There has been much discussion of the role that recent advances in information and communication technologies (ICTs) could play in improving health systems in developing countries. There is no doubt that the advancement of ICTs has brought both brought opportunities and challenges to developing countries in their efforts to ensure socio-economic development and improve public governance. In the wake of globalization, developing countries have no choice but to take advantage of the opportunities and face the challenges. Despite the fact that many developing countries are taking actions to strengthen their ICT capabilities in both private and public sector organizations, the process has been limited mostly to national and provincial capitals leaving behind majority of the communities and institutions operating in remote areas.
This paper took a case study of implementing computerized Health Information Systems (HIS) in the context of the Ethiopian public health care system and investigated the potentials of the new ICT based system and the challenges encountered at provincial and district levels. The findings also revealed that even those with access to modern ICT infrastructure do not get maximum benefit from ICT advancements due to inadequacies in data quality and lack of knowledge in data management and use for decision making and action. To this end, there is an urgent need for governments of most developing countries in general and for sub-Saharan African countries in particular to double their efforts to address constraints threatening to increase technology gap between urban minority and marginalized rural majority by setting up favorable policies and appropriate strategies. For example, the empirical analysis of this study revealed that in order to make IT-based systems work in the Ethiopian public health seating, there is an urgent need to develop proper strategies that took into account the local context.