Integrating mHealth into adolescent sexual and reproductive health promotion in Nigeria: prospects and barriers
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20174801Keywords:
Adolescent, Reproductive health, Mobile phones, mHealth, NigeriaAbstract
Adolescent sexual and reproductive health (ASRH) is a key public health issue because of its impact on health and development. Adolescent SRH is linked to available information which often determines sexual behaviours. The use of mobile phones for health (mHealth) has shown success in delivering health education and behaviour change interventions for young people for smoking cessation, nutrition and in SRH. This article explores the possible prospects and barriers to the use of mHealth for ASRH promotion in Nigeria. This paper reviews secondary data from international and local literature obtained from database search. A conceptual framework and an applicability and transferability (A&T) tool guided the analysis of ASRH issues and feasibility of mHealth use in ASRH in Nigeria. The prospects of mHealth use for ASRH in Nigeria include the widespread coverage of mobile phone services and the acceptability of its use for health by Nigerian adolescents, unmet need in ASRH information provision and the similarity of some characteristics of Nigerian adolescents to other study populations where mHealth has been successfully used. Other prospects include the Nigerian government’s focus on ICT solutions and the availability of essential technical and organisational expertise for implementation. Possible barriers to the successful use of mHealth include poor funding for ASRH and inadequate information on implementation costs and cost-effectiveness which may make it difficult to present a business case. In conclusion, the use of mHealth in ASRH promotion in Nigeria is feasible and can be effective, however, measures must be taken to address specific barriers identified.
References
UNICEF. Progress for children: A report card on adolescents: 2012. Available at: www.unicef.org/ publications. Accessed on 22 June 2014.
WHO. Making health services adolescent friendly: developing national quality standards for adolescent friendly health services, 2012. Available at: http://www.who.int/maternal_child_adolescent/documents/adolescent_friendly_services/en/. Accessed on 12 March 2014.
Chandra-Mouli V, Bloem P, Ferguson J. The World Health Organization's work on adolescent sexual and reproductive health. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 2013;56(2):256-61.
UNAIDS. Fact sheet: Adolescents, young people and HIV. Geneva: Joint United Nations Program on HIV/AIDS, UNIAIDS, 2012. Available at: www.unaids.org/.../unaids/.../20120417_FS_adolescentsyoungpeoplehiv_en. pdf. Accessed on 25 January 2014.
Hindin MJ, Fatusi AO. Adolescent sexual and reproductive health in developing countries: an overview of trends and interventions. International perspectives on sexual and reproductive health 2009;35(2):58-62.
Olasode OA. Sexual behaviour in adolescents and young people attending a sexually transmitted disease clinic, Ile Ife, Nigeria. Indian J Sexually Transmitted Dis AIDS. 2007;28(2):83-6.
WHO. mHealth: New horizons for health through mobile technologies: second global survey on eHealth: 2011. Available at: www.who.int. Accessed on 22 January 2014.
ITU. International Telecommunications Union: ICT facts and figures. International Telecommunications Union, 2013. Available at: http://www.itu. int/en/ITU-D/Statistics/Pages/stat/default.aspx. Accessed on 20 March 2014.
Thirumurthy H, Lester RT. M-health for health behaviour change in resource-limited settings: applications to HIV care and beyond. Bulletin of the World Health Organization 2012;90(5):390-2.
Vital Wave C. mHealth for development: The opportunity of mobile technology for healthcare in the developing world: 2009. Available at: http://www.globalproblems-globalsolutions-files.org/unf_website/assets/publications/technology/mhealth/mHealth_for_Development_full.pdf. Accessed on 22 January 2014.
Istepanian R, Laxminarayan S, Pattichis CS. M-health Emerging Mobile Health Systems. New york: Springer, 2006.
Mechael P, Batavia H, Kaonga N, et al. Barriers and gaps affecting mHealth in low and middle income countries: Policy white paper, 2010. Available from: http://cgsd.columbia.edu/files/2012/11/mHealthBarriersWhitePaperFINAL.pdf. Accessed on 20 January 2014.
Fjeldsoe B, Marshall A, Miller Y. Behavior change interventions delivered by mobile telephone short-message service. Am J Prevent Med. 2009;36:165-73.
Curioso WH, Kurth AE. Access, use and perceptions regarding internet, cell phones and PDA's as a means for health promotion for people living with HIV in Peru. BMC Med Informatics Decision Making. 2007;7(24):1-7.
Cafazzo JA, Casselman M, Katzman DK, Palmert MR. Bant: an mHealth app for adolescent type I diabetes - a pilot study. (Impact of Trauma on Teens: Building the Safety Net.). Journal of Adolescent Health 2012;50:S77-S8.
Ormel H, van Beijma H. Hype or hope? Using mobile technology to advance sexual and reproductive health. Exchange on HIV / AIDS Sexuality and Gender. 2012;2:1-3.
Akinfaderin-Agarau F, Chirtau M, Ekponimo S, Power S. Opportunities and limitations for using new media and mobile phones to expand access to sexual and reproductive health information and services for adolescent girls and young women in six Nigerian States. (Special issue: Promoting youth sexual and reproductive health in Africa: the need for a paradigm shift.). Afr J Reproductive Health. 2012;16(2):219-30.
Mitchell KJ, Bull S, Kiwanuka J, Ybarra ML. Cell phone usage among adolescents in Uganda: acceptability for relaying health information. Health Edu Res. 2011;26(5):770-81.
Namirembe E and Hoefman B. Promoting youth reproductive health through text messaging. Exchange on HIV and AIDS, sexuality and gender. 2012;2:4-6.
Labrique A, Vasudevan L, Kochi E, Fabricant R and Mehl G. mHealth innovations as health system strengthening tools:12 common applications and a visual framework. Global health: science and practice. 2013. Available at: www.ghspjournal.org/ content/early/2013/.../GHSP-D-13-00031.full.pdf. Accessed on 4 March, 2014.
Neema S, Ahmed FH, Kibombo R, Bankole A. Adolescent Sexual and Reproductive Health in Uganda: Results from the 2004 National Survey of Adolescents, 2006. Available at: www.guttmacher. org/pubs/2006/08/14/or25.pdf. Accessed on 20 March 2014.
Senderowitz J. A review of program approaches to adolescent reproductive health. 2000. Available at: http://pdf.usaid.gov/pdf_docs/PNACK597.pdf. Accessed on 4 March 2014.
Naidoo J, Wills J. Foundations of Health Promotion. 3rd ed. Edinburgh: Elsevier, 2009.
Mehl G, Vasudevan L, Gonsalves L. Harnessing mHealth in low-resource settings to overcome health system constraints and achieve universal access to health. In: Marsch L, Lord S and Dallery J, (eds.). Transforming Behavioral Health Care with Technology: The State of the Science. Oxford: Oxford University Press, 2014.
Buffet C, Ciliska D, Thomas H. Can I Use This Evidence in my Program Decision? Assessing Applicability and Transferability of Evidence, 2007. Available at:http://www.nccmt.ca/registry/view/ eng/24.html. Accessed on 18 March 2014.
Wang S, Moss J, Hiller J. Applicability and transferability of interventions in evidence-based public health. 2005;21:76-83.
UNFPA. Nigeria, Adolescent population: selected socio-demographic variables, 2010. Available from:http://nigeria.unfpa.org/pdf/adolescents2010.pdf. Accessed on 12 March, 2014.
Kirby D, Raine T, Thrush G, Yuen C, Sokoloff A, Potter SC. Impact of an intervention to improve contraceptive use through follow-up phone calls to female adolescent clinic patients. Perspectives on Sexual Reproductive Health. 2010;42(4):251-7.
Dehne KL, Reidner G. Sexually transmitted infections among adolescents: the need for adequate health services. 2005. Available at: http://www.who. int/reproductivehealth/publications/adolescence/9241562889/en/. Accessed on 12 March, 2014.
Temin MJ, Okonofua FE, Omorodion FO, Renne EP, Coplan P, Heggenhougen HK, et al. Perceptions of Sexual Behavior and Knowledge About Sexually Transmitted Diseases Among Adolescents in Benin City, Nigeria. Int Family Planning Perspectives. 1999;25(4):186-90.
Geary C, Silverstein L, Fatusi AO. USAID/NIGERIA: Adolescent sexual and reproductive health program review and design. 2010. Available at: http://www.ghtechproject.com /files/1%20413%20Nigeria%20Youth%20Assessment%20%205%2012%2011_Final%20508.pdf. Accessed on 14 April, 2014.
NACA. Federal Republic of Nigeria:Global AIDS response country progress report Abuja:National Agency for the Control of AIDS, 2012.
NPC. Nigeria Demographic and Health Survey 2008. Federal Republic of Nigeria, 2009.
Orji EO, Esimai OA. Sexual behaviour and contraceptive use among secondary school students in Ilesha south west Nigeria. J Obstetr gynaecol: the J Institute Obstetrics Gynaecol. 2005;25(3):269-72.
Slap GB, Lot L, Huang B, Daniyam CA, Succop PA. Sexual behaviour of adolescents in Nigeria: cross sectional survey of secondary school students. Br Med J. 2003;326(7379):15.
Moore AM, Biddlecom A. Transactional sex among adolescents in sub-Saharan Africa amid the HIV epidemic. Population Association of America, 2007 Annual Meeting. New York, 2007:14.
Beckett MK, Elliot MN, Martino S, Kanouse DE, Corona R, Klein DJ, et al. Timing of parent and child communication about sexuality relative to children's sexual behaviour. Paediatrics 2010;125(1):34-42.
Nwokocha ARC, Bob-Okon I, Ibe BC. Social Factors Predisposing Nigerian Adolescents in Enugu to STI. World J Life Sci Med Res. 2012;2(5):186-92.
Okonkwo J, Obionu C, Uwakwe R, Okonkwo C. Sources of sexual information and its relevance to sexual behaviour in Nigeria. West Africa J Med. 2002;21(3):185-7.
Nwagwu WE. The Internet as a source of reproductive health information among adolescent girls in an urban city in Nigeria. BMC Public Health. 2007;7(1):354.
Chandra-Mouli V, McCarraher DR, Phillips SJ, Williamson NE, Hainsworth G. Contraception for adolescents in low and middle income countries:needs, barriers, and access. Reproductive Health. 2014;11:1.
FMOH-Nigeria. National strategic framework on the health and development of adolescents and young people in Nigeria. Abuja: Federal Ministry of Health, Nigeria; 2007.
FMOH-Nigeria. Assessment Report of the National Response to Young People Sexual and Reproductive Health in Nigeria; 2009. Available at:http://www.actionhealthinc.org/publications/docs/Assessment%20Report%20of%20National%20Response%20To%20Young%20People's%20Sexual%20and%20Reproductive%20Health%20in%20Nigeria.pdf. Accessed on 10 April, 2014.
Okonta PI. Adolescent sexual and reproductive health in the Niger Delta region of Nigeria--issues and challenges. Afr J Reprod Health. 2007;11(1):113-24.
FMOH-Nigeria. National guidelines for the integration of adolescent and youth friendly services into primary health care facilities in Nigeria. In:(NPHCDA) NPHCDA, (ed.). Abuja: Federal Ministry of Health, Nigeria; 2013.
Williamson J. SMS 4 SRH: Using Mobile Phones to Reduce Barriers to Youth Access to Sexual and Reproductive Health Services and Information, 2013. Available at:http://www.mariestopes-us.org/sites/www.msi-us.org/files/SMS%204%20 SRH%20%282013%2011%2013%29.pdf. Accessed on 17 April, 2014.
FMOCT-Nigeria. National information and communication technology (ICT) final draft policy; 2012. Available at: http://www.researchictafrica.net/ countries/nigeria/Nigeria_National_ICT_Policy_(draft)_2012.pdf. Accessed on 25 May, 2014.
Terragon. State of digital media Nigeria. Nigeria: Terragon Limited; 2013. Available at: http://www. twinpinenetwork.com/.../Nigeria-%20State%20 of%20Digital%20Media.pdf. Accessed on 12 April 2014.
FMOH-Nigeria. National Health Promotion Policy, Abuja:Federal Ministry of Health, Nigeria; 2006.
mHealth Alliance. New Public-Private Initiative Leverages Mobile Technologies to Save One Million Lives in Nigeria mHealth Alliance, 2012. Available at: http://www.mhealthalliance.org/ media-a-esources/press-releases/54-new-public-private-initiative-leverages-mobile-technologies-to-save-one-million-lives-in-nigeria-. Accessed on 24 May 2014.
FMOCT-Nigeria. Mobile drug authentication. Abuja:Federal Ministry of Communication Technology; 2013. Available at: http://services.gov. ng/drug-authentication. Accessed on 13 June, 2014.
Madden M, Lenhart A, Duggan M, Cortesi S and Gasser U. Teens and technology 2013. Available at:http://www.pewinternet.org/Reports/2013/Teens-and-Tech.aspx. Accessed on 20 March, 2014.
Perry RC, Kayekjian KC, Braun RA, Cantu M, Sheoran B, Chung PJ. Adolescents' perspectives on the use of a text messaging service for preventive sexual health promotion. The Journal of adolescent health: official publication of the Society for Adolescent Med. 2012;51(3):220-5.
EVA. Education as a vaccine; Sustaining change by and for children and young people. Abuja: Education as a Vaccine, 2013. Available at: http://evanigeria.org. Accessed on 14 April, 2014.
Kahn JG, Yang JS, Kahn JS. Mobile health needs and opportunities in developing countries. Health Affairs. 2010;29(2):254-61.
Gold J, Lim MSC, Hellard ME, Hocking JS, Keogh LA. What's in a message? Delivering sexual health promotion to young people in Australia via text messaging. BMC Public Health. 2010;10:792.
Levine D, McCright J, Dobkin L, Woodruff AJ and Klausner JD. SEXINFO: a sexual health text messaging service for San Francisco youth. Am J Public Health. 2008;98(3):393-5.
Malbon K, Romo D. Is it ok 2 txt? Reaching out to adolescents about sexual and reproductive health. Postgraduate Medical J. 2013;89:534-9.
Cole-Lewis H, Kershaw T. Text messaging as a tool for behaviour change in disease prevention and management. Epidemiologic Rev. 2011;32(1):56-69.
Gold J, Lim MSC, Hocking JS, Keogh LA, Spelman T, Hellard ME. Determining the impact of text messaging for sexual health promotion to young people. Sexually Transmitted Diseases. 2011;38(4):247-52.
Lim MS, Hocking JS, Aitken CK, Fairley CK, Jordan L, Lewis JA, et al. Impact of text and email messaging on the sexual health of young people:a randomised controlled trial. J Epidemiol Community Health. 2012;66(1):69-74.
Mechael P, Donner J, Beijma H, Benjamin P. mHealth in Practice: Mobile technology for health promotion in the developing world. In: Mechael P and Donner J, (eds.). London. UK: Bloomsbury Academic, 2012.
Gold J, Aitken CK, Dixon HG, Lim MS, Gouillou M, Spelman T, et al. A randomised controlled trial using mobile advertising to promote safer sex and sun safety to young people. Health Educ Res. 2011;26(5):782-94.
Cornelius JB, Dmochowski J, Boyer C, St Lawrence J, Lightfoot M, Moore M. Text-messaging-enhanced HIV intervention for African American adolescents:a feasibility study. The Journal of the Association of Nurses in AIDS Care: JANAC. 2013;24(3):256-67.
Juzang I, Fortune T, Black S, Wright E and Bull S. A pilot programme using mobile phones for HIV prevention. Journal Telemed Telecare. 2011;17(3):150-3.
mHealthAlliance. Saving One Million Lives in Nigeria mHealth Alliance, 2013. Available at:http://www.mhealthalliance.org/our-work/initiatives/saving-one-million-lives-in-nigeria. Accessed on 24 May, 2014.
IFAD. Statement by Dr. Akinwumi Adesina, Honourable Minister of Agriculture and Rural Development, Federal Republic of Nigeria, Governor from Nigeria, at the 36th Session of the IFAD Governing Council. International Fund for Agricultural Development (IFAD), 2013. Available at: www.ifad.org/events/gc/36/speech/nigeria.htm. Accessed on 24 May, 2014.
Okoro EO, Sholagberu HO, Kolo PM. Mobile phone ownership among Nigerians with diabetes. Afr Health Sci. 2010;10(2):183-6.
Lester RT, Ritvo P, Mills EJ, Kariri A, Karanja S, Chung MH, et al. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1):a randomised trial. Lancet. 2010;376:1838-45.
WorldBank. Country data WorldBank, 2014. Available at: http://data.worldbank.org/indicator. Accessed on 24 May 2014.