YAhealth (Youth and Adolescent Health)

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An innovative mobile and web application for accessing information on adolescent family planning and sexual and reproductive health.

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CASE STUDY SOURCE

YAhealth (Youth and Adolescent Health)

PROJECT STATUS

Project Pilot

IMPLEMENTATION PARTNERS

Ministry of Health, Rwanda.
Rwanda Biomedical center
IntraHealth International
University of Rwanda
Technical Support Progress MIH Develop

FUNDER

USAID
IntraHealth International

GEOGRAPHIC SCOPE

Rwanda

Target Users

Client, Health Care Provider

Enabling Environment Building Blocks

Strategy and Investment

Family Planning Program Classification

Demand Generation, Service Delivery

Introduction

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.

About YAhealth

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:

  1. Adolescent development
  2. Conception and Pregnancy
  3. Menstrual cycle and hygiene
  4. HIV/AIDS and STIs
  5. Family Planning
  6. Gender-Based Violence
  7. Human Sexuality
  8. Youth relationships

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

Evaluation and Results

YAhealth has an inbuilt database that supports access to the analytics including:

  • Number of downloads
  • Number of people who visit the platform
  • Frequency of user engagement with the platform.

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.

Lessons Learned

  • There is a lack of family planning/ASRH experts for digital content creation and review.
  • Community outreaches do not reach as many youth and adolescents as digital platforms can in this technology-driven era.
  • There is a need to strengthen the capacity for content creation to adequately respond to the needs of the target groups.
  • At the beginning of this project, the target populations, and family planning/ASRH trainers were not familiar with digital platforms due to limited knowledge in the use of smart devices. The feedback from the users was helpful for us to keep making YAhealth simpler and easier to use.
  • YAhealth is age group-centered, which makes it challenging for the age group of 10-14, who may not have their own smartphones or have to depend on the use of their parents’ smartphones.
  • While developing YAhealth more focus was on access to youth and adolescent family planning/sexual reproductive health information and services uptake, however, the current trend shows that young adults and older persons also face challenges in seeking similar services. Therefore, there is a need to increase the target age groups.

CONCLUSION

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.

References/Resources

  1. National Institute of Statistics of Rwanda (NISR) [Rwanda], Ministry of Health (MOH) [Rwanda], and ICF. (2020). Rwanda Demographic and Health Survey 2019-20. Available as online pdf: https://dhsprogram.com/pubs/pdf/PR124/PR124.pdf
  2. National Institute of Statistics of Rwanda (NISR) [Rwanda], Ministry of Health (MOH) [Rwanda], and ICF. (2020). Rwanda Demographic and Health Survey 2014-15. Available as online pdf: https://dhsprogram.com/pubs/pdf/PR124/PR124.pdf
  3. National Institute of Statistics of Rwanda (NISR) [Rwanda], Ministry of Health (MOH) [Rwanda], and ICF. (2020). Rwanda Demographic and Health Survey 2014-15. Available as online pdf: https://dhsprogram.com/pubs/pdf/PR124/PR124.pdf

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