Background: Worldwide immunization coverage shows an increase in the past years but the validity of the official reports for measuring change over time has been questioned. Facing this problem, donor supported initiatives like the Global Alliance for Vaccine and Immunizations, have been putting a lot of effort into assessing the quality of data used, since accurate immunization information is essential for the Expanded Program on Immunization managers to track and improve program performance. The present article, discusses the practices on record keeping, reporting and the support mechanism to ensure data quality in Mozambique.

This article presents results from a study on the use and appropriation of information and communication technologies (ICT) in Mozambique with a focus on the health sector. The three provinces of Gaza, Inhambane and Niassa were surveyed and two questionnaires addressing 1) computer users and their ability to manage ICT, and 2) health workers and their handling of health information, were used. Based on this study appropriate strategies for developing an ICT‐infrastructure with the needs of the health sector as points of departure are discussed. The study is born out of a program to strengthen and further develop the health information and management systems at district and provincial levels as part of a process to support decentralisation of the health system in Mozambique. The study shows that computers and Internet are rapidly being spread to the provincial capitals and major districts in Mozambique. A main problem identified is the lack of ICT‐skills and education and poorly developed infrastructure and networks of support. There are very few formal ICT companies providing hardware, and even less, software support. Maintenance and learning about ICT are to a large extent going on within informal networks of computer users in the provinces. A main finding in this study is that development of ICT capacity and information systems at district and provincial levels in Mozambique needs to be an integrated effort across sectors. A district health information system cannot be developed in a void. A general recommendation is to develop educational programmes ranging from training of ICT entrepreneurs and health workers and managers, to Masters and PhD programmes in ICT and health information systems. A specific recommendation related to health information systems development is to focus on the district level and to develop a strategy which encompasses and integrates all districts, both the advanced districts with computers and the majority of the districts where there are no computers.

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