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Health Information Systems (HIS) are vital for the collection, storage, analysis, and dissemination of health data to support effective decision-making and resource management at all levels of healthcare. However, despite their importance, many healthcare professionals do not effectively use routine health information, leading to missed opportunities for data-driven decisions and weakened health system performance. This study aimed to assess the utilization of routine health information and its determinants among healthcare professionals in public health facilities in the Banadir Region, Somalia. A facility-based cross-sectional study was conducted from March to June 2024 across 32 public health facilities in the Banadir Region, Somalia. A total of 405 healthcare professionals were selected using a two-stage cluster sampling technique. Data were collected using self-administered questionnaires and observational checklists developed based on the PRISM framework. The questionnaire included items assessing factors influencing RHIS use, such as the availability of training, standardization of indicators, level of supervision, and attitudes toward data utilization. Data were entered and cleaned in Excel and analyzed using SPSS version 27. Bivariable and multivariable binary logistic regression analyses were performed, with variables showing p < 0.05 in the multivariate analysis considered statistically significant. In this study, 68.1% of healthcare professionals demonstrated good RHIS utilization (95% CI: 63.5%–72.6%). Multivariable analysis showed that professionals working in hospitals were less likely to utilize health information than those in health centers (AOR = 0.273, 95% CI: 0.144–0.519). Lack of HIS training (AOR = 0.061, 95% CI: 0.030–0.125), non-standardized indicators (AOR = 0.188, 95% CI: 0.047–0.745), and lack of supervision (AOR = 0.195, 95% CI: 0.098–0.386) were associated with lower utilization. Additionally, untrained professionals in data analysis were less likely to use health information effectively (AOR = 0.165, 95% CI: 0.029–0.926). Health professionals with a positive attitude toward data utilization were 2.8 times more likely to use health data (AOR = 2.861, 95% CI: 1.155–7.090). The study found that 68.1% of healthcare professionals demonstrated good RHIS utilization. Key barriers included inadequate training, insufficient supervision, non-standardized indicators, and limited data analysis skills. Strengthening in-service training, improving supervision and feedback mechanisms, enhancing access to digital tools, and standardizing indicators are recommended to improve RHIS utilization and foster evidence-based decision-making in the Banadir Region.