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
An innovative mobile and web application for accessing information on adolescent family planning and sexual and reproductive health.
YAhealth (Youth and Adolescent Health)
Project Pilot
Ministry of Health, Rwanda.
Rwanda Biomedical center
IntraHealth International
University of Rwanda
Technical Support Progress MIH Develop
USAID
IntraHealth International
Rwanda
Client, Health Care Provider
Strategy and Investment
Demand Generation, Service Delivery
YAhealth is a freely available software solution with online-offline features for accessing age-appropriate family planning and adolescent sexual and reproductive health (ASRH) content.
In Rwanda, 78,000 babies were born to teenage mothers from 2016 to 2020 [1]. According to the Rwanda Demographic Health Survey 2009/2010 and 2014/2015, teenage pregnancy increased from 6.1 percent in 2010 to 7.3 percent in 2015. While 99.1 percent of women aged 15 – 19 and 100 percent of women aged 20-24 have heard of at least one contraceptive method, just 2.3 percent of girls aged 15-19 and 21.3 percent of those aged 20-24 have used modern contraceptives. [2,3]
Youth and adolescents usually opt not to seek sexual and reproductive health (SRH) services due to the lack of awareness about the availability of services, misconceptions about some services, affordability, fear of judgment by their peers, families, communities, health workers, and stigma or embarrassment [2].
The Youth and Adolescent health (YAhalth) digital platform enables the users to get age-appropriate family planning/ASRH information both offline and online. The goal of this intervention is to increase demand rapidly and sustainably improve youth and adolescents’ access and uptake for family planning/ASRH services.
YAhealth is a freely available innovative software solution with online-offline mobile and web applications accessible in IOS, Android, and Windows operating systems. Progress MiH Ltd developed the software and the family planning/ASRH content was developed by community health boosters, family planning/ASRH experts, and the Rwanda Biomedical Center. The content was developed in a creative and friendly manner and tailored to suit the different user-age categories in both written and audio-visual modes. The content was made available in both English and Kinyarwanda.
YAhealth integrates service geo-tracking with satellite and map view, a menstrual cycle tracking system, a discussion forum, live chat, gamified quiz, and three dedicated channels for content creation. YAhealth has eight family planning/SRH Modules, namely:
In Rwandan culture, it is taboo to discuss family planning/ASRH matters among youth, which prevents youth from being aware of their body. YAhealth empowers adolescents and youth with age-specific knowledge and skills about sexual and reproductive health and rights.
The target age groups include 10-14, 15-19, 20-24, and above 24. They are given information specific to their age and level of understanding in both written and audio. This includes visual messages available in the form of cartoons for the 10-14 group, illustration and infographics for the 15-19 group, and real photo and video content for the 20-24 group.
The geo-tracking system locates all needed services for users. It helps users to connect and chat with health care providers in all health facilities and eliminate the fear of judgment and stigma from the service provider and peers. Discussion forums and live chat give users a platform to discuss freely in private and confidential ways with peers, parents, and SRH specialists either anonymously or with a registered account. Menstrual cycle tracking systems help girls track their next periods and give them notifications alerting them. Tracking the menstrual cycle helps young girls and women who don’t know whether they are irregular or regular to track their menstrual cycle for up to six months
YAhealth has an inbuilt database that supports access to the analytics including:
Users are subjected to a quiz related to the information they read and earn reward points based on the level of correctness in the quiz. The reward points are a form of incentive for participation and give a measured level of understanding of the content. The frequency of use of YAhealth is another realistic form of assessment, as well as the number of youth and adolescents who use chat for interacting with family planning/SRH experts on any concern.
Girls can track their cycle and get alert notifications before their period. Based on how often they use YAhealth, we can evaluate the effectiveness and how it brings solutions to girls who face challenges of tracking their periods. With YAhealth, youth and adolescents can locate facilities that offer family planning/SRH services.
In the pilot phase, over 100 downloads for the application were made. Health topics of inquiry included: youth relationships, human sexuality, family planning, positive masculinity, and menstrual cycle. A total of 60 youth and 32 adolescents participated in the quiz. Participants who took the quiz before reading the content scored 34 percent compared to 86 percent for those who took the quiz after reading the content. Upon approval from the Rwandan Ministry of Health, the application will be made available for public use.
YAhealth was approved and endorsed by the Ministry of Health through Rwanda Biomedical Center due to its accuracy and innovativeness. It boosts the accessibility of family planning/ASRH information and raises awareness of the facilities that provide family planning/ASRH services. It also gives a free confidential platform for youth and adolescents to interact with family planning/ASRH specialists and also engage with their friends and peers through open discussion. After feedback gathered from field-testing, YAhealth’s next step is to implement the intervention in 20 districts where 40 secondary schools will be trained about the use of YAhealth and peer educators in respective districts. A survey will be conducted to assess the uptake of family planning/ASRH services in different supported health facilities and youth-friendly centers with and without the YAealth intervention.
The number of health facilities and family planning/SRH stakeholders who will endorse YAhealth will be monitored as an indicator of how YAhealth is suitable and fit for the target beneficiaries. Finally, we are targeting different stakeholders and institutions that promote access to sexual and reproductive health services for the youth and adolescents and train their healthcare providers and reproductive health services for the youth and adolescents and train their healthcare providers.