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.
A family planning mobile app to support frontline health workers, peer promoters, and advocates with counseling conversations about contraceptive choices
Digital Projects Manager
Hesperian Health Guides
Hesperian Health Guides
Formative research and initial prototype for the Swahili version of the Family Planning app was developed with support from K4H.
Funding for the development and testing of the multilingual Family Planning app came from the following sources:
The Edith and Erik Bergstrom Foundation
Virginia Wellington Cabot Foundation
Anna Lalor Burdick Fund of the Lalor Foundation
2019 - 2020
137 countries and territories across all continents but Antarctica, with the highest use in Africa and Latin America.
Client, Health Care Provider
Services and Applications, Workforce
Despite impressive increases in contraceptive use worldwide, each year, more than 200 million women have an unmet need for contraception (Darroch et al., 2016), and account for 84 percent of all unintended pregnancies, often resulting in unintended pregnancies and unsafe abortions. High rates of maternal and child mortality are often associated with lower rates of contraceptive use. Frontline health workers (FLHWs) are well suited to deliver contraceptive services to women and adolescents; however, they often lack confidence and experience in discussing these stigmatized topics. The expanding geographic reach of mobile technologies and the growing number of users of mobile devices is creating new opportunities to disseminate vital family planning and reproductive health information. Analytics of the use of the free online health information from Hesperian Health Guides, a nonprofit health information and health education source, shows that more than 90 percent of user-traffic to reproductive health topics comes from cellphones.
The Family Planning app is a practical tool to support contraceptive counseling. It features an interactive method chooser, with accessible, unbiased information about contraceptive methods and their use, as well as stories and suggestions to develop and improve counseling skills. Hesperian conducted multiple iterations of medical review and user testing—starting with an online prototype and then testing fully functional versions of the app.
Hesperian’s Family Planning app is a portable, discreet, and accessible tool for FLHWs and peer promoters to utilize when counseling women and adolescents about contraception and family planning. Employing clear, non-judgmental language, the app seeks to increase the capacity and comfort level to discuss sex, sexuality, and family planning. As promoters and other community health workers are often peers that operate outside of formal health systems, they may be the best suited to provide appropriate, sustainable, and effective counseling that will help connect underserved and hard-to-reach adolescents and women to family planning, with a greater likelihood that they remain engaged with these programs.
Available for both IOS and Android phones and tablets, the Family Planning app works offline and does not require a data plan once downloaded, making it accessible to those who face economic and/or location limitations. The accurate and unbiased information in this app can help FLHWs or peer promoters to counsel women and adolescents anywhere, making it particularly useful in underserved and marginalized communities, no matter how far away.
This multi-lingual app is currently available in English, Spanish, French, and Swahili (the user can select the language) and is accessible in the different regions of the world with documented needs for increased contraceptive use, such as Africa and Latin America.
The Family Planning app was designed to be easily adaptable into local languages and contexts, making it easy to scale it globally for greater reach and impact. Given Hesperian’s deep experience with translating resources into multiple languages and keeping them up-to-date across translations, the expectation is to translate the app into additional languages in the near future.
After receiving initial feedback from community partners and medical experts in 2018 who reviewed the online prototype of the app, a mobile version of the Family Planning app was tested by health providers, peer promoters, health educators, and community advocates in Latin America and Africa during 2019. The Spanish, English, French, and Swahili versions of the app were tested (in their respective languages) in Burkina Faso, Cameroon, Côte d’Ivoire, Dominican Republic, Ghana, Guatemala, Kenya, Liberia, Mali, Mexico, Tanzania, and Uganda, reflecting different degrees of accessibility to methods and social stigma around the topic. User feedback was received through focus groups, in-depth interviews, and iterative reporting of practical counseling experiences.
Analysis of feedback led Hesperian to make several modifications to the app, including: continued improvements to navigation in general and specifically, of the interactive method chooser feature, the revamping of the counseling section to include in-depth explanations of counseling skills and broader variety of counseling stories, among other changes. Hesperian will continue to update the app in response to user feedback, changes in medical criteria, changes in the availability of contraception methods, or to include technological improvements to enhance its use.
Through Google Analytics, Hesperian is able to see the number of people actively using the app, which country they are using it from, and what pages are being accessed. During the last six months, 5,554 people used the app in 151 countries, led by Colombia, Ethiopia, Ghana, India, Kenya, Mexico, Nigeria, the Philippines, Uganda, and the United States. During this same period, the app’s most used features, measured in the number of times the page was accessed, included: What birth control is best (15K), How each method works (15K), General information about contraceptives (7.1K), Method Chooser Questionnaire (3.7K) and Frequently Asked Questions (2.2k).
In order to be helpful, family planning information needs to be clear, accessible, adaptable, and easy to use. The practical information contained in Hesperian’s Family Planning app is supporting frontline health workers, such as community health workers, midwives, and peer promoters to feel more capable of providing quality contraceptive counseling. The iterative design and user testing resulted in the creation of a clear, accessible mobile app that is relevant and useful across cultural contexts. This process validated the content, style, and diverse possible users of the Family Planning app. The multilingual design offers potential for expansion into additional languages.
Continued testing of the Family Planning app by diverse types of FLHWs working in different countries, regions, and cultural settings will be instrumental to ensure the app’s utility. Feedback from testing will allow Hesperian to bring the app to scale in additional languages and localized contexts, so that vital contraception information will reach those who need it most.
Darroch, J. E. et al. Adding it up: Costs and benefits of meeting the contraceptive needs of adolescents. 2016. Guttmacher Institute: New York, USA.
Although all Hesperian materials contain reproductive health information, the following online resources contain more in-depth information: