Establishing Digital Health Interventions in Nigeria
New
Digital Health Interventions (DHIs) to ensure sustained provision of sexual reproductive health (SRH) information and services during the pandemic in Nigeria.
As low- and middle-income countries transition from paper to digital systems, family planning programs can benefit from unprecedented opportunities to improve services. Investments in digital health tools have expanded exponentially, but information on what works—and what does not— remains limited and scattered. As investments have increased, digital applications and data fragmentation have proliferated, but stakeholders are moving towards more coordinated efforts to scale digital health solutions, support countries’ digital health infrastructure, and share evidence-based learnings.
This Digital Health Compendium enables users to explore case studies across a range of digital health technologies used to enhance family planning programs mainly in sub-Saharan Africa, but also in other regions of the world. Digital health applications in family planning programs can be broadly classified as those affecting demand generation, service delivery, supply chain management, and the policy and enabling environment. In many low- and middle-income countries, digital health innovations were adopted earlier in other health sectors, including HIV/AIDS, maternal and child health, and noncommunicable disease prevention and response. As a result, much of the impact evidence is likewise restricted to those sectors. To advance greater adoption of digital technology in family planning programs, more data and information on the challenges, opportunities, scalability, and results are needed. This compendium aims to consolidate emerging information and data on applications of digital technology in family planning programs to inform adoption and scale-up of successful approaches.
All of the case studies were submitted by the implementing organizations and include a description of the digital health intervention, program context, and, if available, important findings and lessons learned through rigorous evaluations or program data. The compendium facilitates a quick search for case studies based on the target user for digital health intervention, building block for the digital health enabling environment, family planning program classification, and country location. The case studies give policy and program decisionmakers insights on real-world applications of digital health, promising practices, challenges, and other lessons that can be applied to current and future programs.
New
Digital Health Interventions (DHIs) to ensure sustained provision of sexual reproductive health (SRH) information and services during the pandemic in Nigeria.
Alden Nouga-Ngog Chief, Strategic Partnership & Development International Planned Parenthood Federation London, UK, [email protected] +1 6174129748
International Planned Parenthood Federation
Supported by a variety of unrestricted and restricted funders
Alden Nouga-Ngog Chief, Strategic Partnership & Development International Planned Parenthood Federation London, UK, [email protected] +1 6174129748
Ongoing
Digital Health Interventions (DHIs) to ensure sustained provision of sexual reproductive health (SRH) information and services during the pandemic in Nigeria.
Constraints caused by the COVID-19 pandemic saw healthcare organizations such as Planned Parenthood Federation of Nigeria (PPFN) – IPPF’s Member Association in the country – heavily impacted. Static clinic hours were limited, open days were restricted, mobile health outreaches were no longer possible, and people were cautious about visiting hospitals.
Additionally, health workers wished to attend to fewer clients for their own precautionary measures. This called for a review of the traditional face-to-face model of health service delivery that clinicians provided to clients and necessitated the adoption of new digital and mobile technologies and innovations. The COVID-19 pandemic accelerated the shift towards the digital world, with PPFN tapping into this opportunity.
PPFN implemented new Digital Health Interventions (DHIs) to ensure sustained provision of sexual reproductive health (SRH) information and services during the pandemic. Using DHIs, PPFN has been delivering comprehensive SRH services, especially on contraception and sexually transmitted infections (STIs), to clients through various digital and online platforms including Short Message Service (SMS), Facebook, Facebook Messenger, WhatsApp, Instagram, Twitter, Zoom and direct telephone calls. These platforms were selected because of their growing popularity among Nigerians, especially young people, and the general rise of internet use.
According to a recent report, over 50% of Nigeria’s population of 208.8 million is using the internet, 93.3% of which do so via a mobile phone (Kemp 2021). WhatsApp and Twitter are the most used digital platforms as they are cheap, easily available and easy to use. The social media platforms were used free-of-charge to deliver live interactive information and educational sessions, one-to-one consultations and to make referrals. Clients who needed more services or those who were not comfortable receiving care digitally were linked to PPFN clinics (45 clinics) or partner clinics (over 150 clinics) nearest to them. Messages were disseminated in English, Pidgin and Hausa languages.
Young people were additionally reached through the Youth Connect website (https://youthconnect.ppfn.org/) that was co-designed and implemented by young people. They accessed information and services by registering on the platform and being connected to a youth-friendly service provider through WhatsApp (chat, voice and video), phone calls and quick chat features on the site.
In addition to social media platforms, PPFN also developed an e-Health application, called ‘The PPFN e-Health App’ to manage, transmit, and record information for SRHR service delivery. The App has two modules: one that transmits information to clients while the other is designed for the service providers. The App integrates features on e-appointment scheduling and a module for online CSE with certification upon completion. The App has a chat (including WhatsApp) and video component and is hosted on Android. Its development followed an interactive process where all stakeholders including PPFN service delivery teams, service providers and clients, were consulted. The App has enabled geolocation matching of clients with their closest service providers.
During the implementation period covering August 2020 to March 2021, PPFN reached over 11 million people with online SRHR information and services. The interactions were tracked through the social media impressions and the registration meter on the youth connect site, the latter reaching 2 million young people alone with SRHR information.
Data on services (mainly consultations, counselling and referral to PPFN and partner clinics) provided online was recorded and segregated by age and gender with the following results:
The use of digital and social media platforms complemented the work that PPFN was already undertaking by increasing the reach of SRH services and information to the target population amidst the pandemic. It also expanded the geographical reach of PPFN’s work, which in turn increased its visibility, coverage, and uptake of its services and consequently, contributing to more impact in the long-term.
– It was found that there was limited public knowledge of what services were available and where to access services immediately. As such, there is a need to allocate funds and raise awareness of hotlines through radio messaging, sound systems for community engagement drives, TV, and national newspaper advertisements.
– Assigning dedicated, full-time staffing by a service provider for hotline management is essential for effective implementation. Full-time dedicated staffing of the hotline wasn’t available before and the service became more effective when it was introduced.
– The high demand for services meant that doctors were answering calls at home, bringing to light the need for adequate funding and resourcing to increase surge capacity.
SGBV care is already an existing and permanent feature of FPAB through clinical services, including screening, counselling and referrals. However, the newly created hotline will support and upscale these existing efforts. Moving forward, the essential SGBV work of FPAB will be enhanced by increasing awareness of services, as well as undertaking local level advocacy and capacity building activities with communities on SGBV.
FPAB will liaise with partners and donors to continue to mobilize resources to increase the sustainability of hotline services. The success of this technological innovation in increasing access to essential and life-saving services will help to protect, restore and improve the lives of victims, thereby improving their health outcomes and the life prospects of their families and communities.