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Text2Speak: Provision of quality health services in Nigeria

Pathfinder International

“Despite the government’s ratification of international charters advancing sexual and reproductive health, the voice of healthcare users is rarely heard.” — Pathfinder


Nigerian women die each year as a result of pregnancy and childbirth complications


with the Nigerian government's SURE-P programme

Start date
October 2014
End date
January 2017
Period: 28 months


Nigeria’s maternal mortality ratio is the tenth highest in the world.

Each year, 40,000 Nigerian women die as a result of pregnancy and childbirth complications, and despite the government's enormous SURE-P initiative, which reinvests revenue from extractive industries into healthcare services, it will fail to meet its Millennium Development Goal targets on maternal and child health.


Text2Speak addresses one of the key barriers that prevents women seeking ante-natal care and delivery in health facilities: poor levels of service from government health professionals. As long as the behaviour of doctors, nurses, midwives and pharmacists discourage women from giving birth in facilities, maternal mortality in Nigeria will remain high.

Deploying an SMS system which gathers feedback on maternal health services, Text2Speak monitors government health workers’ performance and delivery of SURE-P. They connect the people who use public health services with those who are responsible for delivering them - health system managers, facility providers, policy makers.

Through Text2Speak, citizens are able to publicly provide feedback on services, giving healthcare stakeholders and government, real-time access to their views. This helps build a solid platform to identify gaps in delivery, helping SURE-P and the government make real-time quality improvement decisions for maternal health services.

This project hopes to offer women a voice in deciding the care they would like to receive. It provides an accountability mechanism for services by ensuring the women’s experiences of the health system is heard, and supports the government’s commitments to decreasing maternal mortality rates in Nigeria.


Pathfinder International works to improve the sexual and reproductive health of women, men and young people in developing countries.