Background: In Nigeria, there were 3.5 million people living HIV/AIDS as of 2015 (UNAIDS, 2015). While the prevalence rate at 3.1% is lower than countries in southern Africa such as Zambia (13%), the large Nigerian population means that these figures actually represent the second biggest HIV epidemic in the world. Data from 2014 showed that prevalence among young women age 15-24 (2.9 per cent) is three times higher than among men of the same age (1.1 per cent), according to the National Agency for the Control of AIDS and UNAIDS 2011.
MyQuestion (My Q) is a free mobile phone service that allows adolescents and young people in Nigeria to access accurate non-judgmental and confidential information anonymously regardless of their location and at their convenience. My Q uses low-end technology such as SMS to enable young people to send in questions and seek information or counselling on sexual and reproductive health. The project is implemented by Education as a Vaccine (EVA) with support from Oxfam Novib, the National Agency for the Control of AIDS and Ford Foundation.
Technology: MyQuestion uses a VAS provider to transfer SMS between end users and the team of counsellors. A VAS provider is a third-party company that has agreements with Mobile Network Operators (MNOs) to provide additional, non-core services to subscribers other than standard voice calls. Major VAS services include SMS services such as the provision of dedicated, toll-free shortcodes, mobile money services, online gaming etc. Toll-free SMS shortcodes allow users to send a message to a dedicated 4 or 5-digit number without having to pay for the cost of the SMS. The cost of the SMS is borne by the company that owns or rents the shortcode, in this case, EVA through their 3rd party VAS provider.
Technology Use: The “My Q&A” service began in Nigeria in 2005, when the youth-led non-profit organization Education as a Vaccine (EVA) was chosen by the National Agency for the Control of AIDS to manage one of the four national hotlines aimed at giving youth free access to sexual and reproductive health, and HIV/AIDS information, counseling and referral. The programme was scaled up in 2007 to include an SMS and web component. This allowed young people to ask questions through text messages (SMS), voice calls and email/web, as well as share their new knowledge through a monthly competition. MyQuestion is Nigeria’s longest-running sex education and reproductive health hotline. Since its inception, the service has exchanged close to a million text messages with young Nigerians.
Interviewed for this case study, Davidson Onuh, Program Manager for MyQuestion at Education as a Vaccine, explained, “The service uses three media: SMS, email and a hotline, operational from Monday to Friday, 9am-5pm. Staff have 24 hours to respond to SMS and email queries. Most responses are provided in English, though the team can also respond in Hausa, Ibo and Yoruba.”
The counsellors, mostly university students studying health or medicine, receive rigorous training so they can accurately respond to any type of sexual health concerns/myths and provide as much factual information as possible. The service is advertised throughout Nigeria in partnership with local NGOs through marketing materials such as flyers, posters, banners, notepads and online advertisements. The SMS service was developed with assistance from OneWorld UK and is currently being run through a VAS (Value-Added Service) provider who provide a dedicated shortcode for toll-free SMS from the youth. This means that the users of the service are not charged to send or receive SMS, and instead, EVA covers this cost.
Organization and Partnerships: Education as a Vaccine (EVA) is a non-profit organization founded in Nigeria focused on improving the health and development of children and young people. EVA encourages curriculum changes in secondary schools, community-wide AIDS prevention programmes, and counselling to those living with HIV/AIDS. They look for innovative ways to reach youth with vital information for their well-being.
The National Agency for the Control of AIDS (NACA) was established in February 2000 to coordinate the various activities around HIV/AIDS in Nigeria. NACA serves to ensure that entities and groups responsible for implementation of the national strategic framework objectives and activities receive the financial, organizational and human resources support required to undertake and complete assigned activities in a multi-sectoral environment
OneWorld UK is a non-profit UK-based organization which develops and creates new media, mobile and web technologies for social good. In Nigeria, they coordinated an HIV/AIDS prevention programme called ‘Learning about Living’ which used a computer-based eLearning programme and mobile phone service for youth to learn about issues surround HIV/AIDS. This programme was then handed over to the Ministry of Education (HIV/AIDS unit) and Education as a Vaccine (EVA) in 2012. My Q currently runs as part of this ongoing programme.
Challenges and Lessons Learned: Since the project started in 2005, it has been extremely popular with approximately 12,000-15,000 questions received on the platform each month through text messages. HIV/AIDS is the most commonly referenced sexual and reproductive health topic. Additionally, the number of repeat users has grown along with the project (OneWorldUK, 2012). The number of young people coming back to use the service repeatedly shows a level of trust in the information that the service provides.
Davidson Onuh explained, “One of the biggest lessons learned by the team is that programmes tend to think that youth are informed or educated, however, based on the kinds of questions the service has received, it goes to show that there is very big gap in information and that providing this information goes a long way in preventing HIV/AIDS. People need information and technology provides an avenue to provide this information in a cost-effective manner. We must embrace technology. There is a big market and a big opportunity to reach target audiences even further”.
The biggest challenges for the project according to Onuh was non-delivery of SMS messages, either to the MyQuestion service or to the youth. Other technical challenges include third-party interferences and delays in SMS movement. “It is very important to choose a reliable VAS provider as they will ultimately determine the success of your projects.”
This case study was compiled with interviews and the following information kindly provided by Education as a Vaccine:
- Project website. http://www.myquestion.org/my-question
- Lessons Learnt and Results from the Scale Up of Learning about Living 2009-2011. Retrieved from http://www.oneworld.org/docs/lal/nigeria/Nigeria_LessonsLearned_Scale-up_2012.pdf. Accessed on 20 March 2017.
- UNAIDS Nigeria HIV and AIDS estimates 2015. Retrieved from http://www.unaids.org/en/regionscountries/countries/nigeria. Accessed on 20 March 2017.
Image source: http://www.myquestion.org/my-question