A family planning counseling session in Adamawa.
Walk into a primary health care facility in Adamawa State, Nigeria, and you may notice something new on the wall: a large, printed chart tracking the health services delivered at that facility, month by month. It is simple by design. And that simplicity is precisely the point.
The tool is called the Reproductive, Maternal, Newborn, and Child Health (RMNCH) Run Chart, introduced by The Challenge Initiative (TCI) in 2025 across nearly 500 public health facilities in 10 states. Rather than requiring health workers to log into a software system or compile data for a distant administrator, the run chart puts information directly in front of the people delivering care – in a format they can read, update, and act on without technical training.
What makes the tool distinctive is its breadth. By capturing both maternal and child health indicators and family planning data on a single visual display, it gives health workers – and the supervisors who visit them – a fuller picture of how a facility is performing, rather than a narrow view of any one service area.
A State Sees the Value and Scales Up
A sample RMNCH Run Chart.
The run chart was designed to be deployable with minimal resources, but TCI did not anticipate how quickly others would recognize its potential. Adamawa State, with support from EU-SARAH – a European Union-funded initiative supported by UNFPA and UNICEF to reduce maternal and adolescent mortality in Nigeria – independently decided to print and distribute the run chart across every primary health care facility in the state, expanding its reach well beyond the facilities where TCI had initially introduced it.
The decision was driven by results. Early feedback from facilities using the tool pointed to improved visibility of performance trends, greater ownership of data among health workers, and more consistent use of information during facility review meetings. Rather than data appearing only in quarterly reports reviewed by managers, it was now visible on the wall, updated regularly, and part of everyday conversation at the facility level.
The Lesson from Adamawa
The Adamawa experience illustrates something that often gets lost in discussions about health data: the barrier to better data use is rarely a lack of information. It is a lack of tools that make information accessible and meaningful to the people who need it most.
When a tool is well-designed, easy to use, and embedded in existing routines – rather than added on top of them – it can drive real behavior change. The Adamawa experience demonstrates how innovation, when combined with local leadership and partner support, can turn data into a powerful driver of improved health outcomes.
