There is an urgent need to address the issue of non-integrated health information systems (HIS) in developing countries. The existing literature on information systems (IS) integration, however, is overly optimistic and prescriptive. It is predominantly technical in orientation, often touting new and better technical approaches to deal with the integration challenges. We identify and build on critical literature that goes beyond the largely unchallenged consensus that integration is desirable (and doable). We are not arguing against integration per se, but discussing the challenges of actually achieving integration, specifically the political aspects of integration. The empirical material is drawn from an ongoing effort to computerize the health care sector and integrate IS systems in India. We focus on the sociotechnical and political aspects of integration of these systems. Our aims are (1) to address the conceptualizations of integration within IS and (2) to provide guidelines for how integration can or should be managed in practice. This article, in understanding the political-technical aspects of integration, has implications not only to health and India, but also to other domains of IS in both developed and developing countries.