Today, daily health problem becomes a great challenge for nations and humanity. Although the problem is serious in developing countries, it is also a concern in developed countries. Such a common problem of humanity requires an effective and efficient strategy or mechanism to solve the problem in a cost-effective manner. Like any other developing country, healthcare delivery in Ethiopia has suffered from many problems. The country has poor health status compared to other low-income countries, the morbidity and mortality rate is very high, the main health problems in the country are communicable diseases and nutritional disorders. Indeed, the government has designed strategies to resolve the problem, but the problem remains there, no major changes have been observed or made. In Ethiopia, life expectancy is 54 years, which is 55.4 years for women and 53.4 years for men. The infant mortality rate is 77/1000, the under-five mortality rate is 101/1000, the maternal mortality rate is 590/100,000 according to the demographic and health survey (2005), even if this figure shows a great improvement compared to previous years, it nevertheless still needs a lot of improvement. According to the strategic plan of the Ministry of Health, the organization of Ethiopia's health system is a three-tier health care delivery system, with the following characteristics. • First level: - District/woreda health system, which contains a primary hospital that covers a population of 60,000 to 100,000 people, health centers that cover a population of 1/15,000 to 25,000 and health posts health satellites which cover a population of 1/3,000 to 5,000 inhabitants, under each health center there are 5 health posts, by means of a referral system primary hospitals, health centers and health posts are interconnected and also form the middle of paper ......rent factors and underinvestment in the health information system (SIS), unfortunately in the country, quality health information is rarely available. Currently, the country needs reliable and timely health data to make decisions, monitor and evaluate the ever-increasing demand for health services, achieve the objectives of the health sector development program and have an overall impact on the health sector. the health of the country. Therefore, HMIS is like a blood vessel that helps in achieving the strategies and objectives of the government HSDP IV, so it is with this need in mind that the study proposed to identify and analyze the factors which affect the efficient and effective design, implementation of HIS in health care delivery of In Ethiopia, it also analyzes the involvement and impacts of international aid agencies and NGOs working in the health sector to improve the SIS..