This research examines the performance evaluation mechanisms and strategic decision-making processes across departments within the Saudi Ministry of Health (MOH), focusing on their effectiveness in delivering healthcare services aligned with Vision 2030 objectives. Using a mixed-methods approach combining quantitative analysis of health system performance metrics and qualitative insights from key stakeholders, this study proposes an integrated framework for enhancing evidence-based decision-making throughout the Ministry. The findings reveal significant opportunities for improving cross-departmental collaboration, data integration, and strategic alignment. The research identifies four essential components for successful health system performance management: standardized evaluation frameworks, integrated information systems, collaborative governance mechanisms, and evidence-based decision-making protocols. This paper contributes to the growing discourse on healthcare transformation in Saudi Arabia by demonstrating how enhanced coordination across Ministry departments can drive system-wide improvements in healthcare delivery, resource allocation, and ultimately population health outcomes in alignment with national development goals.