Community health workers form the backbone
of healthcare systems globally. The rapid
expansion of mobile communications systems
represents an opportunity to improve the
productivity of community health workers in rural
areas. Here, we describe a programme in rural
Nepal that aimed to implement a mobile phone
system for collecting health surveillance data, yet
did not reach its fullest potential due to several
programme management challenges during the
implementation of the surveillance programme.
Despite early successes with the mobile phone
system itself, the programme ultimately failed
due to leadership transitions, poor process
design and a lack of consistent vision of how to
operationalise the data. This field report provides
important insights into the design, maintenance
and pitfalls of similar community-based mobile
health initiatives and technology innovation
projects in general.