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For my point of view, the interoperability problem start by the lack of eHealth Strategy in a lot of Country. Because this document constitutes a guideline to build a framework for the Health Information System as component of the Health System. Many stakeholder start thinking of Interoperability after the implementation of some eHealth applications at the national level. Some countries don’t have even eHealth Strategies or Roadmap document that express their need in term of eHealth tools implementation. Interoperability is not a common concept in the vocabulary of stakeholder unless the need of sharing data is raised on the ground and at that time most country realize that some eHealth tools may share data and some not. But in my point of view, the starting point is to have a Master Facility List, an Interlinked Health Worker Registry and to provide a unique identifier to the population that will allow to build a longitudinal Electronic Health Record System to track patient across the country.