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Active Research Initiative · INV-089732

Pathways for AI-Enabled
Point-of-Care Ultrasound
in Nigeria

A three-year Gates Foundation-funded effectiveness-implementation study generating the evidence, clinical protocols, and financing strategies to scale AI-POCUS sustainably across Nigeria's maternal health system.

29%
Nigeria's Shareof global maternal deaths — ~75,000 annually
1.7M
Lives Could Be Savedby ultrasound scale-up in LMICs by 2040
60
AI-POCUS Devicesdeployed across 3 states, 36-month study
3
Nigerian StatesGombe · Kano · Ogun, 2026–2028
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PATH4AIPOCUS complements manufacturers' market strategies by partnering with government to generate rigorous evidence on service delivery, economic viability, and financing models — delivering the data policymakers need to justify and sustain nationwide AI-POCUS scale-up as a routine component of antenatal care.

PROSPERO Registered
Jan 2026 – Dec 2028

Bridging the Gap Between Innovation and Impact

Nigeria bears a disproportionate share of the global maternal mortality burden — nearly 29% of all maternal deaths, approximately 75,000 annually. Yet only 63% of Nigerian women receive antenatal care from a skilled provider, and critical diagnostic services remain inaccessible in primary health centres where most women seek care.

AI-enabled point-of-care ultrasound (AI-POCUS) offers a transformative solution — portable, simplified, and operable by non-specialist providers. PATH4AIPOCUS exists to generate the evidence needed to deploy this technology at scale, equitably, and sustainably.

  • Limited access to ultrasound in PHCs, especially in rural and underserved areas
  • Severe shortage of radiologists and sonographers due to brain drain
  • Absence of evidence-based implementation models for task-shifted AI-POCUS
  • Lack of sustainable financing strategies beyond short-term donor funding
  • Fragmented health system with low ANC attendance and facility-based delivery rates
97.4%
Increase in ANC attendance reported following ultrasound introduction in rural Uganda
145M
Disability-adjusted life years (DALYs) ultrasound could avert in LMICs by 2040
"The goal is to generate rigorous implementation evidence on the feasibility, effectiveness, system readiness, and financing models for integrating obstetric AI-POCUS into Nigeria's maternal health delivery system."
— PATH4AIPOCUS Project Goal Statement, 2026
3 States
Gombe · Kano · Ogun

Six Core Objectives

System Readiness
Evaluate health system readiness and implementation barriers to deploying obstetric AI-POCUS.
Provider Competency
Establish competency and service delivery outcomes of non-expert AI-POCUS providers.
Magnet Effect
Determine AI-POCUS influence on maternal care-seeking behaviour and ANC attendance.
Clinical Decision-Making
Evaluate AI-POCUS influence on clinical decisions and appropriate referral of high-risk pregnancies.
Costing & Financing
Generate costing and financing evidence including out-of-pocket, insurance, and state funding models.
Real-Time Monitoring
Develop a real-time reporting and monitoring system for AI-POCUS service delivery across all sites.
0
Maternal deaths per 100,000 live births in Nigeria — among the highest globally
0+
Non-expert providers (nurses, midwives, CHEWs) to be trained and certified
0
Month study timeline generating longitudinal service performance and financing evidence
0
Structured work packages delivering actionable policy outputs for policymakers

A Rigorous, Phased Research Approach

Grounded in Participatory Action Research principles, our implementation-effectiveness study is structured across nine work packages spanning 36 months, producing actionable evidence at every stage.

WP 01
Stakeholder Engagement & Governance
Systematic stakeholder mapping, policy and regulatory analysis, ethics approval, AI-POCUS procurement, and community engagement protocols.
Months 1–6
WP 02
System Readiness Assessment
Facility readiness using adapted WHO SARA tool, provider and organizational readiness assessment, community perception qualitative research.
Months 6–9
WP 03
Demand Creation & Community Engagement
State-specific demand strategies, pre-tested communication packages in local languages, trained champions linked to Ward Development Committees.
Months 9–33
WP 04
Training & Competency Development
Phased training and certification for 120+ non-expert providers using Nigeria-adapted AI-POCUS curricula, with expert review panels for quality assurance.
Months 9–12
WP 05
AI-POCUS Service Deployment
Deployment of 60 AI-POCUS devices across hub-and-spoke facility clusters in Gombe, Kano, and Ogun with intensive supportive supervision.
Months 12–33
WP 06
Implementation Research
Assess fidelity, competency, feasibility, acceptability, adoption, and sustainability using validated instruments and routine service logs.
Months 12–33
WP 07
Economic Analysis
Full economic analysis covering capital, recurrent, and training costs. Cost-effectiveness, budget impact, and willingness-to-pay assessments.
Months 12–33
WP 08
Financing Model Evaluation
Evaluation of 2–3 financing pathways including OOP, state health insurance schemes (SHIS), BHCPF, and public-private partnership models.
Months 12–36
WP 09
Synthesis, Dissemination & Policy Translation
Scale-up roadmap, peer-reviewed publications, policy briefs, and national stakeholder dissemination workshops to guide AI-POCUS integration.
Months 33–36
Northeast
Gombe State

Co-implementation with Johns Hopkins University effectiveness evaluation. Intensive implementation research focus.

3.96MPopulation (2022)
39.1%ANC 4+ visits
11Local Govt Areas
37.9%SBA delivery rate
Northwest
Kano State

Highest population state, embedded in JHU impact evaluation framework with complex urban-rural dynamics.

15.5MPopulation (2022)
51.3%ANC 4+ visits
44Local Govt Areas
36.3%SBA delivery rate
Southwest
Ogun State

Pilot state for Phase 1 training and deployment. High ANC coverage enables robust magnet-effect assessment.

6.38MPopulation (2022)
73.7%ANC 4+ visits
20Local Govt Areas
82.6%SBA delivery rate

Facility Structure: Healthcare facilities organized in hub-and-spoke clusters — secondary facilities (hubs) connected to 4–5 primary healthcare centres (spokes) — enabling analysis of referral pathway effectiveness within authentic care networks.

Project Milestones

Q1 2026 · Months 1–3
Project Launch & Stakeholder EngagementStakeholder mapping, federal and state government consultations, ethics submissions, protocol finalization with JHU and state partners.
Q2–Q3 2026 · Months 4–9
Readiness Assessment & ProcurementFacility readiness surveys, community perception research, AI-POCUS device procurement from Edan, Philips, or GE Healthcare.
Q4 2026 · Months 9–12
Training & Pilot DeploymentPhase 1 training of 20 providers in Ogun, pilot deployment of 10 devices with intensive expert panel oversight and feedback.
Q1 2027–Q1 2028 · Months 12–33
Full Deployment & ResearchScale-up across Gombe and Kano, implementation research, economic analysis, and financing model testing underway.
Q2–Q4 2028 · Months 33–36
Synthesis & Policy DisseminationEvidence synthesis, scale-up roadmap development, peer-reviewed publications, national stakeholder workshops, and policy briefs for FMOH.

Study Design Framework

Approach
Participatory Action Research (PAR) principles with Expert Recommendations for Implementing Change (ERIC) strategies, embedded in JHU's broader impact evaluation
Quality Assurance
Expert review panel of 12–18 obstetric sonologists providing virtual scan review, structured feedback, and diagnostic concordance monitoring (κ ≥0.70 target)
Governance
Walt and Gilson's Health Policy Triangle framework for policy analysis; AGREE II instrument for guideline quality assessment; NVivo for qualitative coding
Expected Outputs
Peer-reviewed publications, policy briefs, AI-POCUS scale-up roadmap for Nigeria, training curricula, and financing model recommendations for national adoption

Investigators, Researchers & Advisors

A multidisciplinary consortium of clinical researchers, implementation scientists, health economists, and global health practitioners committed to advancing maternal health through evidence.

EE
Prof. Ehigha Enabudoso
Principal Investigator
University of Benin, Nigeria
Lead PI
Obstetrics & Gynaecology specialist with expertise in maternal health systems and clinical research in low-resource settings.
JH
JHU Collaborators
Co-Investigators
Johns Hopkins University, USA
Research Partner
Impact evaluation design, epidemiological methods, and effectiveness assessment across Gombe and Kano states.
AT
Alison Tumilowicz
Investment Owner
Bill & Melinda Gates Foundation
Gates Foundation
MNCNH programme lead overseeing strategic alignment and investment governance for the project.
PW
Peyton Wall
Investment Coordinator
Bill & Melinda Gates Foundation
Gates Foundation
Day-to-day coordination, reporting, and grantee liaison for the PATH4AIPOCUS investment.
SI
Sydani Initiative
Fiscal Agent & Implementation
Sydani Initiative for International Development
Fiscal Agent
Grants management, financial oversight, and implementation support across all Nigerian study states.
SG
State Governments
Implementation Partners
Gombe · Kano · Ogun Ministries of Health
Government
State-level facility access, regulatory authorizations, and integration with existing health system structures.
SR
Expert Review Panel
Quality Assurance
Obstetric Sonologists, Nigeria
Clinical QA
Panel of 12–18 expert sonologists providing virtual scan review, structured feedback, and competency certification.
CB
Community Partners
Participatory Research
Ward Development Committees · Women's Groups
Community
Community co-researchers shaping implementation design, demand creation strategies, and community engagement.
Are you a researcher or implementer interested in joining?
PATH4AIPOCUS welcomes collaboration from implementation scientists, health economists, maternal health specialists, and digital health experts. Get in touch to explore partnership opportunities.

Global Collaboration for Local Impact

PATH4AIPOCUS is made possible through the commitment of world-class funders, academic institutions, government bodies, and technology partners united by a shared mission to improve maternal and newborn health.

Primary Funder
Lead Institution
Academic & Research Partners
Technology Partners (AI-POCUS Manufacturers)
Regulatory & Professional Bodies

Become a Partner. PATH4AIPOCUS welcomes collaboration from global health organizations, research institutions, professional associations, and technology companies aligned with our mission to scale AI-POCUS sustainably in sub-Saharan Africa. Contact us to explore partnership opportunities →

Latest Project Milestones

Launch
January 2026
PATH4AIPOCUS Officially Launched with Gates Foundation Funding
The University of Benin announces the launch of PATH4AIPOCUS (INV-089732), a three-year implementation research project to scale AI-enabled point-of-care ultrasound across three Nigerian states.
Read Announcement
Partnership
February 2026
Johns Hopkins University Partnership Formalized for Impact Evaluation
Collaboration agreement signed with JHU to embed AI-POCUS effectiveness assessment within their broader maternal and neonatal health impact evaluation in Gombe and Kano states.
Read More
Research
March 2026
Systematic Review Protocol on AI-POCUS Guidelines Registered with PROSPERO
The team's protocol for systematically reviewing national and international guidelines on AI-enabled obstetric POCUS in sub-Saharan Africa has been formally registered and is underway.
View Protocol

Reports, Publications & Downloads

Access project documentation, research protocols, policy briefs, and publications as they become available throughout the project lifecycle.

Grant Document
Project Proposal Narrative
Research Protocol
AI-POCUS Guidelines Systematic Review
Policy Brief · Forthcoming
Regulatory Landscape for AI-POCUS in Nigeria
Data · Forthcoming
Study Site Readiness Assessment Reports
Training Material · Forthcoming
Non-Expert AI-POCUS Training Curriculum
Publication · Forthcoming
Economic Analysis of AI-POCUS Financing Models

Additional project documents, datasets, and publications will be made available here as the project progresses. Subscribe to project updates for notifications.

Contact the Project Team

We'd love to hear from you

Whether you are a researcher, policymaker, clinician, implementation partner, or global health professional, we welcome your inquiries, collaborations, and feedback on the PATH4AIPOCUS project.

Emailpath4aipocus@uniben.edu.ng
Lead InstitutionDepartment of Obstetrics & Gynaecology, University of Benin, PMB 1154, Benin City, Edo State, Nigeria
Investment Owner (Gates Foundation)atumilowicz@gatesfoundation.org
Follow Our ProgressProject updates will be posted on this website and via partner institutional channels.