Developing the i-MoMCARE application in Cambodia: an iterative co-design approach using rapid prototyping

To develop a mobile health (mHealth) application (i-MoMCARE app) to support village health support groups (VHSGs) and health centre staff in delivering maternal and child health (MCH) services in rural Cambodia.

We adopted a co-design strategy to guide the development of the i-MoMCARE app. In phase 1, key stakeholders identified and proposed app features based on research-informed end-user needs. Phase 2 involved prioritising high-impact features for app development. In phase 3, VHSGs and health centre staff participated in usability testing of the i-MoMCARE app. Interview data collected through rapid qualitative interviews were thematically analysed.

Sixteen stakeholders participated in phases 1 and 2 and 10 users participated in phase 3. The i-MoMCARE app comprises five core features: (1) clinical decision support system (CDSS), (2) electronic medical record (EMR) system, (3) educational resources, (4) digital worklog sorting and (5) offline functionality. Users reported that the CDSS improved consistency of care and boosted clinical confidence while the EMR enhanced data accuracy and retrieval efficiency. Educational resources were valued for supporting self-learning and community education. Meanwhile, worklog sorting improved time management and manpower planning, whereas offline functionality helped to ensure continued usage by mitigating connectivity issues. In addition, participants recognised the app's potential to extend beyond clinical functions, highlighting its role in streamlining administrative tasks such as inventory tracking and automated reporting.

This study demonstrates the value of CDSS and EMR systems in supporting VHSGs and health centre staff in their daily operations. Supplementing these with educational and administrative features further increases the app's utility, positioning it as a comprehensive tool for advancing the delivery of MCH services in resource-limited settings.