Assessing Supply Chain Data Quality and Use for Decision-Making: A Realist Evaluation of Maternal, Newborn, and Child Health Commodities in Nigeria

Background
Availability of essential maternal, newborn, and child health (MNCH) commodities at primary healthcare facilities (PHCs) in low- and middle-income countries remains inadequate, significantly affecting maternal and child survival. Effective logistics management information systems (LMIS) are critical to improving commodity availability, but limited evidence exists on factors influencing LMIS data quality and use.
Methods
This study applied a mixed-method realist evaluation approach in two Nigerian states to identify key contextual factors and mechanisms and outcome (CMO) configurations driving LMIS data quality, data use, and MNCH commodity availability. Key informant interviews explored the causal links between CMO factors. Quantitative descriptive and regression analyses using health facility assessments and commodities data quality assessments characterized predictors of data quality, use, and MNCH commodity availability.
Results
The study identified three primary mechanisms of LMIS data quality, use, and availability of MNCH commodities: 1) low perceived value of MNCH commodity documentation undermined data completeness and accuracy under decentralized financing; 2) PHC staff feeling valued and supported due to adequate funding, staffing, infrastructure, and active community oversight; and 3) accountability, including scrutiny through active community oversight, data reviews, and supportive supervision. Descriptive analyses showed chronic gaps in data availability and accuracy, but high performance in timeliness and aspects of completeness, with notable improvements in overall data quality over time. Regression models showed that stronger general data systems and infrastructure were positively associated with commodity data use. Analyses of MNCH commodity stockage outcomes indicated that data system strength consistently predicted better commodity availability across stocking dimensions.
Conclusion
The results emphasize the role of tangible, incentive-based resupply policies, adequate infrastructure, sustained community engagement, and explicit accountability structures in ensuring LMIS quality data, use, and availability of essential MNCH commodity at PHCs in Nigeria.

Emmanuel Adegbe, PhD, MBBS – Consultant, Data For Impact; Timi Omole, MS, BPharm – Principal Advisor, Penjuan Integrated Services; International Association of Public Health Logisticians; Siân Curtis, PhD – Professor, Maternal and Child Health, University of North Carolina - Chapel Hill, Gillings School of Global Public Health