In recent years, many different types of e-government projects have been implemented across the developing world. One important application area, especially following the Millennium Development Goals, is the introduction of health information systems to improve the management of health care for development. Despite significant investments in these projects, experience reveals a disjuncture between macro-level policy priorities and micro-level implementation of these programmes. We use a broad conceptualisation of evaluation to synthesise priorities at different levels during the implementation of an e-government project— Health Information Systems Project (HISP) in Andhra Pradesh, India. This enables us to identify important enabling processes and conditions which serve to connect policy and implementation priorities. Our findings suggest that evaluation does help us to understand the disjuncture between policy at macro level and implementation at micro level and to identify linkages between the two. Finally, we discuss some of the key institutional issues which need to be addressed to translate the learning derived from the field into policy actions.