Rationale 

Rural communities in low- and middle-income countries continue to face persistent health challenges linked to limited access to services, uneven information flows, and structural inequalities that constrain health literacy. Meanwhile, extension, a system through which trained practitioners (extension workers) share knowledge, skills, and innovations with communities, traditionally agrarian, is increasingly engaged in cross-sectoral roles, including community health education. This shift positions extension workers as trusted intermediaries capable of mediating health knowledge in culturally meaningful ways. 

In this regard, mobile learning (m-learning) has emerged as a promising approach for expanding access to education in marginalised settings due to its flexibility, affordability, and capacity for context-aware learning. While existing research demonstrates that mobile interventions can improve health knowledge, much of it treats m-learning, health literacy, and extension services as separate domains. Moreover, many interventions prioritise technological delivery over pedagogical design, rely on short-term evaluations, and position rural people as passive recipients rather than active co-creators of learning. 

This research addresses such gaps by examining how rural extension workers can function as digital learning facilitators, using m-learning tools to strengthen health literacy and health practices in rural communities over time. Grounded in learner-centred digital pedagogy and empowerment-oriented models of health literacy, it contributes empirical and theoretical insights at the intersection of m-learning, rural extension, and community health. 

Method 

The study adopts a convergent mixed-methods design informed by constructivist and interpretivist perspectives, recognising health literacy and technology use as socially situated practices. The research will be conducted in two rural areas characterised by limited health access and low digital infrastructure in Nigeria. Participants include 30 rural extension workers, 120 households, and 5-8 local health officers. 

A six-month m-learning intervention will be co-designed with stakeholders and delivered through an offline-capable platform. Learning materials consist of short audio-visual modules on hygiene, malaria prevention, maternal health, and safe water use, complemented by interactive quizzes and SMS/WhatsApp discussion groups facilitated by extension workers. The design would follow UDL principles to accommodate low literacy, shared phone use, and intermittent connectivity. 

Quantitative data will be collected through pre- and post-intervention surveys measuring health literacy, self-reported health practices, and digital confidence. Qualitative data will be gathered via focus group discussions, semi-structured interviews, and field observations to explore experiences of adoption, facilitation, and contextual use. Usage logs will provide descriptive insights into engagement patterns. Data will be analysed using descriptive and inferential statistics alongside thematic analysis, with findings integrated during interpretation. 

Intended Outcomes 

Since this research is at the proposal stage, the focus is on what it will achieve and contribute rather than on results. It therefore aims to investigate how m-learning, when mediated by trained extension workers, can support the development of functional and interactive health literacy and inform health practices over a six-month period. It will explore how adoption and sustained engagement are shaped by sociocultural norms, facilitation quality, gendered access to devices, and local relevance of content. Similarly, the role of participatory, scaffolded learning designs in fostering meaningful engagement compared to one-way health messaging. 

Hence, it assesses the potential of repositioning rural extension workers as digital learning facilitators and of embedding m-learning within relational, context-sensitive pedagogical practices. Through integrating health literacy theory, m-learning design, and extension practice, a model that may inform community health education in low-resource settings would be developed. These are intended to contribute to discussions on digital pedagogy, extension policy, and health promotion, with specific attention to the role of pedagogy, participation, and equity in shaping sustainable digital innovation.