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Phase: Review

Providing comprehensive sexuality education to adolescents using mobile phone applications.

Rosalia:Use of mobile phone apps to provide comprehensive sexuality education to areas with high teen HIV and pregnancy rates ,DSM,Tanzania

Photo of Eunice Kajala
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What specific problem(s) are you trying to address?

The challenges that I am trying to address are : Young people have special sexual and reproductive health needs because of their relatively high risk of being exposed to inaccurate or incomplete information, which leads them to acquiring HIV and other sexually transmitted infections, pregnancies and maternal complications.(Rani and Lule, 2004)The Ministry of Health(Tanzania) reports that one-third of incomplete abortion cases that turn up in health facilities involve adolescents, and one in five of the girls are students.(UWEZO, TENMET and Hivos/Twaweza ,2010).The most recent prevalence data comes from the 2007/2008 HIV/AIDS and malaria indicator survey.HIV prevalence rises rapidly among adolescent girls and young women.

What are some of your unanswered questions about the problem(s) you are working to address?

Gaps still exist within programs that target both knowledge and behavior change in the sexual activities of adolescents.Programs need to go beyond HIV and focus on broader topics in sexual and reproductive health.Currently, in many programs, other sexually transmitted infections and pregnancy prevention are conspicuously absent.Communication from any reliable source on sexual and reproductive health needs , needs to empower adolescents to negotiate behavior on the basis of accurate information.

Explain Your Idea

My idea, is to design an ehealth intervention to provide comprehensive sexuality education to adolescents via mobile phone applications.The ehealth intervention to be designed using Persuasive System Design model by creating an on line platform of sexual health information and discussions. The information on comprehensive sexuality education to be based on three theories 1)Social learning theory 2) Health risk theory 3)Development theory. The aim of the intervention is to increase health seeking behavior at the Sexual and Reproductive Health Services. The basic information to be provided, are on the body function, sex, reproduction, contraceptives and choices,sexual negotiation and refusal skills, prevention and transmission of HIV/STDs and resources . The online platform will have contacts or referral sites for the sexual and reproductive health services where by adolescents can receive a wide range of services after being equipped with age appropriate, culturally acceptable sexuality education. The platform will have contact points/ referral for HIV counseling and testing and linkage to treatment and care. There will be a contact form where by adolescents can ask private questions and receive responses. The idea will be developed from contextual enquiry, values, requirements, prototype, then usability testing.Persuasive elements are to be added in the platform, these will increase, the rate of health seeking behavior by adolescents.Ethics and privacy are to be considered.

Name the three most important ways that your idea will address your identified problem(s).

My idea will impact in the following areas : 1) Adolescents will be informed and equipped with the knowledge and skills to make responsible decisions about sexuality, relationships, HIV and other sexually transmitted infections. 2) They will increase their health seeking behavior at the Sexual and Reproductive Health Services.3) They will increase the use of Family Planning and prevent the rate of unintended pregnancies and reduce the complications due to child birth.They will be an increase in the HIV counseling and testing, early initiation of HIV treatment.They will be able to reduce high risk behavior and practice safer sex, reducing the new HIV infections.

How is your idea unique?

Sexual health information has been provided in special centers e.g Youth Friendly Services, by providing resources: books, fliers, pamphlets.This is a traditional method and is likely to miss a large number of adolescents, in institutions and schools.Sexual health education needs privacy and confidentiality.Many adolescents do not present in Youth Friendly Services because of the stigma and the judgemental attitude by health care providers.Providing comprehensive sexuality education by means of mobile phone applications will be able to reach a large number of adolescents.Clearly, internet and social networking holds promise for reaching adolescents populations, given the documented high use of technology among this age group.(Bull et al 2007) Other organizations have been using, Youth Friendly Services which is likely to miss a large number of adolescents. The other, method is by using peer educators, this is said to be benefiting the educators themselves( Chandra -Mouli et al , 2015)

What are some outstanding concerns or questions that you have regarding your idea?

The concerns or questions I have are: 1) User's illiteracy and personal preferences on the mobile phone applications. 2) Reliable network, internet and electricity/power pre requisites.3) Technical or expert knowledge for maintenance and development of platforms will be required.4) Airtime costs for end users. I am still at a planning stage, at a contextual inquiry phase. 5) Ethical consideration for adolescents below 18 years and the need for parental/ guardian consent.

Who are your end users?

My end users are, adolescents and youths (15-24) years.The adolescents and youths will be informed and equipped with the knowledge and skills to make responsible decisions about sexuality, relationships, contraceptives, HIV and other sexually transmitted infections. Through my idea, I hope to address the knowledge gap on the sexual health information, which is scientifically accurate, realistic and non judgemental.I will be able to address young men's reproductive health concerns , which usually are not met by the traditional Sexual and Reproductive Health Services. My idea is expected to reach a significant number of adolescents, both males and females in areas with high teen pregnancy and HIV rates.

Where will your idea be implemented?

  • Ethiopia
  • Tanzania
  • Uganda

What is the primary type of emergency setting where your innovation would operate?

  • Epidemic

Tell us more about the emergency setting that you intend to implement in

The emergency setting that I'm proposing to implement my idea, in the area that is geographically defined as, hyper endemic area with high prevalence and incidence of adolescents' pregnancy, Sexually transmitted Infections and HIV in the city of Dar es salaam.The area may be characterized by high level of low social economic status and other criminal activities.Special consideration : a number of adolescents may be on substance and drug abuse.

What is your organization's name?

Rosalia Health Innovation

Tell us more about you.

I am a Medical Doctor/ Entrepreneur, based in Dar es salaam, looking for a collaborator.

Organizational Characteristics

  • Women-led organization

What is the current scale of your proposed innovation?

  • Still in planning phase and does not exist yet

Experience in Implementation Country(ies)

  • Yes, for more than one year.

Expertise in Sector

  • Have not worked in sector, but excited to learn more.

Organization Location

It is still in establishing phase. Based in Dar es salaam, apparently, not registered. The official registration is expected to be after 30th November 2017, due to the governmental logistics.

What is your organizational status?

  • Not registered but plan to in the future.

What is the maturity of your innovation?

  • Early Stage Innovation: exploring my innovation, refining, researching, and gathering inspiration.

Website

Not yet developed
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Attachments (7)

USERMAP2.doc

An adolescent girl, scheduling an appointment with an older man to the night club.

USERMAPCSE.docx

This is a representation of the characteristics and lifestyle of adolescents in the areas with high teen pregnancy and HIV rates.

48.1_10.190881968-2017.100.pdf

183281e.pdf

115968E.pdf

Persuasive Systems Design.pdf

PAPER BASED PROTOTYPECSE.docx

This is a paper based prototype of a mobile phone application that will be providing comprehensive sexuality education to adolescents and youths(15-24) in the high teen pregnancy and HIV/AIDS rates.The prototype contents will include, login in for users, profile, messages, photos and images, categories of the comprehensive sexuality education, persuasive elements( a scoring and rewarding system), services information, professional support, on line peer platform, contact form and report, updates.

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Photo of Eunice Kajala
Team

Hi Makuvaza, thanks for your question, the intervention is going to run initially as a formative pilot program in high teen pregnancy and HIV rate(epidemic) in the city of Dar es salaam-Tanzania.By formative evaluation, we will be able to know what works and what does not work, at the same time doing additions and subtraction along the process.Once the summative(final) evaluation is done for the impact and uptake of the intervention.The impact of the ehealth technology will be evaluated in organizational, clinical and behavioral terms.Then the scaling up phase comes in, to include those hard to reach.Through partnership with other NGOs, community health workers, in those resources constraints areas, we can work together and see how we can supply the apps and also complement the program with seminars, workshops etc.Statistically, by 2013, global penetration of mobile phones is estimated to reach over 95% of the population worldwide which means that more people will have access to mobile phones than water and sanitation services.This shows the large and rapid expansion of mobile phone ownership in the developing world.Reference: ITU: The World in 2013: ICT Facts and Figures. 2013, Geneva: International Telecommunication Union.Prior to the intervention, they will be surveys, researching, focus group discussions, review of previous studies in the areas, in all these reviews, adolescents from even hard to reach areas will be included.This can also tell us on how to reach those in hard to reach areas. There are also other factors to consider apart from inaccessibility to apps, e.g the behavior of the guys anticipated to take up an ehealth intervention, the laggards.If those areas have laggards, relatively isolated, slow in taking up an intervention, we may need to reconsider, not to scale up to those areas.We may consider other options, as I have mentioned earlier on.Addressing adolescents' sexual health needs multisectorial approach, one approach may not be able to cover and address the unique and diverse sexual health needs of adolescents.(Ref: What Does not work in Adolescent Sexual and Reproductive Health: A Review of Evidence on Interventions commonly Accepted as Best Practices by Venkatraman Chandra-Mouli,Catherine Lane, Sylvia Wong August 31, 2015)

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