Disconnected data: mHealth data systems and challenges for primary health care workers in India

Mobile health (mHealth) uses mobile devices and wireless technologies to support health systems and improve healthcare delivery. It has been heralded as a way to streamline data management and move away from paper-based system inefficiencies. This paper examines the transition to mHealth systems in primary healthcare in rural West Garo Hills, Meghalaya, India, focusing on health workers’ experiences with data collection and its implications for healthcare delivery. Through qualitative interviews with 49 participants across the health system, we found that although mHealth platforms were introduced alongside existing paper-based practices to address barriers to care, the transition often exacerbated systemic inefficiencies. Specific challenges included extensive duplication of data entry across paper and digital platforms, poor data management, and a displaced burden of data entry, often at the expense of patient care. This was compounded by contextual barriers, including insufficient training, infrastructural limitations, unreliable internet connectivity, and poor offline functionality, rendering digital tools ineffective in some settings. Additionally, community hesitancy complicated data collection efforts, while restricted access to uploaded health data hindered patient follow-ups and delayed early detection of those in need of care. These findings highlight the disconnect between the theoretical benefits of mHealth systems and practical implementation in resource-constrained settings. While mHealth has the potential to enhance data management and strengthen primary healthcare systems, realizing its full benefits requires prioritizing user-centered design, robust infrastructure, ongoing training, and streamlined, interoperable digital platforms to effectively strengthen local health systems.