PurposeGovernance of e-government is rarely discussed in the initial digitization stage, especially in developing countries where the government’s focus is mainly to pursue rapid proliferation of digital adoption rather than to implement governance. This study aims to explore the consequences of this absence of governance at local level conditions.Design/methodology/approachAn in-depth exploratory case study is conducted at a municipal health government in a southern city in Kalimantan Island, Indonesia, examining the conditions of local actors in response to various nationwide health digitization imperatives. The postcolonial theory with the critical paradigm is used to interpret and conceptualize the empirical findings.FindingsThis study identifies two critical failures of digitization governance that represent the mainstream condition: horizontal sectoral ego and vertical asymmetry and misalignment. These failures have resulted in undesirable consequences at the subalterns indicated by diverse ambivalence and de-voiced constructs displayed by the local actors.Practical implicationsThis paper suggests that various issues that emerge from local level implementation in nationwide digitization agenda might not always be issues of local technology adoption, but rather negative impacts due to the absence of governance practice at the strategic level.Originality/valueThrough a critical perspective, this study unearths the underlying power and structural inequity responsible for generating the various issues and undesirable consequences that emerge at local levels related to the nationwide digitization agenda.