The Use of Information and Communication Technology in Family Planning, Reproductive Health, and Other Health Programs: A Review of Trends and Evidence

"...[E]xisting ICTs - particularly mobile technologies - have the capacity to improve access to family planning and reproductive health information and services for women, men, and youth, with the ultimate potential to better both their health status and their quality of life. ICTs also have the potential to strengthen the health care workforce through education and training opportunities..."

From the Management Sciences for Health (MSH)-led AIDSTAR-Two Project, which is funded by the United States Agency for International Development, this technical paper focuses on the ways in which new information and communication technologies (ICTs) have the capacity to improve access to family planning and reproductive health information and services.

Opening sections of the paper present context, definitions, and trends. The paper then presents examples of ICTs being used in Ethiopia, Kenya, Rwanda, Senegal, Tanzania, Malawi, India, and Bangladesh, and looks at how digital platforms and mobile technology are being integrated into the overall health system strengthening approach. These ICT examples are grouped under the following 5 elements:

1. Build a high-performing, well-trained staff - examples are provided of programmes that use SMS (text messages) and web-based and wireless eLearning platforms.
2. Provide strong leadership - example: The Virtual Leadership Development Program (VLDP) uses the internet, a print workbook, and teamwork to strengthen the capacity of health workers to overcome workplace challenges.
3. Communicate effectively - examples are provided of programmes that use SMS (text messaging) to engage, educate, and inform the community about family planning/reproductive health, HIV/AIDS, and other health issues, as well as the availability of related services.
4. Base decisions on evidence (M&E) - two examples cite interventions using mobile collection tools to facilitate M&E and research efforts.
5. Assure contraceptive security with a strong logistics system - example: The Bangladesh Supply Chain Information Portal allows users to manage data and create presentations using web-based dashboards.

An excerpt from the report follows:

"This paper identifies nine overall enabling conditions for ICT use and scale-up in family planning and other health programs, as follows:

1. Appropriate Infrastructure: While the ICT infrastructure in Africa has dramatically improved during the last decade, the Internet is said to still be in its infancy in sub-Saharan Africa. Efforts to advance broadband capacity are just beginning, and fiber optic cables have been put in place around the African continent....
2. Cost: Health systems have competing priorities, and some people within the system consider ICT a luxury, particularly the current mobile and digital versions....Civil society organizations, nongovernmental organizations (NGOs), the public sector, and other stakeholders should join forces to leverage their collective power to negotiate lower rates from private sector telecom providers.
3. ICT Literacy: Overburdened health workers may view ICTs as just another work requirement for which they must struggle to make time. Many health workers may not have received basic computer training, and some from rural areas may never have used a computer. Successful engagement with health workers is crucial...
4. Standards and Interoperability: The proliferation of digital and mobile ICTs has created systems that, though well intentioned, are often incapable of sharing information....Applications based on open source, as well as open standards, can further ICTs that can be more broadly shared, more effectively evaluated, and more cost effective for resource-poor countries.
5. National Policies and Regulations:...With the exponential growth in eHealth, officials and policy makers must now distinctly consider ICTs in their official approaches. Many countries in Africa must also overcome the challenge of restrictive telecom regulations that hinder ICT progress.
6. Contextual Understanding: Sociocultural contexts shape behavior and attitudes toward family planning, and much of family planning counseling takes place outside the formal health sector, delivered by local community health workers (CHWs). Marrying the complexities of counseling with the resources available to locally based service providers requires a focus on the needs of the community members themselves, including support to adopt and adapt new technologies.
7. Sound Management:...Building the capacity of health workers and other intermediaries to be able to effectively use, work with, manage, adapt, and develop appropriate ICTs is an ongoing task.
8. Language: With the exception of radio and television programming, the issue of language is frequently ignored in ICT programs, most of which offer very little content in local languages. Improving health workers' capacity to deliver effective family planning or other health services involves providing these workers with updated information and guidance in a language they can easily understand - preferably their own.
9. Evaluation:...Evaluation measures impact and allows corrective measures to be taken where necessary and offers opportunities for sharing lessons and exchanging knowledge."

Click here for the 53-page report in PDF format in English.
Click here for the 62-page report in PDF format in French.