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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. Keywords: Africa, Antenatal Care, BELT, Burkina Faso, Community Health, Framework, Internet Connectivity, mHealth, Postpartum Monitoring, Pregnancy, STREAMS, UN-Sustainable Development Goal #3

telehealth and medicine today

Using the BELT Framework to Implement an mHealth Pilot Project for Preventative Screening and Monitoring of Pregnant Women in Rural Burkina Faso, Africa