Evaluation of Impact of the M-SAKHI mHealth App on Knowledge, Skills and Acceptance of use of App by Maternal and Child Health Community Health Workers in Rural Maharashtra

Introduction: Accredited Social Health Activists (ASHAs) play a vital role in bridging the gap between rural communities and the public healthcare system. Through the Mobile Solutions Aiding Knowledge for Health Improvement (M-SAKHI) clustered randomized controlled trial, ASHAs were equipped with a mobile application for real-time data collection and face-to-face counselling. This study evaluates the App’s impact on their knowledge, skills, and acceptance. Method Knowledge was assessed using multiple-choice pre- and post-test questionnaires. ASHA skills were continuously evaluated across five domains: (1) participation in meetings/trainings, (2) server monitoring of activities, (3) App and phone operating skills, (4) 5% random checks, and (5) field supervision feedback. ASHA’s Performance was graded as poor, satisfactory, or good based on performance scores. Feedback was collected on M-SAKHI training, mobile and app usability, and preferred features in the App using a 3-point Likert scale. Results Knowledge assessment showed a significant decline in the ASHAs' scoring in “Poor” category 18.7% (p = 0.00) (pretest 32% (48/150) vs post-test 13.3% (20/150)) and a 14% (p = 0.00) increase in the number of ASHAs scoring “Good” category (pretest 4.7% (7/150) vs post-test 19.3% 29/150)). Only a fifth displayed poor performance in skills assessment across attributes. Data or device misuse was limited to 6.7% (10/150). Over 90% (139/150) of ASHAs could operate the device and app independently; nearly all found the App's content user-friendly and easy to understand. Conclusion The M-SAKHI app positively impacted ASHAs’ knowledge and enhanced their implementation capacity. With the very high acceptance of mHealth technology by ASHA workers, this shows promise in empowering ASHAs to deliver services more effectively in rural settings. Trial Registration Number: CTRI/2018/02/011915 [Registered on: 15/02/2018] https://ctri.nic.in/Clinicaltrials/searchbyctri.php