Design, development and implementation of a digital burial record-keeping and management system in Bangladesh.

Background: Digitalisation of death documentation in Bangladesh's graveyards is crucial for accurate mortality data and public health planning. Additionally, studying the usability, technology acceptance, and implementation aspects of the digital death record-keeping system, an innovative intervention that has not been previously explored, ensures the effectiveness, user adoption, and long-term sustainability. We designed, implemented, and evaluated a digital mortality surveillance system in graveyards in Dhaka city of Bangladesh.

Methods: The study was conducted in six graveyards of the Dhaka North City Corporation (DNCC). First, we conducted formative research to understand the documentation process of the graveyard record-keeping and inform architecture for a digital record-keeping system. We then developed a digital record-keeping system for graveyard. A cross-sectional quantitative and qualitative study was conducted among web and app users, and graveyard managers and death records keepers.

Results: A total of 200 app and web users and 14 record-keepers and managers participated. App and web users had high levels of system usability (88%) and found them easy to use (100%) and well-integrated (100%), with disagreement on complexity (100%), inconsistency (100%), and technical support needs (100%). These users had high technology acceptance and agreed the tools help accomplish tasks quickly (100%), improve performance (100%), and were easy to learn (100%). Digital death record-keepers reported using the system frequently (71%) but found it somewhat complex (14%) and not consistently easy to use (28%), with some reported that the systems were well integration (50%) and easy to learn (43%). While technology acceptance varied, death record keepers generally agreed that the system helps with quick task completion (50%) and performance improvement (57%), increase productivity (43%), enhance effectiveness (57%), and easy to use (50%). The digital death record-keeping system received mixed reactions, with younger, tech-savvy operators being optimistic, while older supervisors were sceptical and uncomfortable with technology. Additionally, the system was found to be feasible to an extent, particularly by data entry operators and graveyard managers.

Conclusions: The digital death record-keeping system was generally well-received by app and web users for its usability and integration, though graveyard supervisor found it somewhat complex, with mixed reactions based on tech-savviness; overall, the system was deemed feasible and sustainable.