02407nas a2200193 4500000000100000008004100001653001300042653001800055653001700073653001900090100001400109700001400123700001200137700001200149245015700161856008200318490002600400520178700426 2019 d10aM-health10aMobile health10aBurkina Faso10aBELT framework1 aArnaert A1 aPonzoni N1 aSanou H1 aNana NG00aUsing the BELT Framework to Implement an mHealth Pilot Project for Preventative Screening and Monitoring of Pregnant Women in Rural Burkina Faso, Africa uhttps://telehealthandmedicinetoday.com/index.php/journal/article/view/100/1780 v4145311311925161162843 a
Introducing mHealth in resource-poor communities is not without technical, financial, and infrastructural challenges. Even today, little is known about the process of implementing sustainable mHealth services in these regions. The Broadband/Bandwidth, Education/ Environment, Leadership, & Technology (BELT) framework helps guide stakeholders in identifying the core contextual elements that ensure successful implementation and organizational readiness. Hence, this paper describes challenges experienced when implementing the Strengthening Relationships and Enhancing Access to Maternal Services (STREAMS) project using this framework, in a rural community in Burkina Faso, Africa.

Methods and Findings:
A focused ethnography using participant observation documented implementing the STREAMS process through the use of descriptive field notes. Despite having a champion who drove implementation, challenges that arose were mainly due to problems of Internet connectivity and a lack of participants’ baseline computer skills, which had negative consequences on the initial training sessions and subsequent service delivery.

Conclusions:
Availability of limited information on the rural context/demographics and similar mHealth projects in Burkina Faso led to a misfit between the initial plan and the contextual reality. Having access to this type of background information is especially important to the success of mHealth initiatives providing humanitarian aid.