Maternal & Newborn
Continuity-of-Care Platform

What is PulseCare?

PulseCare is a digital health platform designed for the specific reality of maternal and newborn care in low-resource, rural Nigeria where the power goes out, the internet doesn't reach, and the nearest skilled healthcare worker is often hours away.

Most women in communities like Toro LGA, Bauchi State attend at least one antenatal care (ANC) visit. But they disappear from the health system during delivery and the postnatal period exactly when the risk of death is highest. PulseCare exists to close that gap.

PulseCare provides the infrastructure that keeps mothers and newborns connected to care from pregnancy through the postnatal period without requiring continuous internet connectivity, expensive equipment at community level, or a smartphone in every household.

Who it's for

PulseCare serves three interconnected groups of users, each with a different role in the care continuum.

How the workflow works

PulseCare follows the maternal and newborn care journey end-to-end from a woman's first ANC visit through delivery and the critical postnatal period.

1. 1
   Registration A CHW or TBA registers the pregnant woman in the PulseCare mobile app name, age, gestational age, village, phone number. Works fully offline.
2. 2
   Antenatal visit at PHC At the PHC, the nurse measures blood pressure using the CRADLE VSA device. Readings and the traffic light alert (Green/Amber/Red) are recorded in the PHC dashboard. High readings trigger immediate referral review.
3. 3
   CHW home visits CHWs conduct structured home visits between ANC appointments. They complete the danger sign checklist, record observations, and check wearable data. The app flags any high-risk patterns immediately.
4. 4
   Danger sign detected → risk engine fires If a danger sign is flagged fever, heavy bleeding, severe headache, newborn feeding difficulty the risk engine classifies the case as High Risk and triggers the referral workflow. An SMS alert is sent to the supervising PHC.
5. 5
   PHC receives alert The PHC dashboard shows the incoming referral. Staff coordinate transport, prepare for the patient, and alert LifeBank if blood or oxygen may be needed.
6. 6
   Postnatal follow-up After delivery, the system schedules postnatal visit reminders for the CHW. The mother and newborn are monitored separately, each with their own danger sign checklist. Missed visits trigger alerts.
7. 7
   Data sync When a CHW or TBA reaches connectivity WiFi, mobile data, or a sync point at the PHC all offline records sync automatically to the central server. No data is lost during offline periods.

CHW Mobile App

The core tool for community health workers and traditional birth attendants. Built for Android, designed for low-end devices, and engineered to work with no internet connection.

Key screens

SMS Fallback System

For communities where smartphones are unavailable or where even the CHW device has run out of charge, PulseCare falls back to structured SMS communication.

SMS infrastructure is supported through active partnership discussions with MTN Nigeria and Airtel Nigeria for connectivity and bulk SMS routing.

Risk Classification Engine

Every recorded visit is assessed by a rules-based risk engine that classifies the case into one of three tiers and determines the appropriate response pathway.

PHC Dashboard

A web-based dashboard used by nurses, midwives, and PHC administrators to monitor all active cases, track referrals, and respond to high-risk alerts in real time.

Solar-Powered Wearable Device

The PulseCare wearable is a low-cost wristband prototype designed for passive vital-sign monitoring between CHW home visits. It is currently in prototype development and is not yet a production-ready device.

What it monitors

How data reaches PulseCare

Wearable data is transferred to the CHW mobile app during each home visit via Bluetooth sync. The app displays the last-recorded readings, adds them to the visit record, and flags any abnormal trends for the CHW to assess. No continuous internet connection is required.

Power

The device is designed to be solar-powered addressing the reality that households in Toro LGA have limited or no access to reliable electricity for device charging.

Referral Coordination

PulseCare manages the full referral pathway from the moment a CHW flags a danger sign to the receiving PHC confirming the patient has arrived and been assessed.

1. 1
   CHW flags danger sign Risk engine classifies as High Risk. Referral recommendation appears in the app with nearest PHC details.
2. 2
   SMS alert sent to PHC Automatic SMS with patient name, danger sign, and CHW contact sent to the designated PHC nurse.
3. 3
   LifeBank notified if needed For haemorrhage or critical cases, LifeBank emergency logistics are alerted for blood and oxygen delivery coordination.
4. 4
   CHW coordinates transport CHW arranges transport and accompanies or escorts the patient where possible. Referral status updated in app.
5. 5
   PHC confirms arrival PHC nurse marks the referral as received on the dashboard. If the patient does not arrive within the expected window, an escalation alert fires.

Danger Signs

PulseCare's danger sign checklist is grounded in WHO maternal and newborn guidelines and MPDSR (Maternal and Perinatal Death Surveillance and Response) surveillance data.

CRADLE VSA Blood Pressure Monitoring

Blood pressure is measured at every PHC antenatal visit using the CRADLE Vital Signs Alert (VSA) device a WHO-validated, low-cost blood pressure monitor designed specifically for use in low-resource settings.

Three top killers all addressed

Three-Layer Vital Signs System

PulseCare combines three complementary layers of monitoring so that no single point of failure leaves a mother or newborn unobserved.

Offline Architecture

PulseCare is built offline-first meaning the app stores all data locally on the device and operates fully without an internet connection. Connectivity is treated as an optional enhancement, not a requirement.

How offline-first works

1. 1
   All data written locally first When a CHW records a visit, registers a mother, or flags a danger sign, the record is written to local device storage immediately no network call required.
2. 2
   Sync queue maintained Every offline record is added to a sync queue. The app tracks which records are pending upload and which have been confirmed by the server.
3. 3
   Automatic sync on connectivity When connectivity is detected WiFi, mobile data, or a designated sync point at the PHC the sync queue uploads automatically in the background. No manual action needed from the CHW.
4. 4
   Conflict resolution If the same record is updated on two devices while offline, the most recent timestamp wins. Conflict logs are maintained for review.

Data Sync

PulseCare uses a bidirectional sync model data flows from CHW devices to the central server, and updated records (new referrals, PHC notes, risk classifications) flow back to CHW devices on next sync.

Technology Stack

Pilot Scope

PulseCare's initial pilot is planned for Toro Local Government Area, Bauchi State, Northern Nigeria selected because it is one of the highest-burden areas for maternal and perinatal deaths in Nigeria, and because it hosts an existing UNICEF-supported maternal and child health programme.

Expansion path

1. 1
   Toro LGA, Bauchi StateInitial pilot 360 women, 60 CHWs, 5 PHCs
2. 2
   Bauchi State-wideScale to additional LGAs following pilot evaluation
3. 3
   Northern NigeriaExpand to other high-burden states
4. 4
   Other African communitiesReplicate in similar low-resource contexts across Sub-Saharan Africa

Milestones

Fellowship phase 4 months

Post-fellowship 4 months to 1 year

Partnerships

PulseCare has active partnership discussions underway across connectivity, financial protection, emergency logistics, government alignment, and global health programmes.

Regulatory & Compliance

PulseCare touches two distinct regulatory domains in Nigeria medical device oversight (because the risk engine and wearable inform clinical decisions) and data protection (because the platform collects sensitive health information about pregnant women and newborns). Both are addressed below as a compliance roadmap, not a completed certification PulseCare has not yet been registered with NAFDAC or formally registered as a data controller with the NDPC. These are planned pre-pilot milestones.

NAFDAC Medical Device & Software as a Medical Device (SaMD)

The National Agency for Food and Drug Administration and Control (NAFDAC) regulates medical devices in Nigeria under the NAFDAC Act, Cap N1, LFN 2004. In 2024, NAFDAC published two instruments directly relevant to PulseCare: the Medical Devices, In Vitro Diagnostics and Related Products Registration Regulations 2024 (a risk-based classification framework covering hardware devices, including wearables), and standalone Guidelines for Registration of Software as a Medical Device (SaMD), which formally bring qualifying mobile apps and digital platforms into the medical device category.

NDPA Nigeria Data Protection Act, 2023

The Nigeria Data Protection Act, 2023 (signed into law 12 June 2023) established the Nigeria Data Protection Commission (NDPC) as Nigeria's data protection regulator. Health information including the danger-sign, vitals, and referral data PulseCare collects falls under the Act's "sensitive personal data" category, which requires a stricter lawful basis than ordinary personal data.

Expanding Beyond Nigeria Data Privacy Across Africa

PulseCare's longer-term roadmap includes replication beyond Nigeria into other high-burden, low-connectivity markets. Data protection law is not uniform across Africa treating NDPA compliance as portable to another country would be a mistake. As of the most recently available information, PulseCare's near-term expansion markets sit at different regulatory maturity levels:

Above the national laws sits the African Union Convention on Cyber Security and Personal Data Protection (the "Malabo Convention"), adopted in 2014 and in force since June 2023 after reaching its 15-country ratification threshold. It sets continent-wide baseline principles for lawful processing and data subject rights, but does not replace the need to comply with each country's own law where one exists.

Live Prototype

PulseCare has a working prototype covering the full CHW workflow registration, visit recording, danger sign detection, referral coordination, and PHC dashboard. Below are screenshots from the actual running application and the wearable hardware prototype.

CHW Mobile App Screens

Login Screen

Phone auth · Offline mode

CHW Dashboard

Active cases · Risk overview

Register Mother

Name · Age · Gestational age · Village

Record Visit

Temperature · Heart rate · Symptoms

Danger Signs

Maternal & newborn checklist

High Risk Alert

Immediate escalation flag

Create Referral

PHC notification · SMS alert

PHC Dashboard

Case tracking · Referral management

Register Newborn

Birth weight · Feeding status

Wearable Hardware Prototype

The PulseCare solar-powered wristband is currently in hardware prototype stage. The device monitors heart rate, SpO2, temperature, and movement between CHW visits, syncing data to the mobile app via Bluetooth.