The Southland District Health Board has voted to merge with the Otago DHB.
The boards have been working together for a number of years and already share a chief executive, senior management, laboratory services and some departments, including IT and human resources.
The "yes" vote clears the way for Health Minister Tony Ryall to make a definite decision on whether the boards should combine.
Last week, the Otago DHB voted unanimously in favour of the merger.
On Thursday, seven members of the Southland board voted for the merger, three voted against and one member abstained.
Many board members believe a merger will ensure better and more sustainable health services in both regions.
However, senior clinicians have expressed concerns that health services in Southland will suffer.
Southland DHB chairperson Paul Menzies says the "yes" vote is the best outcome for both districts.
