There are some questions you may not ask in a clinic: Providing contraception information to young people in Kenya using SMS

Vahdat, Heather L.; L’Engle, Kelly; Plourde, Kate F; Magaria, Loice; Olawo, Alice

doi:10.1016/j.ijgo.2013.07.009

Cited by 70 publications

(111 citation statements)

References 9 publications

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“…These results seem to be consistent with previous studies [13, 28–30] which found privacy and confidentiality of young people during family planning and counselling as important determinants of use of services. The lack of youth engagement strategies and low cost/discounted RHC services to adolescents was apparent in both public and private RHC facilities.…”

Section: Discussionsupporting

confidence: 93%

Identifying youth-friendly service practices associated with adolescents’ use of reproductive healthcare services in post-conflict Burundi: a cross-sectional study

2017

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BackgroundVery little is known about reproductive health service (RHS) availability and adolescents’ use of these services in post-conflict settings. Such information is crucial for targeted community interventions that aim to improve quality delivery of RHS and outcomes in post-conflict settings. The objectives of this study therefore was to examine the density of RHS availability; assess spatial patterns of RHC facilities; and identify youth-friendly practices associated with adolescents’ use of services in post-conflict Burundi.MethodsA cross-sectional survey was conducted from a full census of all facilities (n = 892) and provider interviews in Burundi. Surveyed facilities included all public, private, religious and community association owned-centers and hospitals. At each facility efforts were made to interview the officer-in-charge and a group of his/her staff. We applied both geospatial and non-spatial analyses, to examine the density of RHS availability and density, and to explore the association between youth-friendly practices and adolescents’ use of RHS in post-conflict Burundi.ResultsHigh spatial patterning of distances of RHC facilities was observed, with facilities clustered predominantly in districts exhibiting persistent violence. But, use of services remained undeterred. We further found a stronger association between use of RHS and facility and programming characteristics. Community outreach, designated check-in/exam rooms, educational materials (posters, print, and pictures) in waiting rooms, privacy and confidentiality were significantly associated with adolescents’ use of RHS across all facility types. Cost was associated with use only at religious facilities and youth involvement at private facilities. No significant association was found between provider characteristics and use of RHS at any facility.ConclusionsOur findings indicate the need to improve youth-friendly service practices in the provision of RHS to adolescents in Burundi and suggest that current approaches to provider training may not be adequate for improving these vital practices. Our mixed methods approach and results are generalizable to other countries and post-conflict settings. In post-conflict settings, the methods can be used to identify service availability and spatial patterns of RHC facilities to plan for targeted service interventions, to increase demand and uptake of services by youth and young adults.

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Section: Discussionsupporting

confidence: 93%

Identifying youth-friendly service practices associated with adolescents’ use of reproductive healthcare services in post-conflict Burundi: a cross-sectional study

2017

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“…An SMS contraceptive education scheme in Kenya suggested improved contraceptive knowledge and use, but suffered from a sample size that was too small, with no control group, thus reducing the ability to draw firm conclusions (22). A Peruvian RCT, using educational SMS to reduce risks of contracting dengue fever, hinted at improved educational equity via SMS but showed no statistically significant improvement over alternative educational schemes (54).…”

Section: Resultsmentioning

confidence: 99%

Assessing the impact of mHealth interventions in low- and middle-income countries – what has been shown to work?

Hall

Fottrell

Wilkinson

et al. 2014

Global Health Action

339

274

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BackgroundLow-cost mobile devices, such as mobile phones, tablets, and personal digital assistants, which can access voice and data services, have revolutionised access to information and communication technology worldwide. These devices have a major impact on many aspects of people's lives, from business and education to health. This paper reviews the current evidence on the specific impacts of mobile technologies on tangible health outcomes (mHealth) in low- and middle-income countries (LMICs), from the perspectives of various stakeholders.DesignComprehensive literature searches were undertaken using key medical subject heading search terms on PubMed, Google Scholar, and grey literature sources. Analysis of 676 publications retrieved from the search was undertaken based on key inclusion criteria, resulting in a set of 76 papers for detailed review. The impacts of mHealth interventions reported in these papers were categorised into common mHealth applications.ResultsThere is a growing evidence base for the efficacy of mHealth interventions in LMICs, particularly in improving treatment adherence, appointment compliance, data gathering, and developing support networks for health workers. However, the quantity and quality of the evidence is still limited in many respects.ConclusionsOver all application areas, there remains a need to take small pilot studies to full scale, enabling more rigorous experimental and quasi-experimental studies to be undertaken in order to strengthen the evidence base.

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“…Reaching young people with information on contraceptives through mobiles phones in Kenya and promoting condom sales and use through a mixture of digital platforms – including Facebook – in Turkey have proven to be effective [23,24]. …”

Section: Discussionmentioning

confidence: 99%

Keeping silent about emergency contraceptives in Addis Ababa: a qualitative study among young people, service providers, and key stakeholders

Both

Samuel

2014

BMC Women's Health

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BackgroundThe growing popularity of emergency contraceptives (ECs) among urban youth in Sub-Saharan Africa is accompanied by debates on morality and health. This study was situated in Addis Ababa, Ethiopia and aimed to explore how these debates affect the way in which the product is promoted at a national level, how it is dispensed by service providers, and how young people access, purchase, and get informed about ECs.MethodsData were collected using qualitative methods: observations in pharmacies, administering semi-structured questionnaires to young people in pharmacies (N = 36), informal interviews with young people (N = 65), and in-depth interviews with service providers (N = 8) and key stakeholders (N = 3).ResultsKey stakeholders, uncomfortable with high sales of ECs, and service providers, worried about women’s health, promiscuity and the neglect of condoms, stay silent about ECs. Most young people had used ECs more than once. In a context where premarital sex is morally sanctioned ECs provide young people with a way of keeping their sexual lives secret and they fit well with their sex lives that often entail infrequent sexual encounters. Young people preferred (but they are also left with no other option than) to seek information from discreet sources, including friends and partners, leaflets and the mass media. In addition, service providers misunderstood young people’s purchasing behaviour, characterized by buying ECs quickly and feeling too embarrassed to ask questions, as a rejection of counselling. The resultant lack of information about ECs sometimes led to confusion about how to take the pills.ConclusionsThe attitudes and beliefs of key stakeholders and service providers result in a lack of clear information on ECs available to young people. This could be addressed by improving the information leaflet, providing clear instructions of use on blister packages, strategically distributing posters, and service providers adopting a more proactive attitude.

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There are some questions you may not ask in a clinic: Providing contraception information to young people in Kenya using SMS

Cited by 70 publications

References 9 publications

Identifying youth-friendly service practices associated with adolescents’ use of reproductive healthcare services in post-conflict Burundi: a cross-sectional study

Identifying youth-friendly service practices associated with adolescents’ use of reproductive healthcare services in post-conflict Burundi: a cross-sectional study

Assessing the impact of mHealth interventions in low- and middle-income countries – what has been shown to work?

Keeping silent about emergency contraceptives in Addis Ababa: a qualitative study among young people, service providers, and key stakeholders

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