In response to the question of health information system and improving health related information for decision making, the Organization World Health Organization (WHO) launched the Health Metric Network in 2005. The measure has two objectives: strengthening the health system in developing countries; the first consists of improving the entire health information and statistics system, the second consists of focusing efforts on strengthening national leadership in the production and use of health information. To meet the main objectives above, there is a need for an agreed framework for the development and strengthening of health systems. information system, 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 METHODOLOGY The study will attempt to analyze the underlying causes of poor performance of the health information system in Ethiopian health facilities. In doing so, it attempts to describe the existing design of HMIS, implementation issues/factors in healthcare settings. It also analyzes the role of NGOs and international aid agencies working in the health sectors in improving Ethiopia's health information system. Analytical research will allow the study to examine the problem in both a descriptive and analytical manner. It will analytically examine the underlying causes by identifying different factors or independent variables that affect the efficiency and effectiveness of the health information system in Ethiopia, as well as the reason for poor decision-making by managers in the delivery of health care/services. Relevant questions will be formulated to study the problem, it will be analyzed...... middle of article...... main challenges of this study. Feasibility of the Study:- When the researcher comes forward with such research questions, it is Based on the practical experience of the researcher in the field of HMIS, the researcher has worked for about 14 years both in the country and 'internationally in the information system, and for 8 years directly in the design of the HMIS, the analysis of information and statistics on health. The researcher has a good understanding of the issues and factors behind the poor performance of HMIS design and implementation in different countries. The researcher therefore believes that the research helps in solving the fundamental problems of the country's HMIS problem. Ethical Issues: - Due to the sensitivity of the study, high ethical standards will be considered - cultural, political, organizational, individual during the collection of primary and secondary data. secondary, formulation of questionnaires.