nigerian I-LEAD implementation. Rather, it was adopted from established literature and operationalised in practice through the combined use of the I-LEAD and GEEKS programmes. We have clarified this distinction in the revised manuscript. The selection of the delegates was based on a balance between the scope of the HIV/AIDS programme in Nigeria and institutions involved in HIS governance, planning and implementation. We have expanded this explanation in the methods section to improve transparency. These consultative sessions in the pre-I-LEAD phase were regular meetings to ensure alignment with agreed objectives and to track progress. We have updated the manuscript to include this description. We have carefully revised the manuscript in line with the feedback provided. Firstly, we sincerely thank you for your thoughtful and encouraging review, and for recognising the manuscript’s overall quality, logical flow, and relevance to countries facing similar Health Information System challenges. The following are our responses to the comments raised: The VSOT framework was not developed during the Nigerian I-LEAD implementation. Rather, it was adopted from established literature and operationalised in practice through the combined use of the I-LEAD and GEEKS programmes. We have clarified this distinction in the revised manuscript. The selection of the delegates was based on a balance between the scope of the HIV/AIDS programme in Nigeria and institutions involved in HIS governance, planning and implementation. We have expanded this explanation in the methods section to improve transparency. These consultative sessions in the pre-I-LEAD phase were regular meetings to ensure alignment with agreed objectives and to track progress. We have updated the manuscript to include this description. We have carefully revised the manuscript in line with the feedback provided. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 23 Feb 2026 Agbonkhese Oaiya , PATH, FCT Abuja, Nigeria 23 Feb 2026 Author Response Firstly, we sincerely thank you for your thoughtful and encouraging review, and for recognising the manuscript’s overall quality, logical flow, and relevance to countries facing similar Health Information System challenges. ... Continue reading Firstly, we sincerely thank you for your thoughtful and encouraging review, and for recognising the manuscript’s overall quality, logical flow, and relevance to countries facing similar Health Information System challenges. The following are our responses to the comments raised: The VSOT framework was not developed during the Nigerian I-LEAD implementation. Rather, it was adopted from established literature and operationalised in practice through the combined use of the I-LEAD and GEEKS programmes. We have clarified this distinction in the revised manuscript. The selection of the delegates was based on a balance between the scope of the HIV/AIDS programme in Nigeria and institutions involved in HIS governance, planning and implementation. We have expanded this explanation in the methods section to improve transparency. These consultative sessions in the pre-I-LEAD phase were regular meetings to ensure alignment with agreed objectives and to track progress. We have updated the manuscript to include this description. We have carefully revised the manuscript in line with the feedback provided. Firstly, we sincerely thank you for your thoughtful and encouraging review, and for recognising the manuscript’s overall quality, logical flow, and relevance to countries facing similar Health Information System challenges. The following are our responses to the comments raised: The VSOT framework was not developed during the Nigerian I-LEAD implementation. Rather, it was adopted from established literature and operationalised in practice through the combined use of the I-LEAD and GEEKS programmes. We have clarified this distinction in the revised manuscript. The selection of the delegates was based on a balance between the scope of the HIV/AIDS programme in Nigeria and institutions involved in HIS governance, planning and implementation. We have expanded this explanation in the methods section to improve transparency. These consultative sessions in the pre-I-LEAD phase were regular meetings to ensure alignment with agreed objectives and to track progress. We have updated the manuscript to include this description. We have carefully revised the manuscript in line with the feedback provided. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Hrzic R. Reviewer Report For: Intergovernmental Learning Exchange to Advance Data-Driven Decision Making: Experiences from Nigeria. [version 1; peer review: 1 approved, 1 not approved] . F1000Research 2025, 14 :759 ( https://doi.org/10.5256/f1000research.183812.r409713 ) The direct URL for this report is: https://f1000research.com/articles/14-759/v1#referee-response-409713 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 05 Sep 2025 Rok Hrzic , Maastricht University, Maastricht, The Netherlands Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.183812.r409713 The authors present a fascinating case study of workforce development in digital health in Nigeria. The manuscript contributes to the emerging literature on best practices in empowering the health and public health workforce to actively engage with the processes of ... Continue reading READ ALL The authors present a fascinating case study of workforce development in digital health in Nigeria. The manuscript contributes to the emerging literature on best practices in empowering the health and public health workforce to actively engage with the processes of digital transformation in health systems. However, in its current shape, the report lacks essential methodological detail. Below, I offer some reflections that may help the authors strengthen the manuscript. 1. Clarify data collection and analysis steps The manuscript reports on preparatory activities and the outcomes of participation in the I-LEAD program. However, the general analytical approach used to generate these reflections is unclear. How were the participants of the programme selected? Were the participants of the programme interviewed or surveyed to prepare this report? How precisely was the ISHO assessment conducted (by the participants)? What data were collected? How precisely did the various discussion sessions and activities shape the conclusions of the ISHO assessment into the redefined HIS challenges? Answering these questions is a prerequisite for this manuscript contributing to the scientific literature. 2. Engage with existing literature on workforce development in DH The authors focus on the present case study and the Nigerian context. However, it would be helpful for them to more actively engage with similar published case studies and emerging international guidance from WHO and other institutions regarding workforce development in digital health. This will better position the case study in the international literature and highlight its contribution to our knowledge. 3. Reflect on generalisability and research contribution These essential elements are currently absent from the discussion. I invite the authors to expand the discussion by adding them. 4. Provide more detail on I-LEAD I suggest that the authors provide more information on the I-LEAD programme, specifically its origins, development, implementation, and eventual localisation. This will support cross-country learning from this case study and provide readers with much-needed context. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? Not applicable Are all the source data underlying the results available to ensure full reproducibility? No Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: comparative health (policy) research, workforce development I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Hrzic R. Reviewer Report For: Intergovernmental Learning Exchange to Advance Data-Driven Decision Making: Experiences from Nigeria. [version 1; peer review: 1 approved, 1 not approved] . F1000Research 2025, 14 :759 ( https://doi.org/10.5256/f1000research.183812.r409713 ) The direct URL for this report is: https://f1000research.com/articles/14-759/v1#referee-response-409713 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 23 Feb 2026 Agbonkhese Oaiya , PATH, FCT Abuja, Nigeria 23 Feb 2026 Author Response Firstly, we sincerely thank you for your feedback and comments. We have strengthened the manuscript by providing more details per the feedback received. Secondly, the following are our responses ... Continue reading Firstly, we sincerely thank you for your feedback and comments. We have strengthened the manuscript by providing more details per the feedback received. Secondly, the following are our responses to the comments raised: The participants of the programmes were purposefully selected, which was based on the scope of the HIV/AIDS programme in Nigeria. This encompassed representatives from institutions involved in national health information systems’ governance, planning and implementation. The selected participants who are decision-makers provided a balance between the government ministries and agencies overseeing the HIV/AIDS programme and HIS (and informatics), as well as partners supporting this ecosystem in Nigeria. No interview was conducted in selecting these public health informatics leaders across these government institutions overseeing the HIV/AIDS programme in Nigeria. On the ISHO assessment, the expedited above-site ISHO assessment was conducted by the selected and participating delegates using a standardised tool. We have strengthened the methods section of the manuscript, explaining how regular, structured consultative discussions were used to synthesise assessment findings, validate priorities, and refine HIS gaps. We recognise the need to engage in similar case studies, ensuring the manuscript is better positioned in the international literature. However, we also recognise the challenges within the Nigerian HIS ecosystem, especially within the HIV/AIDS programme in meeting both a combined vision of HIV/AIDS epidemic control and the Nigerian government’s goal of a no-AIDS nation. As such, we presented a case of capacity-building for government leadership, linked with embedding realistic challenges and embedding solutions towards what the country is currently facing. We shared and referenced all source data using FigShare, and these are available at: https://doi.org/10.6084/m9.figshare.29345027 We have carefully revised the manuscript in line with the feedback provided. Firstly, we sincerely thank you for your feedback and comments. We have strengthened the manuscript by providing more details per the feedback received. Secondly, the following are our responses to the comments raised: The participants of the programmes were purposefully selected, which was based on the scope of the HIV/AIDS programme in Nigeria. This encompassed representatives from institutions involved in national health information systems’ governance, planning and implementation. The selected participants who are decision-makers provided a balance between the government ministries and agencies overseeing the HIV/AIDS programme and HIS (and informatics), as well as partners supporting this ecosystem in Nigeria. No interview was conducted in selecting these public health informatics leaders across these government institutions overseeing the HIV/AIDS programme in Nigeria. On the ISHO assessment, the expedited above-site ISHO assessment was conducted by the selected and participating delegates using a standardised tool. We have strengthened the methods section of the manuscript, explaining how regular, structured consultative discussions were used to synthesise assessment findings, validate priorities, and refine HIS gaps. We recognise the need to engage in similar case studies, ensuring the manuscript is better positioned in the international literature. However, we also recognise the challenges within the Nigerian HIS ecosystem, especially within the HIV/AIDS programme in meeting both a combined vision of HIV/AIDS epidemic control and the Nigerian government’s goal of a no-AIDS nation. As such, we presented a case of capacity-building for government leadership, linked with embedding realistic challenges and embedding solutions towards what the country is currently facing. We shared and referenced all source data using FigShare, and these are available at: https://doi.org/10.6084/m9.figshare.29345027 We have carefully revised the manuscript in line with the feedback provided. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 23 Feb 2026 Agbonkhese Oaiya , PATH, FCT Abuja, Nigeria 23 Feb 2026 Author Response Firstly, we sincerely thank you for your feedback and comments. We have strengthened the manuscript by providing more details per the feedback received. Secondly, the following are our responses ... Continue reading Firstly, we sincerely thank you for your feedback and comments. We have strengthened the manuscript by providing more details per the feedback received. Secondly, the following are our responses to the comments raised: The participants of the programmes were purposefully selected, which was based on the scope of the HIV/AIDS programme in Nigeria. This encompassed representatives from institutions involved in national health information systems’ governance, planning and implementation. The selected participants who are decision-makers provided a balance between the government ministries and agencies overseeing the HIV/AIDS programme and HIS (and informatics), as well as partners supporting this ecosystem in Nigeria. No interview was conducted in selecting these public health informatics leaders across these government institutions overseeing the HIV/AIDS programme in Nigeria. On the ISHO assessment, the expedited above-site ISHO assessment was conducted by the selected and participating delegates using a standardised tool. We have strengthened the methods section of the manuscript, explaining how regular, structured consultative discussions were used to synthesise assessment findings, validate priorities, and refine HIS gaps. We recognise the need to engage in similar case studies, ensuring the manuscript is better positioned in the international literature. However, we also recognise the challenges within the Nigerian HIS ecosystem, especially within the HIV/AIDS programme in meeting both a combined vision of HIV/AIDS epidemic control and the Nigerian government’s goal of a no-AIDS nation. As such, we presented a case of capacity-building for government leadership, linked with embedding realistic challenges and embedding solutions towards what the country is currently facing. We shared and referenced all source data using FigShare, and these are available at: https://doi.org/10.6084/m9.figshare.29345027 We have carefully revised the manuscript in line with the feedback provided. Firstly, we sincerely thank you for your feedback and comments. We have strengthened the manuscript by providing more details per the feedback received. Secondly, the following are our responses to the comments raised: The participants of the programmes were purposefully selected, which was based on the scope of the HIV/AIDS programme in Nigeria. This encompassed representatives from institutions involved in national health information systems’ governance, planning and implementation. The selected participants who are decision-makers provided a balance between the government ministries and agencies overseeing the HIV/AIDS programme and HIS (and informatics), as well as partners supporting this ecosystem in Nigeria. No interview was conducted in selecting these public health informatics leaders across these government institutions overseeing the HIV/AIDS programme in Nigeria. On the ISHO assessment, the expedited above-site ISHO assessment was conducted by the selected and participating delegates using a standardised tool. We have strengthened the methods section of the manuscript, explaining how regular, structured consultative discussions were used to synthesise assessment findings, validate priorities, and refine HIS gaps. We recognise the need to engage in similar case studies, ensuring the manuscript is better positioned in the international literature. However, we also recognise the challenges within the Nigerian HIS ecosystem, especially within the HIV/AIDS programme in meeting both a combined vision of HIV/AIDS epidemic control and the Nigerian government’s goal of a no-AIDS nation. As such, we presented a case of capacity-building for government leadership, linked with embedding realistic challenges and embedding solutions towards what the country is currently facing. We shared and referenced all source data using FigShare, and these are available at: https://doi.org/10.6084/m9.figshare.29345027 We have carefully revised the manuscript in line with the feedback provided. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 01 Aug 2025 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 Version 2 (revision) 23 Feb 26 read Version 1 01 Aug 25 read read Rok Hrzic , Maastricht University, Maastricht, The Netherlands Maureen Adoyo , Kenya Medical Research Institute, Nairobi, Kenya; Rongo University (Ringgold ID: 390296), Rongo, Kenya Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2026 Hrzic R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 24 Feb 2026 | for Version 2 Rok Hrzic , Maastricht University, Maastricht, The Netherlands 0 Views copyright © 2026 Hrzic R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The authors sufficiently addressed my comments. Competing Interests No competing interests were disclosed. Reviewer Expertise comparative health (policy) research, workforce development I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Hrzic R. Peer Review Report For: Intergovernmental Learning Exchange to Advance Data-Driven Decision Making: Experiences from Nigeria. [version 1; peer review: 1 approved, 1 not approved] . F1000Research 2025, 14 :759 ( https://doi.org/10.5256/f1000research.196534.r461432) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-759/v2#referee-response-461432 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Adoyo M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 03 Nov 2025 | for Version 1 Maureen Adoyo , Kenya Medical Research Institute, Nairobi, Nairobi County, Kenya; Information Science, Health Records and Systems, Rongo University (Ringgold ID: 390296), Rongo, Migori County, Kenya 0 Views copyright © 2025 Adoyo M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The paper is adequate in both form and content. The logical flow and documentation of processes are well executed and provide valuable insights that are worth sharing for adoption by countries facing similar HIS challenges. However, there are a few areas that require further elaboration and improvement to enhance clarity and practical applicability Regarding the VSOT framework and other approaches mentioned, please clarify whether they were developed during the implementation of the program or adapted from an existing source. If it is an original innovation, consider providing a visual presentation to facilitate adoption by other programs. If not, please acknowledge the source appropriately. Methodology It is important to clarify how the number of 17 delegates for participation in the I-LEAD programme was determined. Was this primarily influenced by a vailable resources, or were there other criteria e.g., expertise, institutional representation, or regional balance, that guided the decision? Additionally, provide details on the distribution of these delegates among the representative government bodies and agencies. Results Check the results section. The sentence “A detailed roadmap outlining the various tasks to be undertaken across the streamlined activities presented in Table 1 was created and is provided in Appendix 1” requires revision. Since the process has already been undertaken, I suggest using a reporting verb. Discussion I appreciate the flow-chart figure providing an overview of the Nigeria I-LEAD experience across three phases—preparatory activities, the I-LEAD main event, and post-I-LEAD activities. However, the multiple consultative meetings and discussion sessions mentioned in the discussion still need further elaboration. It is important to specify the number of these sessions and describe what each session achieved. Please also clarify whether the sessions were designed to address separate objectives or whether each session informed the next convening. This additional information should also be incorporated into the methodology section to guide countries that may wish to replicate the i-LEAD approach to strengthening HIS. Conclusion Looking at the conclusion and the stated aim of the I-LEAD programme aims to empower leaders, managers, and technical experts engaged in public health informatics in envisioning the digital health landscape, formulating effective strategies to realise their vision, and successfully implementing and sustaining these strategies” —it would strengthen the paper to highlight specific leadership attributes the program developed that are critical for revolutionizing the digital health landscape. Additionally, please indicate any strategies, for example, approaches to sustainable funding developed through this process. Key lessons or highlights in implementing effective and efficient public health informatics or advancing a robust digital health landscape would also provide valuable insights for replication and scale-up. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly References 1. Oaiya A, Onimode O, Olatoregun O, Gomez G, et al.: Intergovernmental Learning Exchange to Advance Data-Driven Decision Making: Experiences from Nigeria. F1000Research . 2025; 14 . Publisher Full Text Competing Interests No competing interests were disclosed. Reviewer Expertise Governance, Digital Health, Health Policy, Health System Surveillance for Emerging and Re-emerging Diseases, and Health Information Systems Strengthening. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (1) Author Response 23 Feb 2026 Agbonkhese Oaiya, PATH, FCT Abuja, Nigeria Firstly, we sincerely thank you for your thoughtful and encouraging review, and for recognising the manuscript’s overall quality, logical flow, and relevance to countries facing similar Health Information System challenges. The following are our responses to the comments raised: The VSOT framework was not developed during the Nigerian I-LEAD implementation. Rather, it was adopted from established literature and operationalised in practice through the combined use of the I-LEAD and GEEKS programmes. We have clarified this distinction in the revised manuscript. The selection of the delegates was based on a balance between the scope of the HIV/AIDS programme in Nigeria and institutions involved in HIS governance, planning and implementation. We have expanded this explanation in the methods section to improve transparency. These consultative sessions in the pre-I-LEAD phase were regular meetings to ensure alignment with agreed objectives and to track progress. We have updated the manuscript to include this description. We have carefully revised the manuscript in line with the feedback provided. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Adoyo M. Peer Review Report For: Intergovernmental Learning Exchange to Advance Data-Driven Decision Making: Experiences from Nigeria. [version 1; peer review: 1 approved, 1 not approved] . F1000Research 2025, 14 :759 ( https://doi.org/10.5256/f1000research.183812.r402549) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-759/v1#referee-response-402549 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Hrzic R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 05 Sep 2025 | for Version 1 Rok Hrzic , Maastricht University, Maastricht, The Netherlands 0 Views copyright © 2025 Hrzic R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The authors present a fascinating case study of workforce development in digital health in Nigeria. The manuscript contributes to the emerging literature on best practices in empowering the health and public health workforce to actively engage with the processes of digital transformation in health systems. However, in its current shape, the report lacks essential methodological detail. Below, I offer some reflections that may help the authors strengthen the manuscript. 1. Clarify data collection and analysis steps The manuscript reports on preparatory activities and the outcomes of participation in the I-LEAD program. However, the general analytical approach used to generate these reflections is unclear. How were the participants of the programme selected? Were the participants of the programme interviewed or surveyed to prepare this report? How precisely was the ISHO assessment conducted (by the participants)? What data were collected? How precisely did the various discussion sessions and activities shape the conclusions of the ISHO assessment into the redefined HIS challenges? Answering these questions is a prerequisite for this manuscript contributing to the scientific literature. 2. Engage with existing literature on workforce development in DH The authors focus on the present case study and the Nigerian context. However, it would be helpful for them to more actively engage with similar published case studies and emerging international guidance from WHO and other institutions regarding workforce development in digital health. This will better position the case study in the international literature and highlight its contribution to our knowledge. 3. Reflect on generalisability and research contribution These essential elements are currently absent from the discussion. I invite the authors to expand the discussion by adding them. 4. Provide more detail on I-LEAD I suggest that the authors provide more information on the I-LEAD programme, specifically its origins, development, implementation, and eventual localisation. This will support cross-country learning from this case study and provide readers with much-needed context. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? Not applicable Are all the source data underlying the results available to ensure full reproducibility? No Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise comparative health (policy) research, workforce development I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (1) Author Response 23 Feb 2026 Agbonkhese Oaiya, PATH, FCT Abuja, Nigeria Firstly, we sincerely thank you for your feedback and comments. We have strengthened the manuscript by providing more details per the feedback received. Secondly, the following are our responses to the comments raised: The participants of the programmes were purposefully selected, which was based on the scope of the HIV/AIDS programme in Nigeria. This encompassed representatives from institutions involved in national health information systems’ governance, planning and implementation. The selected participants who are decision-makers provided a balance between the government ministries and agencies overseeing the HIV/AIDS programme and HIS (and informatics), as well as partners supporting this ecosystem in Nigeria. No interview was conducted in selecting these public health informatics leaders across these government institutions overseeing the HIV/AIDS programme in Nigeria. On the ISHO assessment, the expedited above-site ISHO assessment was conducted by the selected and participating delegates using a standardised tool. We have strengthened the methods section of the manuscript, explaining how regular, structured consultative discussions were used to synthesise assessment findings, validate priorities, and refine HIS gaps. We recognise the need to engage in similar case studies, ensuring the manuscript is better positioned in the international literature. However, we also recognise the challenges within the Nigerian HIS ecosystem, especially within the HIV/AIDS programme in meeting both a combined vision of HIV/AIDS epidemic control and the Nigerian government’s goal of a no-AIDS nation. As such, we presented a case of capacity-building for government leadership, linked with embedding realistic challenges and embedding solutions towards what the country is currently facing. We shared and referenced all source data using FigShare, and these are available at: https://doi.org/10.6084/m9.figshare.29345027 We have carefully revised the manuscript in line with the feedback provided. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Hrzic R. Peer Review Report For: Intergovernmental Learning Exchange to Advance Data-Driven Decision Making: Experiences from Nigeria. [version 1; peer review: 1 approved, 1 not approved] . F1000Research 2025, 14 :759 ( https://doi.org/10.5256/f1000research.183812.r409713) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-759/v1#referee-response-409713 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions Adjust parameters to alter display View on desktop for interactive features Includes Interactive Elements View on desktop for interactive features Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list: Examples of 'Non-Financial Competing Interests' Within the past 4 years, you have held joint grants, published or collaborated with any of the authors of the selected paper. You have a close personal relationship (e.g. parent, spouse, sibling, or domestic partner) with any of the authors. You are a close professional associate of any of the authors (e.g. scientific mentor, recent student). You work at the same institute as any of the authors. 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