Beyond Knowledge: A Dual-Perspective Needs Assessment of Maternal Health Care-Seeking Barriers and mHealth Design Requirements in

Abstract

Formative assessment is needed to determine whether maternal mobile health (mHealth) applications should prioritise educational information, support for timely care-seeking, or both. Methods: A descriptive needs assessment included 50 pregnant women and 30 midwives in Sokoto State, Nigeria. Structured questionnaires examined maternal-health knowledge, perceived care-seeking barriers, phone access, communication preferences and proposed app features. Responses were summarised using frequencies, percentages, knowledge scores and weighted rankings. Results: Women obtained a mean score of 10.44/12 (87.0%) on prompted knowledge questions; 49/50 (98.0%) identified reduced or absent fetal movement correctly. However, 22/30 midwives (73.3%) selected failure to recognise danger signs as a care-seeking barrier. Husband/family permission was reported by 38/50 women (76.0%) and 24/30 midwives (80.0%). Of the women, 45/50 (90.0%) preferred Hausa-language information and 39/50 (78.0%) preferred audio only. Danger-sign guidance received the highest reported provider-weighted feature score (105). Conclusion: Prompted knowledge responses and midwives' perceptions indicate potentially different dimensions of care-seeking. The findings support testing a Hausa audio-first application that combines practical danger-sign guidance, facility information, discreet communication and optional household-shareable messages. The descriptive design cannot establish which barrier is causal or most important in the wider population.