In response to the issue of health information system and to improve health-related information for decision making, the World Health Organization (WHO) launched the Health Metric in 2005 Network. The metric has two focuses to strengthen the healthcare system in developing countries; the first is to improve the entire health information and statistical system, the second is to focus efforts on strengthening national leadership in the production and use of health information. information system, it is absolutely necessary. It is with this need in mind that WHO has developed the following framework, which is a universally accepted standard to guide the collection, reporting and use of health information by global agencies and countries (WHO 2007).5. RESEARCH METHODOLOGYThe study will attempt to analyze the underlying causes of poor health information system performance in Ethiopian healthcare facilities. This attempts to describe the existing HMIS design, implementation issues/factors in healthcare facilities. It also analyzes the role of NGOs and international humanitarian agencies working in health sectors in improving Ethiopia's health information system. Analytical research will allow the study to examine the problem both descriptively and analytically. It will analytically examine the underlying causes by identifying different factors or independent variables that influence the efficiency and effectiveness of healthcare information system in Ethiopia and the reasons behind poor decision making by managers in healthcare/service delivery. Relevant questions will be formulated to investigate the problem, ...... half of the article ...... the main challenges of this study will be analysed. Feasibility of the study: - When the researcher presents such research questions, it is on the basis of the practical experience of the researcher in the field of HMIS, the researcher has worked for about 14 years both nationally and internationally in information system, and from this for 8 years directly in HMIS design, health information analysis and statistics. The researcher understands well the problems, factors behind the poor performance of HMIS design and implementations of different countries. So the researcher believes that the research helps to address the fundamental issues of the countries' HMIS problem. Ethical issues: - Due to the sensitivity of the study, high ethical standards will be considered: cultural, political, organisational, individual during both primary and secondary data collection, formulation of questionnaires.