The United Nations Reliefs and Work Agency for Palestine Refugees in the Near East (UNRWA) Health Department started developing a comprehensive reform effort in 2009; it included two main components: the establishment of the Family Health Team (FHT) approach and the move to e-Health information system. The overall objective of the e-Health implementation is to improve the health status of Palestine refugees through improved quality and efficiency of UNRWA health care services. The e-Health project should, complemented with the FHT approach, reduce staff workload, improve daily operations (data recording and reporting), improve the quality of data, reduce medical errors, and reduce paperwork. It should also improve the credibility of statistical information (e.g. accuracy, completeness, errors, duplication, etc.) and thereby the quality of evidence-based planning and management and subsequently improve the effectiveness and efficiency of the health centres. As already mentioned in a previous evaluation of the FHT the e-Health system was challenging to implement and as key part its implementation will reflect on the reputation of the Health Department as a whole.