FPedge Application

Nigeria accounts for between 14%-19% of the global MMR and is 1 of the 6 low-medium income countries accounting for over the 50% of the global burden. Maternal mortality is “the death of a woman while pregnant or within 42 days termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes”. (WHO)

The major causes of maternal mortality are haemorrhage, complications during delivery, sepsis, hypertension in pregnancy and unsafe abortion. 

Unsafe abortion accounts for about 40% of maternal deaths in Nigeria. Unplanned and unwanted pregnancy has been identified as the principal cause of unsafe abortion. 

Our solution, a mobile platform for family engagement will increase contraceptive prevalence by providing unencumbered, adequate information and access to services. This will go a long way in reducing maternal deaths in Nigeria.

Modern contraceptive use is 28% among sexually active unmarried women and 12% among married women (NDHS 2018) despite efforts at improving this to reduce maternal mortality. This can be attributed to poor access to family planning information, methods and services as a result of spatial differentials in the location of the clients and the distribution of facilities, media exposure , education, socio-economic status, knowledge of modern methods of contraception.

Increasing access to reproductive health information and services for all women of reproductive age and empowering women to plan their pregnancy requires an innovative method to surmount identified barriers. This will increase the contraceptive prevalent rate for modern methods (mCPR) and decrease the unmet needs for contraception.

Practices such as early marriage contribute to the increase maternal mortality as the most affected age group is 15 -22 years. There is also a need to ramp up support to girls in this age group who are inadvertently being  exposed to the risk of death from pregnancy-related complications.

The FPedge app will bring together major stakeholders in the FP value chain including; women of reproductive age (15-49), pregnant women and their spouses, other interested men, FP service providers, State Ministry of Health officials and implementing partners

The features are:
• A platform to exchange FP information among stakeholders and provide information on modern methods of FP (pros, cons, side effects, effectiveness, how to administer)
• A platform for male engagement on issues of family planning
• Address myths and misconceptions on modern FP methods
• Provide directions on where to access FP
• A safe space/platform for women of reproductive age group to discuss issues on FP
• Enables healthcare facilities to maintain a digital record of all members and content.
• Allows the seamless collection of information through automated pulls from a registered phone number & USSD platform.
• Allows messages, pictures, or videos to be shared with the community.
• Users can watch educational videos and service Livestream
• Providing interface for query/information from clients through the USSD codes or through automated call back response services on registered numbers

The solution is targeted primarily at women of reproductive age i.e. 15-49 years. Adolescents and young adults have been reported to have the highest rates of maternal mortality. This, coupled with the practice of early girl child marriage make the adolescent and young adult a key focus among the primary targets. 

Secondary targets are also included in the solution for an encompassing coverage of the stakeholders in the FP landscape. These include; 

• pregnant women and their spouses
• other men who are spouses to the primary targets
• health workers in the FP space
• state officials responsible for FP  to take care of the system related barriers
• development partners working in the FP space. 

All targets will be linked to the application platform through different channels of engagement and mobilization. They will participate in the exchange of information in their respective capacities.

The FPedge app would ensure that women get pregnant when they want to hence improving their reproductive health. This would contribute to improving the mCPR and unmet need for contraception. 

Barriers to FP uptake at the community level will be addressed by directly engaging health workers, preventing stigmatization, and the spousal resistance towards getting correct information from the health facilities. Myths and misconceptions will be  addressed promptly and directly leaving no room for misleading information from third parties. 

System levels barriers will be addressed by ensuring high quality of health workers on the platform in terms of skills and attitude. 

In the mobilization for FP programmes in Nigeria, it can be said that effort has largely been limited to physical engagement with the targets. The result has not been commensurate with the inputs in term of resources and effort. 

With the identified barriers still very much in place, FPedge provides innovative features that bypass these barriers and thereby create more values for the resources and efforts being committed to the use of FP services to reduce maternal mortality. 

This innovation serves the various stakeholders in the FP value chain as follows:
• FPedge has a centralized digital database where information of reproductive health can be pulled out at any time.
• The app enables remote registration for FP services and methods
• Gives critical information through educational videos and materials ‘on the go’ without physical contact or visit to the facilities.
• Ensures client-provider interaction confidentiality.
• The technology being used has had tremendous impacts on other social and human activities in the country.

Software /mobile application, big data

It would feature:

• Mobile App for IOS
• Mobile App for Android
• Back-end Application
• Admin Dashboard
• Backend Cloud Infrastructure

The growing impact of the use of mobile applications and big data in the lifestyle of Nigerians has grown steadily since the introduction of the mobile technology of communication. This can be seen in the burgeoning trends in e-commerce, mobile banking and other technology applications in transportation and investment. The success in these areas lends a credibility to impact expected from the adoption of the same technology in the uptake of FP service with the attendant reduction in the maternal mortality rate.

IF there is engagement with women of reproductive age and their spouses using  FPedge app to provide information on family planning and IF there is training of health workers on interpersonal communication also using the app. IF correct information on modern family planning is shared in the community and IF myths and misconception are dispelled, IF the health facility is easily accessible and family planning commodities are available and IF there is improved knowledge on interpersonal communication by the health workers towards clients seeking family planning and IF health workers can develop good interpersonal relationship with clients, IF women and men perceive increased acceptability of and approval for family planning in the community and IF there is positive outcome expectation for spousal communication on family planning and IF equitable decision making on uptake of family planning is increased among women of reproductive age,THEN there will be an increased demand for and uptake of family planning among women of reproductive age in the communities and country at large.

Using Lagos State as the as Pilot, the estimated population of women of reproductive age is about 3 million. A projection of enrolling 5% (150,000) of this population into the platform is made for the first year and an increase of 10% for succeeding years up to 1.2 million in five years depending on the continued availability of resources to maintain the platform and prevailing data of needs assessment.

This solution currently serves 0 people

In one year, it should serve at least 150,000 people

In five years, it should serve at least 1,200,000 people

The application creates a platform for women of reproductive age (and interested men) to access family planning information from their devices. This would enable them make informed choices about when and how they want to get pregnant.

We expect up to 1000 active users learning from the platform and sharing experiences within the first year. We believe that this would lead to a reduction in unwanted pregnancies and unsafe abortions.

The capacity of the platform would be increased with a growing audience to accommodate more users. Health facilities of more states would also be involved as growth occurs and users increase in those states/regions.

The versatility of the platform allows it to serve people everywhere in providing information. However, when it comes to access of services, coverage of states would increase based on data.

1. Attitudinal disposition of health workers  towards users of FP services especially the adolescent and unmarried adults.
2. Internet access: Some women or families that should benefit from this platform might not be able to access it for lack of internet-enabled devices or poor network connectivity and the cost of the mobile internet data in Nigeria.
3. Some cultures/communities do not consent to adolescents and women using FP methods so they may have to be discrete about it and may not receive support from their family.

1. Careful selection and training of HWs on the platform and ensuring confidentiality as well the demographic consideration in the selection of the participating Local government areas (LGAs).
2. Provision of some services via the USSD platform and pre-recorded voice notes.
3. Ensuring confidentiality of all members on the platform.

Centre for Communication and Social Impact (CCSI) is a national not-for-profit, Non-Governmental Organization (NGO) that focuses on the central role of communication to impact health and social behaviour change.

CCSI has over 10 years of experience in delivering quality health interventions working with international and local partners; largely on maternal and child health with a deep commitment towards mobilization for family planning service uptake across the country. 

Having been part of the challenges and the modest achievement in the observed improvement in FP in Nigeria, CCSI sees this as an opportunity for further reducing maternal mortality rate in the country. Therefore, a solution driven by CCSI will offer a seamless synergy with the existing efforts towards the improvement of the maternal health indices in Nigeria.

CCSI can support healthcare provider training (maternal, neonatal, child health providers) by producing entertainment-education videos. These would show them what they need to know in ways that would make it easy for them to remember and apply in their day-to-day work.

CCSI works within communities so these learning videos would be adapted to different languages required for the communities, also taking into consideration their local nuances.

CCSI would use this award to further strengthen existing interventions that improve maternal health in Nigeria.