Background About 99% of global maternal mortality occur in developing countries and Nigeria accounts for 20% of all maternal mortality. Major contributory factors include poverty, distance, cultural and religious beliefs, and ignorance. Mobile health technology (mHealth) is emerging in Africa. While SMS has been the most common intervention, mobile apps have not been explored for maternal care in Nigeria. This study describes the process of design, development, and testing of mobile app for pregnant women in Nigeria.

Methods Using a user-centred design, we conducted semi-structured interviews at each stage of mobile app development with randomly selected pregnant women attending antenatal clinics in Oyo State, Nigeria. The first interview focused on need assessment or empathy, followed by alpha and beta testing of the mobile application prototype at health facilities in Ibadan, Nigeria.

Results The barriers to accessing perinatal care was distance to nearest facility (mean = 3.3km), lack of perinatal education, and cost. Low fidelity prototype of the mobile app was designed with five features (gamified microlearning, lifestyle tracking, clinic connection, financial planning, and chat). Alpha testing showed that 56% (n=7) of pregnant women surveyed considered lifestyle tracking and gamified microlearning as the most useful features of the mobile app. Mobile app increased the level of knowledge of preeclampsia by 179%. User feedback from alpha-testing informed the development of high-fidelity prototype for beta testing. 95.2% of pregnant women surveyed were willing to download the mobile app. The final app developed was uploaded on Google Playstore (MyBelle Pregnancy App) for free download.

Conclusion mHealth apps have the potential to increase access to prenatal information and services in Nigeria and may reduce maternal and childhood mortality. This paper has described the process of development of first indigenous mobile app specifically for pregnant women in Nigeria using user-centred design thinking approach.