Does mHealth help or hinder health care needs? Insights from two Indian states

\articletype Original Articles This paper explores the digitalization of healthcare delivery, through mobile health (mHealth), at the grassroots level in two Indian states, Andhra Pradesh and Rajasthan. Based on qualitative interviews with frontline health workers we analyse how health workers engage with the digital tools they are asked to use. Along with documenting the areas where mHealth helps frontline workers with their tasks, the paper identifies five critical concerns: to what extent mHealth meet frontline worker’s needs, whether enabling conditions for adoption exist (adequate infrastructure, reliable connectivity, training), whether mHealth (re)produces exclusion (especially through compulsory use of digital access), whether it diverts attention from core responsibilities (by increasing administrative burden on health workers) and whether digital monitoring enhances accountability or merely extends surveillance. Our findings suggest that current deployment of mHealth is being used as much to build a national electronic medical records repository that is intended to facilitate data portability as they are being used to make frontline worker’s tasks easier. Its current implementation - top down and coercive at times - often undermines worker motivation and efficiency. The paper underscores the importance of aligning technological innovation with health system capacities and democratic values. Echoing the Lancet–FT Commission’s emphasis on equity, inclusion, and solidarity, it argues that the digitalization of healthcare must remain subservient to public health goals. In the Indian context, meaningful gains from mHealth require shifting from punitive, compliance-driven practices toward participatory and enabling approaches that genuinely support frontline workers and the communities they serve.