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Efforts to build statistical capacity in the developing world have often failed to produce the expected increases in information use in management and planning. The ways in which culture influences evidence-informed and results-oriented decision making in organizations in low- and middle-income countries are not well understood. In this explorative study, a sample of health managers working in the public sector in a rural district in Burkina Faso was interviewed to elucidate the relationships between cultural dimensions at the organizational level, organizational practices, and the use of routine health information in decision making. Based on the results, a conceptual framework for these relationships is proposed, and strategies are suggested for overcoming cultural constraints to information use.