A Telemedicine Platform for Maternal and Child Health in Rural Nasarawa State

Maternal and child mortality rates in rural Nasarawa State, North Central Nigeria, are driven partly by inadequate access to specialist healthcare and delayed recognition of obstetric emergencies. This study develops a telemedicine platform connecting rural primary healthcare workers in Nasarawa State with obstetric and paediatric specialists at the Dalhatu Araf Specialist Hospital, Lafia. The platform is built using React.js for the web interface and Flutter for the community health worker mobile app, with a Node.js backend supporting asynchronous consultation records. The design and development follows the agile methodology, with four sprints guided by a stakeholder group of eight doctors, 20 community health extension workers (CHEWs), and patient representatives. Key features include video and voice consultations, patient case submission, specialist review and feedback, referral generation, and maternal health monitoring checklists. Evaluation over 14 weeks at five rural PHCs measures consultation completion rate, referral appropriateness, and health worker confidence scores. Results show that 74 percent of submitted cases received specialist feedback within 12 hours, and health worker clinical decision confidence improved by 61 percent. The study recommends satellite internet provisioning for rural PHCs as a connectivity infrastructure prerequisite. Keywords: telemedicine, maternal health, Nasarawa State, community health worker, obstetrics