Strengthening District- and Regional-Level Supportive Supervision for Facility HMIS Data Quality and Data Use in Somalia: A Healthcare Leadership Commentary.

Somalia's health system continues to face persistent challenges in routine health information system performance, particularly in data quality, data use, and feedback mechanisms. This evidence-informed commentary focuses on external supportive supervision received by health facilities from district and regional HMIS teams; internal facility review is treated as a complementary process. Somalia-specific studies report routine health information system utilization of 68.1% among 405 professionals in 32 public facilities, good overall data quality of 65.3% across 36 public facilities, and good HMIS utilization of 57.7% among 411 respondents from public and private facilities in Mogadishu. These cross-sectional findings identify associations with supervision and feedback but do not establish that all feedback occurs through supervisory visits or that supervision alone causes better performance. We argue that the priority is not to introduce supervision as a new activity, but to make existing supervision consistent, documented, risk-based, mentorship-focused, and accountable We propose a Somalia-specific operational model that adapts existing WHO and national guidance by defining supervisory levels, risk-based scheduling, verification and root-cause analysis, closed-loop action tracking, escalation pathways, partner alignment, and measurable implementation indicators. Strengthening these managerial routines can help shift HMIS practice from compliance-based reporting toward continuous learning, local problem-solving, and evidence-informed decision-making.