This thesis offers a usability and user documentation review of a Health Information System, District Health Information System 2 (DHIS 2). To reach the Millennium Development Goals (MDGs) for health improvement set by Unites Nations, it is important to develop instruments for monitoring health status. To gain full benefit from Information Systems, these instruments must be fully implemented and customized for the users and their needs. The thesis includes two studies on the real world value of user documentation in the health management information system DHIS 2, with a particular focus on its implementation in Malawi. DHIS 2 is a software used for the collection, validation, analysis and presentation of aggregate statistical data. This study addresses the current usability of DHIS 2 and the value of its user documentation. It reviews literature about software usability and user documentation. It covers various types of documentation and analyzes how the documentation of DHIS 2 fits in with this. The studies apply both quantitative and qualitative methods. One study is a questionnaire with qualitative and quantitative questions (mixed methods research) that surveys workers in Malawi who enter and analyze data, using DHIS 2. The study participants are Malawian Health Management Information System officers from the 29 administrative districts. The second study is a non-participant observation study of students at University of Oslo using DHIS 2 for the first time. Important positive findings of the study were a reported high level of satisfaction with the use of DHIS 2. All the surveyed participants would recommend the use of DHIS 2 to other countries. The data indicate that the software s error messages are particularly useful. The user manual is also highly valued by a portion of the users. Among the more concerning findings was that one third of the participants reported not to be aware of the user manual. Also, the dominant problem-solving approach was contacting others by external communication options although an integrated functionality is offered within the DHIS 2 software.