Objective: This report aims to provide practical advice about the implementation of a public health monitoring system using both geographic information system technology and mobile health, a term used for healthcare delivery via mobile devices. application amongst household residents and community stakeholders in the limited resource community. Methods: A public health monitoring system was implemented in a semi-rural district in Thailand. The challenges encountered during implementation were documented qualitatively in a series of monthly focus group discussions, several community hearings, and many targeted interviews. In addition, lessons learned from the expansion of the program to 75 other districts throughout Thailand were also considered. Results: All challenges proved solvable yielding several key pieces of advice for future project implementation teams. Specifically, communication between team members, anticipating technological challenges, and involvement of community members are critical. Discussion: The problems encountered in our project were mainly related to the capabilities of the data collectors and technical issues of mobile devices, internet coverage, and the GIS application itself. During the implementation phase, progressive changes needed to be made to the system promptly, in parallel with community team building in order to get the highest public health impact.

Background Reactive case detection (RACD) or testing and treatment of close contacts of recent malaria cases, is commonly practiced in settings approaching malaria elimination, but standard diagnostics have limited sensitivity to detect low level infections. Reactive drug administration (RDA), or presumptive treatment without testing, is an alternative approach, but better understanding regarding community acceptability and operational feasibility are needed. Methods A qualitative study was conducted as part of a two-arm cluster randomized-controlled trial evaluating the effectiveness of RDA targeting high-risk villages and forest workers for reducing Plasmodium vivax and P. falciparum malaria in Thailand. Key informant interviews (KIIs) and focus group discussions (FGDs) were conducted virtually among key public health staff, village health volunteers (VHVs), and household members that implemented or received RDA activities. Transcriptions were reviewed, coded, and managed manually using Dedoose qualitative data analysis software, then underwent qualitative content analysis to identify key themes. Results RDA was well accepted by household members and public health staff that implemented it. RDA participation was driven by fear of contracting malaria, eagerness to receive protection provided by malaria medicines, and the increased access to health care. Concerns were raised about the safety of taking malaria medicines without having an illness, particularly if underlying health conditions existed. Health promotion hospital (HPH) staff implementing RDA noted its operational feasibility, but highlighted difficulty in traveling to remote areas, and requested additional travel resources and hiring more VHVs. Other challenges were highlighted including the need for additional training for VHVs on malaria activities and the inability of HPH staff to conduct RDA due to other health priorities (e.g., Covid-19). More training and practice for VHVs were noted as ways to improve implementation of RDA. Conclusions To maximize uptake of RDA, regular education and sensitization campaigns in collaboration with village leaders on the purpose and rationale of RDA will be critical. To alleviate safety concerns and increase participant safety, a rigorous pharmacovigilance program will be important. To accelerate uptake of RDA, trust between HPH staff and VHVs and the communities they serve must continue to be strengthened to ensure acceptance of the intervention. Trial registration This study was approved by the Committee on Human Research at the University of California San Francisco (19–28,060) and the local Ethics Committee for Research in Human Subjects at Tak Provincial Health office (009/63) and Kanchanaburi Provincial health office (Kor Chor 0032.002/2185). Local authorities and health officers in the provinces, districts, and villages agreed upon and coordinated the implementation of the study. All methods in this study were carried out in accordance with relevant guidelines and regulations.

BACKGROUND Use of geographic information system (GIS) for public health has been increasing in Thailand, particularly for studies of major infectious diseases. However, the lack of evaluating the health impact of GIS-embed mHealth makes it impossible to identify the benefit and cost-effectiveness in a developing country where the budget for health promotion is limited. OBJECTIVE In this paper, we described the process, problems encountered, and lessons learned in 4 dimensions including reach, effectiveness, adoption, implementation, and maintenance during translation of mHealth technology in a rural community of Chiang Mai, Thailand. METHODS An implementation research has been conducted to evaluate the impact of translating mHealth technology amongst household residents and community stakeholders in the rural area of Chiang Mai province, Thailand. RESULTS The challenges and problems affected by the individual level and setting level have been evaluated and reported based on the RE-AIM model. The application reached more than 60% of the project's targeted provinces. The application efficiency test and satisfactory test were higher than the acceptable level according to the SUS score system. The problems encountered in our field settings were mainly related to the capabilities of the data collectors and technical issues of mobile devices, internet coverage, and the GIS application itself. Progressive changes were made to the system during the implementation phase per the feedback from the data collectors and local community contexts. After resolving various problems and learning valuable lessons, the health information system thus developed was easy to use and understand for both the data collectors and the local policymakers. CONCLUSIONS The GIS-linked community health profile generated by our system can be used as a baseline by the local public health authorities to design appropriate interventions and measure changes in the health status of the community members. Our field experiences will serve as a guide in future scaling-up of the project and can provide valuable information for other researchers planning to conduct research using GIS in similar contexts.