Background: Mobile phones and other technologies are widely used in health programming in developing countries, many introduced by international nongovernmental organizations (INGOs) to accelerate data collection. This research examined; How are INGOs adopting the innovation of mobile technology into monitoring and evaluation (M&E) systems for health care programs in international settings, and what factors are facilitating or inhibiting this innovation? Methods: A mixed-methods approach employed key informant interviews with INGO leaders (n=12) and platform providers (n=9) and an online survey of INGO personnel (n=311). The research used the Diffusion of Innovation (DOI) framework to structure the data collection. Univariate and bivariate analyses of the quantitative data were conducted using SPSS Version 21 and qualitative analysis used MaxQDA Version 11. Results: Of all survey respondents, 70.6% had used mobile technology during the last year, 77.2% were intending to use mobile technology over the next year in their programs, and 72.6% had seen organizations like theirs using mobile technology. Only 55.7% had used mobile technology specifically for M&E applications in health. Three of the five DOI areas--tension for change, innovation-system fit, and support and advocacy--showed INGOs to be far along toward the adoption of mobile technology. Assessing the implications of adoption and dedicating time and resources to the adoption--were relatively further behind. Discussion: The research shows high levels of readiness for change in the INGO community. However, the full power of mobile technology to change the way M&E systems are built and how data are collected at a systems level has not yet taken hold. The high level of organizational readiness for change can be leveraged if organizations are going to adopt mobile technology into M&E systems. The researcher proposed a strategy to assist INGOs that would like to adopt mobile technology into M&E systems that includes disseminating the findings widely among research participants, platform providers, donors and the wider public and to repeat the survey research to track change over time.Doctor of Public Healt
