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Nigeria faces enormous challenges in meeting the growing demands for maternal healthcare. Due to the protracted humanitarian crisis, Borno state is particularly burdened by compounded maternal health needs. For this reason, the UNFPA Maiduguri Sub Office is prioritizing digital technologies to increase equitable access and uptake of skilled maternal healthcare services and ultimately improve maternal health outcomes. One of these technologies is Text4Life. 

Text4life is a phone-based innovative message service system that enables instant reporting of maternal pregnancy-related events, including HIV/AIDS, Malaria, Family Planning, COVID – 19 and other issues often in need of referral to secondary health facilities with timely notification to the health worker.

The short message service (SMS) system-based technology enables dual communication between women, girls, men, boys, persons with disabilities, vulnerable people, and healthcare providers. It functions as an alert system and supports the documentation of pregnancies and other illnesses within the community. Pregnant women also receive health messages related to preconception, childbirth, and the postnatal period, which helps resolve delays for women seeking care. Using this service only requires access to a mobile phone; access to the internet is not required.  

The App also ensures unhindered access and minimal downtime. Among other features of the system  is an uninterrupted power supply source supported by a central database server. The App is available on a USSD platform (*347*161#), is free, user-friendly, and does not require a smartphone for access.
 
On the 23rd and 24th of September 2022, the Maiduguri sub-office conducted a training which engaged two civil society organizations as part of measures to enhance access to life-saving healthcare information and essential health services. Part of the training was the distribution of 32 sim-card registered mobile phones to the health workers from the health facilities to help them communicate with the people within the community. These two way-communication processes also support reporting suspected cases of COVID-19 infection, gender-based violence incidents and other sexual and reproductive health issues for prompt and professional clinical intervention and management. 
 
The event had the participation of the Executive Director of Borno State Primary Health Care Development Agency (BOSPHCDA), and the Borno State Honorable Commissioner of Health. This advocacy visit was important because both the Executive Director of BOSPHCDA and the Honorable commissioner of Health were newly appointed and need a firsthand view of the system and context. This way, they were able to see how the program will contribute to the lives of women, girls, men, boys, persons with disabilities and the elderly.
 
The mass movement of health workers from different locations across Borno  is due to the ongoing emergency where the State Government often transfers health workers to other locations where their services are more immediately needed to close service gap.
 
UNFPA Nigeria is increasing technology in its programs. Because when properly utilized, the application will equally contribute to closing health service gaps and also support by significantly  reducing unmet need for family planning, ending maternal mortality, and increasing access to GBV services while also  ultimately promoting quality health and education for young people in Borno State.