The Gambia government has set an ambitious goal to establish an E-government aimed at promoting service efficiency, productivity, and accountability. The Public Healthcare System is one of the primary sectors to benefit from this initiative where healthcare service and service delivery sector faces difficult challenges. These challenges in the public health sector include lack of Healthcare Information Systems, electronic medical record systems and quality service delivery. In this study, we provide situation analysis of the healthcare system, policies, and practices. The objectives are to identify structural and policy gaps; based on the outcome of the analysis, we present a design and development framework of an interoperable Healthcare Information System (HIS) for a nationwide adoption. The focus is about interoperability between Public Health Information Platform (PHIP) and Health Information System (HIS). The goal is about Integration of regional Population Health Information Platforms (PHIP) with HIS at healthcare service delivery levels. The framework will allow analysis of data collected from multiple sources and the recommendations provided will also serve as implementation guide for policy for informed decision making.