Background: Since the enactment of health decentralization policy, many argued that Indonesian health information system became more fragmented. While there’s no comprehensive national policy on district health information systems (DHIS) integration and interoperability, some districts have initiated different approach and innovations influenced by internal and external factors. Wonosobo is a district with 735.000 population, located in the Central Java province which has started a wireless wide area network DHIS by the end of 2006. Objective: This article aims to (1)describe factors determining Wonosobo district to adopt Open Source platform, (2)present preliminary results of the developmental phase and (3)discuss upcoming agenda. Results: Previous failure e-Gov implementation has strongly influenced the District Health Office (DHO) to adopt Open Source approach for DHIS development. According to the RFP document, one of the objectives of this project is to develop an open source DHIS software as well as open source community for Indonesian public health domain. The selected vendor has been implementing the software in the DHO and 21 primary health centers. Before the implementation, 60% of the operators were using computer mostly for writing letter and report. Each primary health centers (PHC) provided with 2 workstations running a web-based application to support clinic activities and community health programs as well. At the DHO, we-based application has been developed to integrate reports from the PHCs, transforming the data into map, graphic and tables and aggregating selected health indicators for vertical report. Application was developed with PHP 5.1 with AJAX and supported by mySQL 5.0.23 database. However, there’s no organizational structure dedicated for maintaining DHIS. Conclusion: Wonosobo district has started an open source approach for DHIS development in Indonesia. Initial phase showed that while technical aspect is relatively fast developed, organizational and human resource aspect should be the main agenda to resolve. - Anis Fuad - Indonesia