The HMIS in development countries lags seriously behind as compared to the developmentrncountries: and the existing HMIS in many developing countries is insufficient to support healthrnmanagement functions.rnThe purpose of the study was; to assess and determine how health information is generated andrnutilized in the decision-making process in Addis Ababa Health Bureau and health care faciliti esrnin the region. The study also attempted to identify factors affecting the quality of reporting,rninformation generation and utilization at regional, sub-city and health fa cility levels.rnThe finding of the study indicated that; there is increased awareness for better quality ofrninformation and steps are taken to improve the HMIS capacity at sub-city and health facilityrnlevels by adopting the District Health Information System (DHIS) softwarernHowever the study also indicated that there is critical constraint of trained personnel; to analyzernvalue and utilize the available data; which seemed to be significant challenge for the progress ofrnthe system at all levels.rnTo improve the performance of HMIS; not only technology acquisition will be required but itrnshould also be viewed as a long-term socio-cultural, political, and technical development process.rnIt is equally important to improve the understanding of health managers and health professionalrnon the importance health information as well as the proper utilization of the available data andrninformation for improved health service management. This can be achieved only through properrntraining and increasing the proportion oftrained staff inHMIS on a sustainable manner