FHI 360’s m4RH team presented their preliminary research findings at the International Confrence on Family Planning. Their presentation explored the potential of mobile-phone-based programs to overcome barriers that young people face in accessing contraceptives. Below is an interview with the principle investigator Kelly L’Engle and co principle-investigator, Heather Vadhat.
1. IYWG: Can you provide a brief overview of the m4RH program for our readers? What exactly is m4RH?
Kelly: m4RH is a family planning information service. Information about a range of short and long acting methods is provided via text message. There is also a searchable database of clinic locations where family planning services can be obtained. M4RH is opt-in, free to the user, an interactive or “ping-pong” system, and available across mobile phone provider inKenya and Tanzania.
2. IYWG: How popular are mobile phones among young people globally?
Heather: Very popular, it is estimated that 27% of the 5.9 billion mobile phone subscriptions world-wide are people under the age of 30.
3. IYWG: m4RH was designed to reach mobile phone users of all ages, but according to your presentation, it is quite popular among young people. What percentage of your users are youth?
Kelly: We only have data from Tanzania, so far. 15% of m4RH users inTanzaniawere 19 or younger during the pilot period. An additional 44% were 29 or younger. So that’s about 60% of all m4RH users who are youth and young adults.
4. IYWG: How are youth using m4RH?
Kelly: We know that young people are looking at a range of different contraceptive methods using m4RH. In fact, younger users access information about more methods in comparison to older m4RH users. Young people tend to be active and frequent information seekers about sexual and reproductive health, and m4RH seems to be supporting young people’s desires to learn about reproductive health by providing a high-quality and comprehensive range of information about contraception.
5. IYWG: Why are mobile phones a good platform for providing contraceptive information to young people?
Kelly: Mobile phones are private and confidential. Young people may stay away from clinics or conversations with health care providers or other adults, for fear of being stigmatized for seeking out information about reproductive health. m4RH provides an alternative method for learning about contraception that is private and confidential, and therefore m4RH may be especially helpful to young people who are thinking about their relationships and planning for the future.
6. IYWG: What are the barriers that young people face in accessing contraceptives?
Heather: Limited knowledge about contraceptive methods is a major barrier for young people; the next challenge is overcoming the common myths and misconceptions about contraception. Often young people are reluctant to seek information or clarification about contraception from a clinic setting because of concerns around privacy and confidentiality, cost of services, and provider biases. Convenience of clinic locations and hours of operation is another challenge for many young people.
7. IYWG: Based on your research with users, how does m4RH seem to be addressing these barriers?
Heather: m4RH allows young people to learn basic information about many different contraception options and where to go to learn more. The service is free and available 24 hours a day, which addresses the convenience factor and the privacy afforded by using a mobile phone has been noted by many of our users as a key benefit of the system.
8. IYWG: m4RH is an informational service, yet your research shows that m4RH is not only increasing knowledge of contraceptive methods among young people but may also be leading to behavior change.
Kelly: That’s correct. When we asked m4RH users to report changes in family planning use after accessing m4RH, numerous changes in contraceptive behavior were reported. In most cases, accessing m4RH messages alone will not cause behavior change, but accessing m4RH messages in conjunction with exposure to other family planning information and health programming can result in positively impacting family planning behavior.
Young people reported many changes in condom use, which shows that mobile phones may be an effective platform for reaching youth with condom information, and m4RH provides an innovative method of reaching out to young people to complement usual ways of reaching youth with family planning and HIV prevention messages. Young m4RH users also reported changes in use of other contraceptive methods, suggesting that there is room for the adoption of a variety of coitally-dependent, short, and long acting contraceptive methods.
9. IYWG: What are the implications of this research on the field of youth sexual and reproductive health?
Kelly: We need to embrace using new technologies such as mobile phones to reach young people with SRH information, support, and services. A number of organizations in developing and developed countries are creatively reaching out to youth via the Internet, smartphones, and through SMS-based programs. Given the large numbers of young people in the world today, these technologies only offer the tremendous opportunity to empower millions of young people with essential information about their bodies and relationships and health.