Youth – Page 3 – C4D Network

Using mobile phone technology to advocate for increased uptake of youth friendly services at Kenyatta University (Pathfinder International, Kenya 2014 onwards)

January 23, 2016

Background: In Kenya young people – including students of university age – are particularly at risk from unintended pregnancy, gender-based violence and coercion, harmful cultural practices that adversely impact their health (such as female genital cutting), and sexually transmitted infections and HIV/AIDS. These issues are often not openly discussed leading to young people having no access to information on how to protect themselves.

To help to tackle some of these issues, Pathfinder’s work in Kenya since 1998 has included a university-based integrated reproductive health and peer counselling project at three public universities: Egerton University, Kenyatta University, and the Jomo Kenyatta University of Agriculture and Technology.

What did the programme involve: Pathfinder’s university-based program initially addressed the social, reproductive health, and informational needs of young people through the recruitment and training of a network of university-based peer counsellors, drawn from both students and faculty.

Throughout the life of the program, Pathfinder provided financial and technical assistance to enhance university service delivery by strengthening and promoting clinic-based, peer counselling and community outreach interventions.

Since mid-2014, Pathfinder International (PI) has developed a mobile application to mobilize and advocate for increased uptake of youth friendly services (YFS) at Kenyatta University by students (population 63,500). This action was triggered by findings of an assessment conducted by PI KCO, which indicated that only 20% of the total population in need of adolescent and youth sexual reproductive health services accessed and utilized services on campus – despite the efforts made by youth peer educators, university counsellors and the existence of a student-dedicated health unit offering YFS on campus.

Why this approach: Mobile phone usage is high amongst university students so PI field staff hypothesized that digitizing the peer educators on campus was the way forward. The easily accessible digital platform informs youth on campus about sexual and reproductive health rights and mobilizes students to take preventive action including booking of medical and counselling appointments.

Results observed: This project is relatively new and ongoing but student-driven content on the mobile phone app has proved popular and has been driven by Kenyatta University students (i.e. peer educators and counsellors) with funding from APHIAplus.

By mid-2016 PI KCO, envisage that the application will result in an uptake in the following areas:
• voluntary use of Long Acting Reversible Contraception by students; uptake of post abortion care service;
• infant care (for students who have delivered babies); utilization of post rape services and increase in the
• number of student support groups and number of peer counselors. The process will lead to the wider launch of the application (http://electrodyn.net/aphia/) in Kenya.

Lessons learnt: Although still relatively new it is possible to draw some lessons from the project. First, the application offers confidentiality – whilst booking an appointment for example. Therefore students, especially those suffering from STIs and HIV/AIDS are not embarrassed to seek medical help.

Second, the programme is limited however, as it is only accessible to those with a smartphone. Developers are currently considering whether an electronic link would be a better option to replace the app or run alongside it. This would allow services to be accessed from a computer as well as a phone.
(Source: Bill Okaka, Communication for Development specialist, Nairobi)

m4Youth SMS service (Pathfinder International, Ethiopia 2014 onwards)

January 23, 2016

Background: Ethiopia currently has over 30 higher education learning facilities with enrolments increasing every year. Many of the young students however lack information to protect themselves against HIV/AIDS infections and many female students face unwanted pregnancy, unsafe abortion and may face sexual and gender-based violence.

To address these issues, Pathfinder International began implementing m4Youth in 2014. This a free, menu-based SMS service provided through the Integrated Family Health Program, in partnership with John Snow, Inc., and supported by USAID. The goal of m4Youth is to impact positively on students’ knowledge of sexual and reproductive health, thereby increasing their utilization of relevant and safe services.

What did the programme involve? m4Youth provides tailored sexual and reproductive health information to university students at Adama Science and Technology University via SMS. Students text ’8990,’ and receive messages containing menus. They can then request information from the menu, texting a number that corresponds to the topic of their interest, and the information is sent to their phone.

When students text they are offered a range of information from six key topic menus including:

· “HIV and sexually transmitted infections” – information about common misconceptions and stigma, in addition to prevention, testing, and treatment facilities.

· “Contraceptive methods”- Information on a full range of methods, with dual method use (a condom plus another method) being encouraged.

· “Sexuality” – the most commonly accessed menu to date, possibly indicating students’ desire for a broad range information on sexual life.

· “Unsafe abortion”

· “Healthy versus abusive relationships”

· “Where to find services” – contact information for sexual and reproductive health services available on and off campus.

Each topic and SMS message was chosen after a baseline survey and discussions with students highlighted issues students felt they lacked information on. Messages were tested to check they were accurate, easy to understand and culturally appropriate. Messages are written in English and Oromifa – a local language.

The service was advertised widely throughout campus with billboard posters and M4Youth also trained peer educators in various sexual and reproductive health issues.

Why this approach? Many young university students have access to mobile phones and are used to text messaging and receiving information in this way.

Results observed: During the first nine weeks of implementation, the menus most accessed by students were: ‘Sexuality’ (39%) and ‘Contraceptive methods’ (20%), followed by ‘Sexually transmitted infections/ HIV’ (15%), ‘Healthy vs abusive relationships’ (12%), ‘Where to find services’ (8%), and ‘Unsafe abortion’ (6%).”

Lessons learnt: SMS Services are strengthened when they are promoted as a part of a wider supportive sexual and reproductive health campaign such as the training peer of educators and the establishment of youth-friendly health facilities.

Learning About Living e-Learning programme (OneWorld UK and Butterfly Works, Nigeria 2007-2011)

January 23, 2016

Background: ‘Learning about Living’ (LaL) was designed to empower young people in Nigeria to make well-informed decisions about their personal lives and relationships by utilising ICTs to provide accurate and non-judgemental information about sexual health. Its objectives included a measurable positive change in adolescent knowledge, attitudes and practices relating to sexual health.

It was initiated in 2006 by OneWorld UK and Butterfly Works, Netherlands, working with key stakeholders’ in the youth sexual and reproductive health field in Nigeria. A two-year pilot ran from 2007 – 2009, followed by a three-year scale-up stage which ran from 2009-2011. In 2012 the programme was passed onto local partners and stakeholders to run and manage.

What did the programme involve? An interactive e-Learning programme in the form of an electronic version of the Family Life and HIV/Aids Education (FLHE) national curriculum was created in order to teach adolescents about all aspects of reproductive health, including HIV prevention. This was based on the curriculum developed by the National Agency for Curriculum Development in the Nigerian educational sector. The programme was rolled out across over 500 schools and wider reach was later provided by a national mobile phone helpline.

Teachers from each school involved received training about how to use the programme – including learning about participatory teaching practices, such as how to encourage and prompt discussion amongst young people in response to the issues raised by the programme. Teachers also received copies of the LaL CD and help with set-up, plus ongoing support provided through local organisations. Some schools were also given a computer.

The e-Learning programme featured virtual peer educators who provided interactive information – through games, activities, cartoons, and quizzes – on various sexual and reproductive health issues including HIV prevention as well as wider issues such as self-esteem and how to stay healthy.

The mobile phone helpline supported this classroom based programme as it meant students who had more personal questions they felt uncomfortable asking or discussing in the classroom could call or text the confidential mobile phone helpline or could be referred by their teacher to a local young-people friendly health service.

Why this approach? The ‘participatory learning’ approach was used as this approach acknowledges and welcomes existing knowledge and competence of the students; students are central in the learning process and teachers become facilitators. Students are given space to develop their own viewpoint through active experience. It is most appropriate when the subject being taught affects deeply help beliefs and attitudes. HIV/AIDs and other reproductive health issues fit into this category, hence the choice of a participatory approach. Participatory approaches should empower young people to co-solve the challenges and co-design the path forward.

Results observed: In the 2012 yearly evaluation, 78% of young people who used the service reported that they passed on the information they received to family and friends. The impact of eFLHE was found to be up to 10-20% more effective as a teaching method when compared to the regular method of teaching the curriculum.

Learning About Living encouraged young people to think about issues relating to sexual health. This is evidenced by the fact that when the mobile phone helpline was launched in November 2007, over 11,000 questions had been sent by the end of January 2008. 27,000 questions had been asked by mid-July 2008. The external evaluation including feedback from students, including one student who said: “I feel free now to talk about issues of sexuality.”

Lessons learnt: One of the key lessons learnt from the case study is the importance of continuing evaluation. Evaluation of the programme in schools highlighted that some students still felt uncomfortable asking certain questions in a class environment. As a result of this, the confidential mobile phone helpline was introduced.

In addition the importance of participation can be seen. Through young people being encouraged to learn actively, they are more likely to share their knowledge with others.

(Source: Learning about Living website)

Freedom HIV/AIDS: The use of mobile technology to raise awareness of HIV/AIDS, (Star Programme, East and Southern Africa, 2006)

January 23, 2016

Background: Freedom HIV/AIDS is a company specialising in mobile game development with the aim of trying to combat HIV/AIDS through the use of ICTs. Their original project was based around educational games created for mobile phones. The success of this project in India led to Freedom HIV/AIDS collaborating with the Africa Reach Programme in 2006 to create the ‘Star Programme’. This programme was implemented in six countries: Kenya, Uganda, Tanzania, Malawi, Mozambique and Namibia, countries of high HIV/AIDS prevalence. The focus was on adolescents and young people, although the games could be used by anyone.

The Star programme aimed to use technology to create HIV/AIDS awareness and sensitivity amongst young people in the target countries. By increasing awareness, the programme aimed to reduce the spread of HIV.

What did the programme involve? Two mobile games were created, in both English and local languages: AIDS Penalty Shoot Out – a football game where players save and shoot penalties whilst receiving information and messages on HIV/AIDS awareness and prevention – and AIDS Fighter Pilot – where a village boy and girl who area peer educators, dedicate their lives to fighting HIV/AIDS as they fly around their village and region, distributing knowledge, condoms and red ribbons.

Why that particular approach? Mobile technology was used due to its prevalence in the target countries. The number of people with mobile phones – especially young people – was rapidly growing and as youth were the target demographic this made focusing on mobile phone technology a logical move. Using technology to communicate information and raise awareness was also deemed to be more cost effective than using health workers, and it was felt it would allow information to reach rural areas that might otherwise be excluded.

Games were used as ‘edutainment’ rather than as just information packages, because edutainment methods can often be more effective at spreading messages and creating awareness than just presenting large amounts of information to target audiences. The games engaged and entertained making it more likely that young people would retain knowledge gained whilst playing.

Results observed: Assessing the results of the programme is difficult. However, in 2006 there were six million downloads of the game, which suggests that the game is both popular and being used widely.

When the games were first launched there was no evaluation system in place to study the impact of the games. However, since then during the game play the score, variety of messages delivered, message weights, levels and replay history were recorded in order to assess the impact. Using this information, it has been suggested that games have increased players’ knowledge of HIV/AIDS. Freedom HIV/AIDS is developing more games and rolling out the initiative to other parts of the world, which suggests the organisation views the edutainment games as a success.

Lessons learned: The Star Programme highlights the importance of formative research. Through connecting with local NGOs the programme initiators learnt about cultural and regional sensitivities, allowing ‘tailoring’ of the games. Formative research also highlighted the popularity of football across Africa which determined the focus of one of the games. However, the lack of evaluation system when the games were first implemented has made it more difficult to evaluate the impact of the project. This highlights the importance of continual monitoring and evaluation.

(Source: Freedom HIV/AIDS website)