Fragmentation of health information systems is a common issue in the world today. Aid agencies and other organizations that seek to resolve a problem in developing countries often introduce their own vertical systems which do not help the decision makers in a country. This thesis sets out to explore the theoretical ideas that can be utilized to understand the development process of an integrated mobile health information system in the Global South. Further it seeks to address how such a system can address the needs of the users at the lowest level, contribute to organizational growth and support users at other locations. In this study I will present a case in Zimbabwe where a mobile health information system was developed and therefore seek to identify the challenges encountered and the strategies used for resolving them. The empirical work of this thesis reduces fragmentation of the health information system in Zimbabwe and limits the need for manual processes. The main contribution was to develop an Android application for data collection, which is integrated with the national health information system in Zimbabwe, DHIS2. The application was set out to improve the pre-existing system for malaria disease surveillance in an ongoing pre-elimination programme in the province Matabeleland South. However, as the project grew, a standardized data collection application emerged aimed at a national roll-out in Zimbabwe, but also targeted internationally to support others in the DHIS2 community. The findings of this study show that utilizing the design-reality gap model and its three aspects of participative methods, rapid prototyping and observational techniques, and in addition utilizing local "hybrids" that work with the pre-elimination programme and have a technical understanding is a good approach. This study concludes that such utilization of the design-reality gap model has been successful. Further, the findings suggest that it is important to fulfill user requirements while on the other hand making decisions to support organizational growth such as moving to the Android platform. The development of the standardized application opens up to the risk of the project moving away from the malaria pre-elimination use-case, therefore a Zimbabwean software development company was engaged in the development process. This study concludes that such an utilization of the design reality gap model has been successful. Further, this study concludes with that moving to the Android platform was necessary for organizational change.