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This thesis is about challenges of the Health Information Systems Programs in Developing Countries and the topic of Success and Failure are in focus with the cases in Vietnam (Thua Thien Hue province and Hochiminh city). Action research approach is the method of this study with the two research questions: 1.What are the challenges of developing and implementing a Health Information System in Vietnam (2004-2008)? 2.Why has the implementation of DHIS not succeed in TT Hue province (2004-2008)? A comparison of the cases of TT Hue province and HCM City. The findings are presented in the cases with the seven gaps and Gap Closure Techniques with discussion the challenges of developing and implementing a Health Information System in Vietnam. The solutions for the proposed questions are concluded in a critical way with references from the involved factors, such as: The health report system and DHIS technological capacities, Implementing strategy, Infrastructure, Staff skills, The Manager, Communication and cooperation, and Monitoring policies of the global towards the local. Besides, the lessons from the cases of TT Hue province and HCM city are also included.