Abstract
BACKGROUND: High-quality routine health information (RHI) is essential for evidence-based decision-making and healthcare quality improvement. However, existing studies in Ethiopia have reported low data quality, especially at district health offices and primary healthcare facilities. Moreover, there is limited evidence comparing RHI quality across different facility types and identifying context-specific factors influencing data quality. To address these the study assesses and compares RHI quality and its associated factors in primary healthcare facilities of Eastern Tigray, Ethiopia. METHODS: A comparative cross-sectional study was conducted in selected health facilities in Eastern Tigray. Simple random sampling was used to select woredas, and 224 departments were assessed. Data were collected using structured questionnaires, observation checklists, and registry reviews. Descriptive statistics and ordinal logistic regression were employed to analyze routine health information quality and associated factors using STATA version 15. The significance level was set at p-value < 0.05 with a 95% confidence interval. RESULT: Only 13.4% of health facility departments met the national standards for routine health information quality. Project support was significantly associated with better data quality (X² = 14.70, p = 0.001). In unsupported facilities, training on health information systems (AOR = 2.17, 95% CI: 1.02–4.64), display of targets (AOR = 2.85, 95% CI: 1.10–7.75), feedback (AOR = 2.84, 95% CI: 1.27–6.35), and perception of RHI importance (AOR = 5.33, 95% CI: 1.40–20.25) were significantly associated with quality. In supported facilities, supervision was a key factor (AOR = 3.81, 95% CI: 1.66–12.43). CONCLUSION: Routine health information quality was below national standards and WHO threshold, with health centers performing worse than hospitals. Support from projects, training, supervision, and feedback were associated with improved data quality. Strengthening training, monitoring, and written feedback across health system levels is recommended. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12911-026-03450-z.