Adolescent & Youth Sexual & Reproductive Health Toolkit: Demand Generation
Digital health is the use of mobile phones and other wireless technology to promote health objectives. 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. Digital health approaches as part of evidence-based multichannel social and behavior change (SBC) strategy can also create demand and facilitate access to sexual and reproductive health (SRH) services for urban young people.
What Are the Benefits?
- Young people’s access to mobile phones is increasing. Mobile phones have changed the way that young people communicate and get information (PSI, 2016). The evidence shows that digital health interventions are being used to increase youth’s access to SRH information and services in low- and middle-income countries (LMICs) (Ippoliti & L’Engle, 2017).
- Evidence is emerging that mobile phones are an effective tool in reaching young people, increasing their knowledge, and changing their behaviors (Ippoliti & L’Engle, 2017).
- Young people can often access digital health initiatives anonymously, which can be important to young people living in environments that consider SRH information and services taboo (Dasra, 2017) and young people who may feel fear or embarrassment talking about SRH issues publicly (Glik et al., 2014).
- Mobile phones can help reach populations with limited mobility, visibility, and agency, like girls who are married, out-of-school youth, or migrant girls (GAGE, 2017).
How to Implement?
Research target audience’s access to and use of mobile technology
Use appropriate language
- 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.
Supplement digital health activities with other initiatives
Programmatic Example: ‘Hello Mama’
In Nigeria, USAID’s Maternal and Child Survival Program (MCSP) initiated “HelloMama” with the goal of improving health outcomes of pregnant women, newborns, children and families in Nigeria. The locally-led initiative uses age- and stage-based mobile messaging to complement the efforts of frontline health workers, in alignment with the national health system’s priorities and policies. HelloMama delivers vital health information to pregnant women, new mothers, and their families through their mobile phones with messages specifically designed for behavior change. The messages correspond to what a woman is experiencing in her pregnancy or in her child’s development. HelloMama uses both text and interactive voice messaging from 10 weeks of pregnancy to 1 year after birth to increase demand for antenatal care, immunization services, childcare and other associated services, including postpartum family planning. Operational research on this promising digital health intervention is ongoing, and the results should be available by early 2019.
Explore opportunities to partner with other initiatives
Ensure safety of user’s privacy
Monitor, evaluate and learn
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 offers 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 young people 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 for 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 (Yinger, 2016).
- 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 podcast developed by young people. The podcast consists of short episodes that clients can receive either through a direct call to their phone or through an on-demand Interactive Voice Response call-in service. During the first three years of activities in Senegal, the project answered approximately 250,000 SMS sent by more than 67,000 individual users (Ippoliti & L’Engle, 2017).
- 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 Facebook, Twitter, Website, 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. As of 2015, the platform has reached 2.8 million adolescents in Kenya.
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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 data on users will help tailor messages and service delivery.
- Find partners also working on initiatives using mobile phones to reach young people 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 than older adolescents 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 different members of the family, meaning that young people may have a difficult time keeping their online activities private. To support young people’s access to the required technology, it is may be beneficial to involve parents and guardians in the program to familiarize 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 on the Internet.
- 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.
Tools Related to This Approach
- Making Content Meaningful Guide: A Guide to Adapting Existing Global Health Content for Different Audiences (English | French), K4Health
- The mHealth Planning Guide: Key Considerations for Integrating Mobile Technology into Health Programs, K4Health
- Mobile for Reproductive Health (m4RH) Toolkit: A guide for family planning programs, FHI360
- Gender and ICT Survey Toolkit: Access and Usage Modules, USAID
- Smart Client and Smart Couples (18-35 years old), HC3
- AMAZE videos, YTH
- Family Planning Workflows, mHero
- Working with Mobiles, Mobiles in-a-box