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 (CHEWs) 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”.

Taking this technology even further, Pathfinder pioneers the use of mobile money for conditional cash transfer, utilizing Commcare data to verify and initiate mobile money payments to women under the government’s conditional cash transfer scheme. 

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. More than 150 CHEWs and midwives have been trained to use CommCare, and 20 primary health centers in Nasarawa State and Abuja are now equipped with our powerful mobile decision support app.

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 to assess the perceptions and change in quality of antenatal care as a result of integrating a mobile phone application.



Your support is critical to ensuring our work can continue. Your gift of $25 or $50 helps women and families access contraception, maternal and newborn care services, and a range of other reproductive health services.

Related Publications

June 2015

mHealth as a Tool for Integrated Systems Strengthening in Sexual and Reproductive Health Programming

This technical brief describes and analyzes how Pathfinder uses mHealth for integrated systems strengthening in sexual and reproductive health programs in four countries: Mozambique, Tanzania, Nigeria, and Haiti.

December 2014

Change Starts Here: Pathfinder International 2014 Annual Report

We believe change starts with expertly trained providers and pharmacies that never run out of supplies. It starts with open conversations among women, young people, men, religious leaders, mothers-in-law, policymakers, and others, joining to discuss their beliefs and remove barriers to their health and well-being. Our 2014 Annual Report shows a few highlights of how Pathfinder has served as a catalyst for change over the past year.

August 2014

Assessment of the Quality of Antenatal Care Services Provided by Health Workers using a Mobile Phone Decision Support Application in Northern Nigeria

A pre/post intervention study assessing the effect of introducing a mobile case management and decision support application for antenatal care in northern Nigeria.

Related Projects

Building Blocks for FP2020 in Pakistan and Nigeria

Building Blocks for FP2020 in Pakistan and Nigeria

Building Blocks for FP2020 supports and advances family planning in Nigeria and Pakistan, two countries that have made ambitious goals for improving access to reproductive health care in the next decade.

Community Actions to Improve Safe Motherhood in Charanchi, Katsina State, Nigeria under the Population and Reproductive Health Capacity Building Program

PAST PROJECT: The project provided capacity building support for two local community-based organizations, including the rollout of Pathways to Change, and mobilized the organizations to identify barriers in the use of quality maternal health services.

Photo by Sarah Day

Community-Based Organization Capacity Building Project

PAST PROJECT: In Nigeria, Tanzania, and Uganda, Pathfinder aims to improve the capacity of community-based organizations to better prevent mother-to-child transmission of HIV.


Firmaron Convenio Internacional para Reforzar Reducción de Mortalidad Materna

Con la finalidad de continuar con la disminución de la mortalidad materna, el Gobierno Regional La Libertad, a través del sector salud y ONG, fortalecerán capacidades.

Despite the odds, one doctor promotes family planning in Muslim Nigeria

For 10 years, Dr. Farouk Mohammed Jega has been championing evidence-based arguments to try to persuade clerics that Islam supports family planning methods, contrary to the views of many clerics in Nigeria.

Scroll to top