Implementation Research on IMCI Application Integrated into National Digital Platforms (DHIS2, OpenSRP): A Study in Barisal District (Bangladesh, 2025)

Digital health innovations are increasingly used to strengthen primary healthcare delivery in low- and middle-income countries. In Bangladesh, a digital Integrated Management of Childhood Illness (IMCI) application was developed in partnership with the Government of Bangladesh and integrated into national health information platforms in 2024.

This study assessed provider efficiency and key implementation outcomes of the IMCI digital application in rural healthcare settings. Mixed-methods implementation research design was employed across intervention (Barishal) and comparison (Jhalokathi) districts.

Acceptability of the IMCI app was high among healthcare providers, who reported improved diagnostic accuracy, structured clinical decision-making, and reduced cognitive burden. The digital system supported treatment and assessment of over 11,000 children and enabled real-time visibility of disease patterns, with fever and respiratory infections being the most prevalent conditions.

Adoption was moderate to high and positively associated with prior digital experience, while gender disparities and connectivity issues constrained use in some settings. The application aligned well with national IMCI protocols and routine workflows; however, feasibility challenges included network instability, device malfunction, power outages, and the burden of dual paper–digital data entry.

Fidelity to standard treatment protocols was generally strong, particularly among less experienced providers. Training was effective in building confidence, though providers recommended longer and refresher sessions. Overall, the digitized system demonstrates strong potential to improve quality and efficiency of child health services in rural Bangladesh. Addressing infrastructure limitations, reducing reporting duplication, and strengthening digital capacity are critical for sustainable national scale-up.