The Ministry of Health in Zanzibar has embarked on Health Information System development with the aim of streamlining health data collection, storage, analysis and reporting in order to attain data-driven informed decision-making. The project involved two aspects: development of essential health data sets and implementation of a computerised data-storage and analysis tool. From January 2005 to December 2007 during the implementation of the project data were collected through a triangulation of qualitative methods: interviews, participant observation, document analysis, software development and training workshops. The study indicates that carefully-planned leadership of a project, clearly-stated goals and distinction between the roles of technical and sponsor networks strengthen an ICT project immeasurably. Lessons drawn include the use of local, culturally-immersed leaders to spearhead the project and the use of flexible open-source software as translators of the primary actor’s interest in achieving the goals through enrolling other actors.