In November 2004, the Ministry of Health in Zanzibar and itsstakeholders conducted a HMIS review. The results revealed that the HMIS isfragmented and does notsupport datadriven decision-making. To address theseshortcomings, a roadmap towards development of HMIS was agreed as follows: (1)development of essential datasets, (2) developing and implementing a computer database. The decision was to take theDistrict Health Information Software (DHIS)developed by the Health Information System Programme(HISP) and customise it tofit the context in Zanzibar. HISP is a global project using Action research andParticipatory design approaches to empower the emerging local health managementstructures and health workers through improved and locally based information systems in a number of developingcountries. At the time of writing this paper there is essential datasets and an implemented computer database usedfor data storage, analysis and reporting