Background
Methods
Study setting
Study design
Stage 1: secondary analysis of village profiles
Stage 2: intervention development
Sample Population | Sample Size | Age Range (Years) | Literate (%) | Married (%) | With Children (%) | Education Level (mean number of years) |
---|---|---|---|---|---|---|
Male Adults | 12 | 25–55 | 56 | 93 | 100 | 4.8 |
Female Adults | 23 | 22–50 | 55 | 95 | 95 | 3.3 |
Male Youth | 24 | 13–24 | 96 | 8 | 8 | 8.5 |
Female Youth | 30 | 14–22 | 91 | 18 | 12 | 6.1 |
Procedure
Analysis
Stage 1
Stage 2
Results
Stage 1
Stage 2
Recognised need of health education
Need for health education
Male Adult, Sikenala: Contraception methods are perceived as for women in this village so if we receive these text messages in our homes we will be able to make an informed decision on which contraceptive method to use as a family.
Nutrition | Hygiene | Family Planning | HIV |
---|---|---|---|
Food groups [MA, FA, FY] | Hand Hygiene [MA, MY, FY] | Advantages to Family Planning [FA, MY, FY] | Prevention [MA,FA, MY, FY] |
How to prepare a balanced meal [MA, MY, FY] | Toilet Practicesa [MA, FA, MY] | Inclusion of Men in Family Planning Education [MA, FA, MY, FY] | HIV Testing [MY, FY] |
Nutrition for people living with HIV [MA] | Kitchen Hygiene [MA, MY, FY] | Contraception methods and side effects [MA, FA, MY, FY] | Treatment [MA, FY] |
Personal Hygieneb [MA, FY] | Child Spacing [MA, FA, MY, FY] | ||
Disease prevention [MA, MY] | STI’s [MY, FY] | ||
Safe Motherhood/Early Pregnancy [FA, MY] |
Prior knowledge
Female Adult Sikenala: We usually go for the injection but some people say it is not good for our health…we do not know the advantages and disadvantages of these contraceptive methods…we use any of the methods without really knowing the side effects.
Acceptability of an mHealth Intervention
Message delivery
Male Youth CDSS: The text messages because you can read them several times while a call you can get the health messages once.Female Youth, Sikenala: …because we can read the messages while in automated calls you can miss the instructions you are being told.Male Adults, Sikenala: …you can read a text message whilst doing other things right at home.
Female Youth, Chimoto: Some of us prefer voice messages since some may not know how to read.
Female Adults, Chimoto: Do it at set times to help those who feel they cannot use a phone confidently.
Male Youth, Sikenala: We should receive notice of when the messages will come so that we should easily remember to go and read them.
Time/frequency
Female Youth, Sikenala:…to some of us it doesn’t matter how many times we receive the messages, as long as we get the information.Male Adults: Sikenala: the time doesn’t matter…even if you receive a message when you are asleep you can always check the message when you wake up.
Male Youth, CDSS: You should send the messages after school hour; you should make sure they don’t affect our studies.
Female Youth, CDSS: …12 midnight can’t work because we will use borrowed phones.
Male Adults, Sikenala: …it’s up to you to decide that, we will always receive the messages.
Barriers to phone access
Phone ownership
Male Youth CDSS: …for us who use borrowed phones it won’t be easy to access the messages sometimes because the owners of the phones may be away.
Female Adults, Sikenala: we are all close so when one of us gets the message she would communicate…yes even if sharing husband’s phone that is no problem.
Male Youth, Chimoto: …to us who share with our relatives, we may not be that comfortable receiving reproductive health on a shared phone.
Parental consent
Facilitator: What do you think of adolescents receiving this information on their mobile phone?Male Adult, Chimoto: With this generation, it really has to be so.
Female Youth CDSS: …for me the parents would not like the [family planning] messages they would think that it’s a boyfriend giving me some advice.Facilitator: Is it because you use a borrowed phone so you are afraid?Male Youth, CDSS: Yes sometimes the parents may not be that friendly.
Trust
Involvement in Intervention Design
Male Youth, Chimoto: Yes we will, because what we are discussing here is exactly what we want so we will trust you to give us the right messages.
Practically, it was noted that message content would be trusted if it was clear where the messages came from;Female Youth, Sikenala: Yes, we will believe after seeing the phone number of the sender.Facilitator: So that means we should have a unique number for project?Female Youth Sikenala: Yes.
Prior knowledge of service
Female Youth CDSS …only the people who are here would trust the messages because we would know it’s you when you send the messages.
Sustainability
Follow up
Male Adult Sikenala: …plead to the authorities that they should not just make false promises but launch this programme.
Face to face communication
Male Youth, Chimoto: …it will really be helpful if we had a club where the youth can meet and discuss about HIV and family planning.Female Adult Sikenala: …apart from sending the messages you should come to conduct awareness campaigns to encourage us to use the health information.