Assessing CommCare’s Impact on Antenatal, Postnatal, and Immunization Uptake: Evidence from Falaba Community Health Center, Sierra Leone.

Background Rural districts in Sierra Leone struggle with timely and complete maternal–child health service use. CommCare, a mobile health (mHealth) platform deployed through partnerships with government and NGOs, supports tracking, reminders, and follow-up. Methods A cross-sectional quantitative study at Falaba CHC (Sulima Chiefdom) assessed CommCare’s effects on (i) timeliness and frequency of ANC, (ii) PNC follow-up and care quality, and (iii) immunization uptake among children <2 years. Data were collected from n=288 participants using a structured CommCare questionnaire aligned with five sections (A–E) and extracted CommCare indicators; analysis used descriptive statistics and chi square χ2 tests (α=0.05), with effect sizes where applicable. Results First-trimester ANC initiation increased from 45% to 65% (χ2=8.34, p=0.004); completion of ≥4 ANC visits rose 55%→78% (χ2=7.72, p=0.009). PNC improved: first-week postpartum follow-up 40%→80% (χ2=6.12, p=0.014). Immunization adherence increased 60%→82% (χ2=11.34, p=0.002); missed vaccination appointments declined by 24%. CommCare reminders showed strong associations with timely attendance (e.g., PNC χ2=28.451, p<0.001) and fewer missed immunization appointments (χ2=55.524, p<0.001; Φ=−0.439, Cramér’s V=0.439). Conclusion CommCare substantially improved timeliness and continuity of maternal and child health services at Falaba CHC. Findings support CHW-mediated, reminder-driven mHealth as an effective strategy in similar rural settings.