This document summarizes lessons learned from scaling up the Health Management Information System (HMIS) in Ethiopia's Southern Nations, Nationalities, and Peoples' Region (SNNPR). The scale up was led by the Federal Ministry of Health with assistance from John Snow Inc. and other partners. Key lessons included developing strong government ownership from the start, harmonizing support from development partners, and being prepared to adapt to changing information needs during the long scale up process. The strategy involved building regional and local capacity, promoting ownership through training and supportive supervision, encouraging partnerships, and enhancing information technology support. After six months initial results were promising with over 700 health workers trained and the regional health bureau taking the lead role.