AYSRH TookitDemand Generation for Youth
What is it?
Digital health is the use of mobile phones and other wireless technology to promote health objectives. Digital health approaches have been used to improve the quality of service delivery, monitor stockouts, manage logistics, provide supportive supervision to community health workers, improve clinical knowledge, and more. These approaches can also create demand and facilitate access to sexual and reproductive health (SRH) services for urban youth.
What Are the Benefits?
- Access to mobile phones is increasing. Mobile phones have changed the way that young people communicate and get information. The evidence shows that digital health interventions are increasing youth’s access to SRH information and services in low- and middle-income countries (LMICs).
- Evidence is emerging that mobile phones are an effective tool in reaching youth, increasing their knowledge, and changing their behaviors.
- Youth can often access digital health initiatives anonymously, which can be important for those living in environments where SRH information and services are taboo and those who may feel fear or embarrassment talking about SRH issues publicly.
- Mobile phones can help reach populations with limited mobility, visibility, and agency, like girls who are married, out-of-school youth, or migrant girls.
How to Implement?
Step 1: Research target audience’s access to and use of mobile technology
While digital health interventions have the potential to reach a wide audience, access to the required technology can vary greatly across a variety of determinants, including age, gender, socioeconomic status, geographical location, urban vs rural, etc. Implementers must take into account the target audiences’ access to and use of the technology required to participate in the intervention activities. Furthermore, you must also consider the target area’s capacity to support the digital health activities. A poor cellular network can negatively affect the continuity, reach, and quality of the intervention.
Step 2: Use appropriate language
Content development for digital health initiatives must use the appropriate language for the target audience, paying special attention to youth vernacular. Ensuring that complete and accurate information is provided within SMS character limits is equally important.
Tips for delivering appropriate content via digital technologies:
- Consider the local language, common slang among youth, local expressions, traditions, taboos, and laws.
- Be mindful of the relevance and appropriateness of metaphors.
- Keep language simple.
- Consider brief stories or examples that the audience can relate to.
Step 3: Supplement digital health activities with other initiatives to support youth
Some may need additional support beyond the intervention’s technological activities—for example, participating in small group or one-on-one discussions in their community.
Programmatic example: “Life Planning for Adolescents and Youth”
Life Planning for Adolescents and Youth (LPAY) is a TCI Youth program in Nigeria that uses a WhatsApp group for its ambassadors to communicate with youth about issues related to their sexual and reproductive health. In weekly hour-long virtual learning sessions, TCI Nigeria mentors the LPAY ambassadors and equips them with skills and resources to lead healthy reproductive lives as well as to grow and thrive in their careers via sessions on topics including Family Planning Methods, Comprehensive Sexuality Education, Leadership, SMART Advocacy, Media Advocacy, Public Speaking, Components of an Effective Meeting, Financial Planning, Public Budgets and Processes, the Art of Storytelling, Reflective Writing and Social Media. Ultimately, the Adolescent Health Desk Officer will take over these virtual learning sessions.
Step 4: Explore opportunities to partner with other initiatives
Consider how your digital health interventions can partner with and integrate with other initiatives—for example, thinking through how mobile technology may enable a young person to also access a mobile savings product that helps them save and protect their financial assets.
Step 5: Ensure users' privacy and safety
As technology advances, issues related to client security need to be prioritized by digital health initiatives, especially those dealing with confidential health information.
Step 6: Monitor, evaluate, and learn
Digital media is constantly changing and evolving, meaning that the infrastructure and functionality of digital health initiatives will need to adapt to make sure project activities remain successful. Service delivery points can also use two-way platforms, such as SMS or WhatsApp, to collect youth feedback once they have accessed a service.
What Is the Evidence?
- In Kenya, The SRHR Alliance supports the Youth for Life website, which provides SRHR information and links young people to facilities that offer youth-friendly services. The platform also features an SMS service to disseminate information and promote discussion about topical issues. A five-month study of the platform showed that digital platforms are effective in reaching adolescents and youth with information and referring them to appropriate services (96% of the study’s sample). The platform’s ease of use, variety of content, convenience, confidentiality, and interactive nature were credited with its success (1st Adolescent Health Symposium, 2015).
- In Madagascar, UNFPA partnered with Marie Stopes and Sisal to use mobile phones to provide free information and payment vouchers through SMS. During the project, peer educators reached out to young people with SRHR information, distributed e-vouchers, and made referrals to clinics. Peer educators even reached young people who did not have access to a mobile phone by using their own phones to redeem an e-voucher. Over 18 months, approximately 2,000 of the 2,714 young women who were given e-vouchers for free services used them, and an estimated 1,900 pregnancies were avoided.
- Started in Nigeria, Learning about Living provides a question-and-answer service via SMS. The project allows young people to text questions they have about SRHR to trained counselors. The counselors aim to respond within 24 hours, but often reply within six hours. With the project’s expansion to Senegal, Morocco, Egypt, and Cambodia, the communication channels have expanded as well to include email and Facebook. In Cambodia, the project supplemented its activities with a youth-developed podcast consisting of short episodes that clients receive either through a direct call to their phone or through an on-demand IVR call-in service. During the first three years of activities in Senegal, the project answered approximately 250,000 SMS texts sent by more than 67,000 individual users.
- In Kenya, LVCT Health’s One2One Integrated Digital Platform (OIDP) seeks to increase young people’s knowledge of SRHR, HIV, and gender-based violence, and to provide space for sharing among adolescents and youth. The project includes a hotline; a SMS service; and online platforms, including a website, Facebook, Twitter, Instagram, WhatsApp, and YouTube. The platform also gives users an opportunity to chat with a professional counselor, links adolescents to services, and reminds patients of upcoming appointments.
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Digital health approaches have been used to improve quality of service delivery, monitor stockouts, manage logistics, provide supportive supervision to community health workers, improve clinical knowledge, and more.CorrectIncorrect
What are some of the benefits of digital health for improving adolescents access to sexual reproductive health?CorrectIncorrect
Younger adolescents are easy to reach. Demographic data has shown that younger adolescents have far more engagement with digital health initiatives than older adolescents.CorrectIncorrect
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- Engage young people as researchers to find out more about their peers’ usage of mobile phones and other media sources, as well as in the content development for digital health interventions.
Record user data to build evidence on the kinds of queries young people have. This can be used for advocacy as well as enhancing programming.
Age- and gender- disaggregated user data will help tailor messages and service delivery.
- Find partners also working on initiatives using mobile phones to reach youth with a more complete set of services (i.e., financial or education services).
- Younger adolescents are harder to reach. Demographic data has shown that younger adolescents have less engagement with digital health initiatives than older adolescents. Additionally, younger adolescents are less likely to own or have access to mobile phones, limiting their access to digital health projects.
- Young people’s Internet access and activity may be controlled by their parents or guardians. In LMICs, mobile phones are often shared among members of the family, meaning that youth may have a difficult time keeping their online activities private. To support their access to the required technology, it may be beneficial to involve parents and guardians in the program, familiarizing them with the website/app/hotline/etc., so they understand their child’s online activity.
- Girls and young women generally have less access to the Internet than their male counterparts. To alleviate this, it may be helpful to find ways to increase girls’ and young women’s Internet access through providing training courses to girls or utilizing interactive voice response (IVR) systems or mobile messaging platforms that do not require Internet access.
- Not all information on the Internet is correct. Young people, especially those living in urban areas where Internet access is better, need social support to help process misinformation they may find online.
- Privacy and security can be difficult to ensure. Digital privacy and security is a complicated and ever-changing issue. More understanding of online privacy—and the role of digital health projects—is needed, especially for younger adolescents.