Effectiveness of E health services at Upazila health complex level in Bangladesh

This study examines the effectiveness of e-health services in improving healthcare delivery at the Upazila Health Complex (UHC) level in Bangladesh. A mixed-method research design was employed in this study. Quantitative data were collected from 384 respondents selected through simple random sampling to measure awareness, readiness, perceived benefits, and perceived barriers of e-health services. Qualitative data were generated through purposive face-to-face interviews with 16 service recipients and 10 service providers to gain in-depth insights into existing practices and challenges at UHCs. Although 81.0% of respondents had internet access at home, 68.0% had never used e-health services. Overall awareness of e-health services was low (Mean = 2.53), whereas readiness to use e-health (Mean = 4.10), perceived benefits (Mean = 4.25), and barriers (Mean = 4.21) were relatively high. Qualitative evidence indicates that UHCs are inadequately equipped to meet rural healthcare needs. Although initiatives such as online record-keeping, and e-health hotlines exist, their utilization remains limited. Key barriers include shortages of ICT equipment, lack of skilled personnel, insufficient training, poor infrastructure, low public awareness, and weak integration with existing health systems. Overall, e-health initiatives demonstrate significant potential to improve rural healthcare delivery in Bangladesh; however, their current impact at the UHC level remains limited. Addressing infrastructural and human resource gaps, strengthening digital literacy and training, and developing clear policy frameworks are essential to enhance the effectiveness and sustainability of e-health services. The findings provide preliminary, context‑specific observations that may inform hypothesis generation for future intervention research. Policy recommendations should be tested through experimental designs before implementation.