m4Change: Improving Service Delivery through mHealth in Nigeria

m4Change was launched in 2012 to improve the quality of services provided by community health workers through the deployment of a mobile phone antenatal care application designed to facilitate more accurate decision-making.

Pathfinder collaborates with Dimagi, Inc and the Nigerian Government to implement the m4Change project in Nigeria. The m4Change project aims to equip community health extension workers with a CommCare, a mobile phone decision support application, in order to improve the quality of antenatal care (ANC) services, contributing to the goal of reducing maternal mortality within the framework of Nigeria’s “Saving One Million Lives Initiative”. In February 2013, the project was formally launched in 20 health facilities in Nasarawa and Abuja states with more than 150 community health extension workers and midwives currently using the application. To date, more than 15,000 women are registered and being followed in CommCare at project health facilities.

Improved Data Dashboards, Standards, and Interoperability
In order to promote data use and effective planning, Pathfinder developed an online reporting portal to allow access to a user-friendly data dashboard where key stakeholders can access data for facility and aggregate level data analysis. Pathfinder also recognizes the power of using data for improved supervision. Pathfinder has partnered with the University of Washington to explore protocol and workflow data collected in CommCare and compared across sites. This data will be shared with supervisors to understand anomalies and effect change to improve the quality of care.

Promoting Antenatal Care Attendance and Facility Based Delivery
The use of SMS reminders have been shown to improve antenatal care attendance and skilled birth delivery rates in many African countries. The m4Change project leverages these findings to use SMS to notify women if they have missed an antenatal care appointment and encourage them to come back into care. SMS alerts are also sent to health workers to follow up on women for birth plans and to promote postnatal care services.

Documenting Change in the Quality of ANC services
A rigorous research study is ongoing assess the perceptions and change in quality of antenatal care as a result of integrating a mobile phone application. The final write up and dissemination of study results will occur in early 2014.

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