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尼日利亚拉各斯地区计划生育服务数字健康平台采用的驱动因素与障碍:一项混合方法研究

Motivators and barriers to the uptake of digital health platforms for family planning services in Lagos, Nigeria: A mixed-methods study.

作者信息

Alhaji Mohammed M, Balarabe Muhammad R, Atama David, Okafor Arizechukwu, Solana Doluwamu, Meyo Francis, Okoye Chinedu Joseph, Okafor Uchenna, Oyelana Babatunde, Anyanti Jennifer

机构信息

Busara Center for Behavioral Economics, Abuja, Nigeria.

Busara Center for Behavioral Economics, Nairobi, Kenya.

出版信息

Digit Health. 2025 Jun 9;11:20552076251349624. doi: 10.1177/20552076251349624. eCollection 2025 Jan-Dec.

Abstract

BACKGROUND

Inadequate access to family planning (FP) services drives low contraceptive uptake in Nigeria. Digital platforms such as e-pharmacy and telemedicine offer potential to improve access, privacy, and convenience. This study examines factors influencing provider and user adoption of digital FP services in Lagos.

METHODS

We used an exploratory sequential mixed-methods design. Interviews ( 79) with FP providers, and current and potential users informed a survey ( 1485) of digital FP platform users. Thematic analysis was applied to qualitative data; quantitative data were analyzed using descriptive, bivariate, and logistic regression methods.

RESULTS

Participants comprised online (FP and non-FP) and brick-and-mortar (FP and non-FP) users. Awareness e-pharmacies for FP was high (78%), yet usage was limited (24%). Similarly, telemedicine awareness was very low (30%), and usage was lower (6%) compared with e-pharmacy. Online platform use for FP (e-Pharmacy/telemedicine) was significantly associated (.01) with age, gender, education level, marital status and higher education. Providers identified key barriers including regulatory uncertainty, technological challenges, and concerns about privacy and quality assurance. Logistic regression suggested higher odds of e-pharmacy use among respondents aged 18-26 Respondents aged 27-35 had significantly lower odds of e-pharmacy use compared to those aged 18-26 (adjusted odds ratios (AORs) = 0.33; 95% CI: 0.22-0.48, .001), while post-secondary education predicted higher telemedicine use (AOR = 6.54; 95% CI: 2.34-18.31, .001).

CONCLUSIONS

E-pharmacy and telemedicine can ease FP access, especially for younger, educated, high-income users. However, effective adoption requires addressing demand-side user barriers and supply-side provider concerns.

摘要

背景

在尼日利亚,计划生育(FP)服务获取不足导致避孕药具使用率较低。电子药房和远程医疗等数字平台有望改善服务获取、隐私和便利性。本研究调查了影响拉各斯地区提供者和用户采用数字计划生育服务的因素。

方法

我们采用了探索性序列混合方法设计。对计划生育提供者、当前和潜在用户进行了79次访谈,为数字计划生育平台用户的1485份调查提供了信息。对定性数据进行了主题分析;定量数据采用描述性、双变量和逻辑回归方法进行分析。

结果

参与者包括在线(计划生育和非计划生育)和实体(计划生育和非计划生育)用户。对电子药房提供计划生育服务的知晓率很高(78%),但使用率有限(24%)。同样,远程医疗的知晓率很低(30%),与电子药房相比使用率更低(6%)。用于计划生育的在线平台(电子药房/远程医疗)使用情况与年龄、性别、教育水平、婚姻状况和高等教育显著相关(P<0.01)。提供者确定了关键障碍,包括监管不确定性、技术挑战以及对隐私和质量保证的担忧。逻辑回归表明,18至26岁的受访者使用电子药房的几率更高。与18至26岁的受访者相比,27至35岁的受访者使用电子药房的几率显著更低(调整后的优势比(AOR)=0.33;95%置信区间:0.22-0.48,P<0.001),而高等教育预测远程医疗的使用率更高(AOR=6.54;95%置信区间:2.34-18.31,P<0.001)。

结论

电子药房和远程医疗可以缓解计划生育服务的获取问题,特别是对于年轻、受过教育、高收入的用户。然而,要有效采用这些服务,需要解决需求方用户障碍和供应方提供者的担忧。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f030/12159478/8ea8c5c9258d/10.1177_20552076251349624-fig1.jpg

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