An mhealth application was developed by a German technological organization for use by frontline community health workers in Bangladesh. The application would guide the health worker in delivering maternal and child health–care services such as:

• Registration of pregnancy

• Reminders for antenatal care visits

• Alerting for birth preparedness

• Motivation for institutional delivery

• Post–natal visits

• Immunization of the child

• Infant and young child feeding practices

• Growth monitoring.

The application was developed entirely in Germany with local input from experts in Bangladesh. The application was developed in Bengali, the local language. It was field tested among 10 health workers who knew the Bengali language in Germany and found to be useful. An implementation study was designed to study the use, acceptability of the application by frontline health workers, ease of its use, perceptions of the frontline workers and the community of the application and its effectiveness in improving quality of maternal and child health–care delivery in a district in Bangladesh.

The study revealed that the frontline workers found the application extremely useful. They felt empowered by the use of the handheld device with the application. Some questions and data formats in the application needed to be changed based on the feedback given by the health workers. The data were captured accurately and in a timely manner. This improved data driven public health decision–making at the district level. There were practical issues with maintenance of the handheld device in some of the remote villages. In some villages where there was no electricity, so charging the devices was a problem.

Discuss the findings of this study. If the country plans to adopt and implement the strategy on a wider scale, how will these findings influence this decision?