Afghanistan Ministry of Public Health (MoPH) conducted Health Information System Assessment in 2009. It found the inadequate use of data as a key problem for health service performance improvement. It emphasized the use of health data is inadequate, non-systematic and poorly standardized at central and provincial level. But the assessment does not answer why health information is used inadequately in health sector.

The study aims to describe behavioral factors that influence the use of health information, assess the overall level of a culture of use information, and identify key organizational culture and behavior barriers to data users and policy makers in using health data. All twelve members of a provincial health team as well as five senior policy makers in central MoPH participated in this study.

The study pursued mixed methods approach. In the quantitative method a self- rating questionnaire was used. The questionnaire was quantifying the answers through a Likert scale, of 1 to 7.

The phone interviews using an interview guide were conducted with senior policy makers, as a qualitative method.

The study found that culture of information and behavior factors concerning use of data in decision making is well stated at strategic level, but this is not supported at the implementation level through availability of health information, simple procedures for sharing the data, and active communication culture. MoPH needs to work with both the private sector and provincial health teams to improve their perception on use of monitoring and evaluation data. The MoPH should also strengthen their work with stakeholders to help them understand and accept the implications of the evidence in MoPH’s decision making.