Between promise and practice: Maternal, neonatal and child health professionals’ experiences of digital service adaptations in Uganda during the COVID-19 pandemic

Introduction: The COVID-19 pandemic severely disrupted maternal, neonatal, and child health (MNCH) services in Uganda. In response, digital health tools were rapidly adopted as one of the strategies to restore service delivery. However, the experiences of MNCH professionals implementing these adaptations remain underexplored. This study aimed to explore how MNCH professionals in Uganda experienced the digital tools adaptations made to restore MNCH services during the pandemic. Methods: This qualitative study involved seven in-depth interviews with MNCH professionals in Kampala, Uganda. Participants were purposively sampled based on their direct involvement in digital health adaptations during the pandemic. Data were analysed using qualitative content analysis to explore both manifest and latent meanings in participants’ experiences. Results: One overarching theme emerged: Experiencing digitalisation as a paradox between promise and practice. This was supported by two sub-themes: realising multi-dimensional gains of digitalisation and recognising digitalisation as only ‘part of the puzzle’, and six categories. The results explored how digital tools improved work-life balance, collaboration, and service continuity, they also exposed infrastructural and socioeconomic barriers, particularly in rural and low-income settings. Conclusions: Digital health innovations offer valuable support for MNCH service delivery during public health emergencies. However, their effectiveness is limited by structural inequities and digital exclusion. This underscores the need for context-sensitive strategies that balance technological innovation with persistent structural and clinical realities.