Database Administration Best Practices in Nigerian Health Management Information Systems

Health Management Information Systems (HMIS) in Nigeria generate critical clinical and operational data, yet the database administration practices underpinning these systems frequently fall short of standards required to ensure data integrity, availability, and security. This study examines database administration practices in HMIS deployments across three geopolitical zones, focusing on installations at teaching hospitals in Owerri (South East), Ilorin (North Central), and Maiduguri (North East). A mixed-methods approach combines database audit findings with interviews conducted with 18 database administrators and IT officers at these institutions. Analysis evaluates backup scheduling, access control policies, performance monitoring, query optimisation practices, and disaster recovery preparedness against ISO 27001 and HL7 standards. Findings reveal that fewer than 40 percent of institutions conduct weekly off-site backups and only one institution maintains a documented database recovery time objective. Performance degradation during peak clinical hours is universally reported but systematically unaddressed. Professional recommendations include standardised HMIS database administration manuals, mandatory DBA certification requirements for government health institutions, and investment in automated database performance monitoring tools. The study contributes practical guidelines for improving HMIS data infrastructure reliability in under-resourced Nigerian tertiary hospitals. Keywords: database administration, HMIS, health data, Nigeria, ISO 27001