Developing countries represent the fastest growing mobile markets in the world. For people with no computing access, a mobile will be their first computing device. Mobile technologies offer a significant potential to strengthen health systems in developing countries with respect to community based monitoring, reporting, feedback to service providers, and strengthening communication and coordination between different health functionaries, medical officers and the community. However, there are various challenges in realizing this potential including technological such as lack of power, social, institutional and use issues. In this paper a case study from India on mobile health implementation and use will be reported. An underlying principle guiding this paper is to see mobile technology not as a “stand alone device” but potentially an integral component of an integrated mobile supported health information infrastructure.