Assumptions that technical refinement alone secures effective data use conceal the relational forces entangled in system engagement. Through an interpretive study of the District Health Information System (DHIS2) deployment, this research shows how hierarchical authority, communal trust norms, linguistic discontinuities, and competing epistemologies subtly reconfigure the appropriation of digital infrastructures. Technology is neither merely adopted nor resisted; it is re-authored through situated negotiations between institutional protocols and lived communal realities. The findings advance theoretical discourse by conceptualizing system use as an ontological negotiation rather than an adaptive convergence. For practice, the study calls for a shift from system-centric optimization to the cultivation of socio-informational architectures capable of accommodating epistemic plurality, relational accountability, and evolving normative frameworks. Sustainable digital health interventions demand not standardization but attentive responsiveness to local ontologies, positioning communities not as recipients of technical solutions but as co-constructors of representational and operational legitimacy.