Frontline Health Workers' Perceptions of Digital Health Platforms: Qualitative Insights From the North Guwahati Block in Assam.

BACKGROUND: Digital health platforms are increasingly promoted as tools for strengthening health systems, improving access to care, and enhancing patient outcomes. In Northeast India, where difficult terrain, dispersed populations, and healthcare access challenges persist, evidence regarding frontline health workers' (FLWs') experiences with digital health platforms remains limited. OBJECTIVES: The objective of this study is to explore the perceptions, experiences, and challenges of FLWs in relation to the adoption and use of digital health platforms in rural Assam. METHODS: A qualitative study was conducted between April and May 2026 in the North Guwahati block of Assam, covering one district hospital, one community health center, three primary health centers-health and wellness centers, and three sub-center-health and wellness centers. FLWs, including medical officers, community health officers, auxiliary nurse-midwives, Multipurpose workers, and Accredited Social Health Activists (ASHA), were selected purposively. Participants were recruited until data saturation was achieved, ensuring that no new themes emerged. Two additional interviews were reviewed after thematic redundancy to confirm saturation. Data were collected through semi-structured, in-depth interviews, which were audio-recorded, transcribed verbatim, and ​thematically analyzed following Braun and Clarke's six-step framework. Digital health platforms included routinely used government-supported digital systems for service delivery, reporting, teleconsultation, and beneficiary tracking. RESULTS: Four key themes emerged: perceived benefits, operational challenges, capacity constraints, and sustainability concerns. While FLWs appreciated the improved access, convenience, and documentation offered by digital platforms, participants reported persistent issues related to poor internet connectivity, duplication of reporting systems, inadequate training, increased workload, and limited interoperability between digital platforms. CONCLUSION: FLWs perceive digital health platforms as beneficial for patient care but face significant operational, capacity, and sustainability challenges. Strengthening infrastructure, ensuring interoperability, providing continuous training, and addressing equity concerns are essential for the effective and sustainable scale-up of digital health initiatives in rural India.