Institute of Development Studies (IDS), University of Sussex, Brighton, BN1 9RE, UK.
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Global Health. 2018 Mar 20;14(1):31. doi: 10.1186/s12992-018-0349-6.
BACKGROUND: Information and Communications Technologies (ICTs) which enable people to access, use and promote health information through digital technology, promise important health systems innovations which can challenge gatekeepers' control of information, through processes of disintermediation. College students, in pursuit of sexual and reproductive health (SRH) information, are particularly affected by gatekeeping as strong social and cultural norms restrict their access to information and services. This paper examines mobile phone usage for obtaining health information in Mirzapur, Bangladesh. It contrasts college students' usage with that of the general population, asks whether students are using digital technologies for health information in innovative ways, and examines how gender affects this. METHODS: This study relies on two surveys: a 2013-2014 General Survey that randomly sampled 854 households drawn from the general population and a 2015 Student Survey that randomly sampled 436 students from two Mirzapur colleges. Select focus group discussions and in-depth interviews were undertaken with students. Icddr,b's Ethical Review Board granted ethical clearance. RESULTS: The data show that Mirzapur's college students are economically relatively well positioned, more likely to own mobile and smart phones, and more aware of the internet than the general population. They are interested in health information and use phones and computers to access information. Moreover, they use digital technology to share previously-discreet information, adding value to that information and bypassing former gatekeepers. But access to health information is not entirely unfettered, affecting male and female students differently, and powerful gatekeepers, both old and new, can still control sources of information. CONCLUSION: Personal searches for SRH and the resultant online information shared through discrete, personal face-to-face discussions has some potential to challenge social norms. This is particularly so for women students, as sharing information may enable them to bypass gatekeepers and make decisions about reproduction. This suggests that digital health information seeking may be exercising a disruptive effect within the health sector. However, the extent of this disruption may depend, not on students' mobile phone usage, but on the degree to which powerful new gatekeepers are able to retain control over and market SRH information through students' peer-to-peer sharing.
背景:信息和通信技术(ICT)使人们能够通过数字技术获取、使用和推广健康信息,有望通过去中介化过程带来重要的卫生系统创新,挑战把关人对信息的控制。大学生在寻求性与生殖健康(SRH)信息时,受到把关人的影响尤为明显,因为强大的社会和文化规范限制了他们获取信息和服务的机会。本文考察了孟加拉国米尔扎布尔(Mirzapur)地区大学生使用手机获取健康信息的情况。它将大学生的使用情况与普通人群进行了对比,询问学生是否正在以创新的方式使用数字技术获取健康信息,并探讨了性别对此的影响。
方法:本研究依赖于两项调查:2013-2014 年的一般调查随机抽取了来自普通人群的 854 户家庭,2015 年的学生调查随机抽取了米尔扎布尔两所学院的 436 名学生。对学生进行了选择焦点小组讨论和深入访谈。icddr,b 的伦理审查委员会授予了伦理批准。
结果:数据显示,米尔扎布尔的大学生在经济上相对较好,拥有手机和智能手机的可能性更大,对互联网的认识也比普通人群更高。他们对健康信息感兴趣,并使用手机和电脑获取信息。此外,他们利用数字技术共享以前保密的信息,增加信息的价值,并绕过以前的把关人。但获取健康信息并非完全不受限制,这对男女学生的影响不同,新旧强大的把关人仍然可以控制信息来源。
结论:个人对 SRH 的搜索以及通过离散的、个人的面对面讨论分享的在线信息具有一定的潜力来挑战社会规范。这对女学生来说尤其如此,因为分享信息可以使她们绕过把关人,对生殖做出决定。这表明,数字健康信息搜索可能正在卫生部门产生颠覆性影响。然而,这种颠覆的程度可能取决于学生的手机使用情况,而不是取决于强大的新把关人能够在多大程度上通过学生的点对点共享来控制和营销 SRH 信息。
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