Abstract
BackgroundInnovations to increase access to sexual and reproductive health (SRH) information, goods, and services are needed, particularly in low-income settings. This study assessed the utilization of a mobile phone application (MPA) to increase access to SRH information, goods, and services among university students in Uganda.MethodsWe conducted a cross-sectional analysis of data from: (1) an endline survey performed as a consequence of a randomized controlled trial (RCT) of the effectiveness of the MPA, and (2) data from use of the MPA for accessing information, goods, and services over the 6-month time period of the RCT, obtained from in-MPA data collection service providers. We performed descriptive analysis of participant characteristics and their association with the utilization of the MPA using logistic regression; analyses of MPA use for accessing different types of information, goods, and services by gender; and analyses of functionality attributes of the MPA and related services.ResultsIn the study population of young (median 22 years) predominantly female (61%) students, the utilization of the MPA by those who downloaded it was high (81% overall, 82% female, and 82% male). The most popular information portal was the frequently asked questions (71% utilization); the most popular goods were condoms for males (77% utilization) and sanitary pads for females (94% utilization); and the most popular service was HIV testing and counseling (60% utilization). The MPA demonstrated predominantly positive (responsiveness, non-distracting in-app advertisements, and ease of use) attributes.ConclusionA mobile phone app to increase access to SRH information, goods, and services among university students in Uganda demonstrated high utilization. The results of this study support ongoing and future technical improvement efforts and research on effectiveness, economic efficiency, and scalability, along the continuum of activities to scale this intervention in order to improve SRH in low-income settings.Trial RegistrationMUREC1/7 No. 07/05-18. Registered; June 29, 2018.
Highlights
Innovations to increase access to sexual and reproductive health (SRH) information, goods, and services are needed, in low-income settings
Some studies have shown moderate to high acceptability of mobile phone application (MPA) and MPA-driven SRH interventions [21,22,23], we found none that were conducted in low-income settings
The MPA was developed by the tech firm Gershom Technologies and pilot-tested by a consortium including GHE Consulting; three health facilities operating near Kyambogo University (KYU)—Kyambogo Medical Centre, Alpha Medical Centre, and Nim Pharmacy; SafeBoda, a transportation company; Beyonic, a payments company; and the Reproductive Health Division of Uganda’s Ministry of Health
Summary
Innovations to increase access to sexual and reproductive health (SRH) information, goods, and services are needed, in low-income settings. Young adult women usually lack awareness of these risks, face social stigma, are often unemployed, with limited access to sexual and reproductive health (SRH) information, goods, and services [2, 3]. This puts them at further risk of SRH health problems such as early and unplanned pregnancies, unsafe abortions, and sexually transmitted infections (STIs), including HIV/AIDS. Given such a large proportion of young adults relative to other adults in the Ugandan population, youthfriendly services, including SRH services, should be a public policy priority. Universal access to modern contraceptives has the potential to prevent up to 30% of the maternal and 10% of the child deaths, reduce STIs, and improve the quality of life among adolescent girls [4]
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