{
  "abstract": "Objectives In Cambodia, village health support groups (VHSGs) are central to maternal and child health (MCH) service delivery, yet maternal mortality remains high with regional disparities. Although digital health solutions show promise, their real-world use is underexplored. This study therefore aims to evaluate the i-MoMCARE app in supporting VHSGs and health centre staff for delivering MCH services.Methods A mixed-methods approach guided by the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework was used. Reach was assessed using programme records (number of users trained and MCH cases managed). Effectiveness and adoption were evaluated using the mHealth App Usability Questionnaire (MAUQ) and qualitative data on user experience and intention to use. Implementation was examined through system usage monitoring and feedback on workflow integration. Maintenance was explored using qualitative insights on long-term use, barriers and recommendations.Results 44 VHSGs and 10 health centre staff were trained, and 96 MCH cases were managed with the app. Usefulness was rated highly (MAUQ 5.58, SD 1.04), with users appreciating the user-centric design that improved usability and integration into daily workflows. Effectiveness was similarly high (MAUQ 5.50, SD 0.95); the clinical decision support system and point-of-care alerts were valued as reliable decision-support tools, and the electronic medical record (EMR) was seen as a secure data repository. However, adoption was hindered by hardware and software limitations (MAUQ 5.79, SD 0.75), including device availability and low digital literacy.Discussion Our findings highlight the value of the i-MoMCARE app in supporting VHSGs, particularly those with limited training, by enhancing their decision-making. The study also lays the groundwork for a unified EMR in primary care. However, concerns around hardware and software limitations hinder adoption and sustained use.Conclusion To enable scale-up, we recommend reducing access barriers and supporting sustained use through diversifying the platform’s design and implementing phased incentivisation strategies.",
  "authors": [
    {
      "affiliations": [
        "Saw Swee Hock School of Public Health, National University of Singapore, Singapore"
      ],
      "name": "Hendra Goh"
    },
    {
      "affiliations": [
        "University of Health Sciences, Phnom Penh, Cambodia"
      ],
      "name": "Dyna Khuon"
    },
    {
      "affiliations": [
        "SingHealth Duke-NUS Global Health Institute, Singapore"
      ],
      "name": "Mengieng Ung"
    },
    {
      "affiliations": [
        "Saw Swee Hock School of Public Health, National University of Singapore, Singapore"
      ],
      "name": "Sreymom Oy"
    },
    {
      "affiliations": [
        "University of Health Sciences, Phnom Penh, Cambodia"
      ],
      "name": "Chhavarath Dary"
    },
    {
      "affiliations": [
        "National Maternal and Child Health Center, Phnom Penh, Cambodia"
      ],
      "name": "Chhorlika Khim"
    },
    {
      "affiliations": [
        "National Maternal and Child Health Center, Phnom Penh, Cambodia"
      ],
      "name": "Sveng Chea Ath Chhay"
    },
    {
      "affiliations": [
        "Singapore Institute of Technology, Singapore"
      ],
      "name": "Yan Fang Lee"
    },
    {
      "affiliations": [
        "National Maternal and Child Health Center, Phnom Penh, Cambodia"
      ],
      "name": "Rattana Kim"
    },
    {
      "affiliations": [
        "Saw Swee Hock School of Public Health, National University of Singapore, Singapore"
      ],
      "name": "Siyan Yi"
    },
    {
      "affiliations": [
        "University of Health Sciences, Phnom Penh, Cambodia"
      ],
      "name": "Vonthanak Saphonn"
    }
  ],
  "title": "i-MoMCARE: AI-enabled mobile app for maternal and child health care in Cambodia – a pilot implementation and evaluation study",
  "uid": "e149772c-2240-5587-bc9a-f81d7645666b"
}