Chukwu Emeka, Gilroy Sonia, Addaquay Kojo, Jones Nki Nafisa, Karimu Victor Gbadia, Garg Lalit, Dickson Kim Eva
Department of Computer Information System, Faculty of Information and Communications Technology (ICT), Msida, Malta.
United Nations Population Fund Country Office, Freetown, Sierra Leone.
JMIR Form Res. 2021 Nov 12;5(11):e23874. doi: 10.2196/23874.
Teenage pregnancy remains high with low contraceptive prevalence among adolescents (aged 15-19 years) in Sierra Leone. Stakeholders leverage multiple strategies to address the challenge. Mobile technology is pervasive and presents an opportunity to reach young people with critical sexual reproductive health and family planning messages.
The objectives of this research study are to understand how mobile health (mHealth) is used for family planning, understand phone use habits among young people in Sierra Leone, and recommend strategies for mobile-enabled dissemination of family planning information at scale.
This formative research study was conducted using a systematic literature review and focus group discussions (FGDs). The literature survey assessed similar but existing interventions through a systematic search of 6 scholarly databases. Cross-sections of young people of both sexes and their support groups were engaged in 9 FGDs in an urban and a rural district in Sierra Leone. The FGD data were qualitatively analyzed using MAXQDA software (VERBI Software GmbH) to determine appropriate technology channels, content, and format for different user segments.
Our systematic search results were categorized using Grading of Recommended Assessment and Evaluation (GRADE) into communication channels, audiovisual messaging format, purpose of the intervention, and message direction. The majority of reviewed articles report on SMS-based interventions. At the same time, most intervention purposes are for awareness and as helpful resources. Our survey did not find documented use of custom mHealth apps for family planning information dissemination. From the FGDs, more young people in Sierra Leone own basic mobile phones than those that have feature capablilities or are smartphone. Young people with smartphones use them mostly for WhatsApp and Facebook. Young people widely subscribe to the social media-only internet bundle, with the cost ranging from 1000 leones (US $0.11) to 1500 leones (US $0.16) daily. Pupils in both districts top-up their voice call and SMS credit every day between 1000 leones (US $0.11) and 5000 leones (US $0.52).
mHealth has facilitated family planning information dissemination for demand creation around the world. Despite the widespread use of social and new media, SMS is the scalable channel to reach literate and semiliterate young people. We have cataloged mHealth for contraceptive research to show SMS followed by call center as widely used channels. Jingles are popular for audiovisual message formats, mostly delivered as either push or pull only message directions (not both). Interactive voice response and automated calls are best suited to reach nonliterate young people at scale.
在塞拉利昂，青少年怀孕率居高不下，15至19岁青少年的避孕普及率较低。利益相关者采用多种策略应对这一挑战。移动技术无处不在，为向年轻人传播重要的性健康和生殖健康及计划生育信息提供了契机。
本研究旨在了解移动健康（mHealth）如何用于计划生育，了解塞拉利昂年轻人的手机使用习惯，并推荐大规模通过移动设备传播计划生育信息的策略。
本形成性研究采用系统文献综述和焦点小组讨论（FGD）的方法进行。文献调查通过系统检索6个学术数据库评估类似但现有的干预措施。在塞拉利昂的一个城市和一个农村地区，对不同性别的年轻人及其支持群体进行了9次焦点小组讨论。使用MAXQDA软件（VERBI Software GmbH）对焦点小组讨论数据进行定性分析，以确定针对不同用户群体的合适技术渠道、内容和形式。
我们的系统检索结果根据推荐评估和评价分级（GRADE）分为沟通渠道、视听信息形式、干预目的和信息传播方向。大多数被审查的文章报告了基于短信的干预措施。同时，大多数干预目的是提高认识和作为有用资源。我们的调查未发现有记录使用定制的移动健康应用程序来传播计划生育信息。从焦点小组讨论可知，塞拉利昂拥有基本手机的年轻人比拥有功能手机或智能手机的年轻人更多。拥有智能手机的年轻人大多用于WhatsApp和Facebook。年轻人广泛订阅仅用于社交媒体的上网套餐，每天费用从1000利昂（0.11美元）到1500利昂（0.16美元）不等。两个地区的学生每天为语音通话和短信充值1000利昂（0.11美元）至5000利昂（0.52美元）。
移动健康促进了计划生育信息的传播，以在全球范围内创造需求。尽管社交媒体和新媒体广泛使用，但短信是覆盖有文化和半文化年轻人的可扩展渠道。我们已将移动健康用于避孕研究，以表明短信其次是呼叫中心是广泛使用的渠道。铃声在视听信息形式中很受欢迎，大多仅以推送或拉取信息方向（而非两者兼有）传递。交互式语音应答和自动呼叫最适合大规模覆盖不识字的年轻人。
