In the field of adolescent sexual and reproductive health (ASRH), candid youth perspectives are necessary for understanding the nuances surrounding contraceptive access and use. Methods of data collection leveraging technological solutions may provide avenues for increased privacy for adolescents. With the use of WhatsApp and other smartphone-based messaging applications as platforms for qualitative methodologies, public health researchers may find increased access to adolescents through utilizing mediums that adolescents already engage with in their daily lives. This article describes the use of WhatsApp as a data collection methodology with adolescents in Malawi. In June 2018, VillageReach used WhatsApp to conduct focus group discussions (FGD) to collect qualitative data on contraceptive use from Malawian youth. WhatsApp FGD participants were male and female adolescents, aged 15-19 representing rural and urban populations across three geographic regions of Malawi (northern, central and southern). Youth researchers (YR), aged 22-25, were trained and facilitated fifteen WhatsApp FGDs, as in-person (12) and remote (3) sessions. WhatsApp FGDs consisted of a YR sharing fictitious but contextually realistic ASRH scenarios, and managing the virtual discussion with questions and probing. Youth indicated comfort using WhatsApp to express their opinions and experiences related to contraceptive use and preferences. Based on the data collected, the researchers felt that use of the technology may increase willingness to provide additional levels of information during anonymized WhatsApp FGDs vis à vis traditional, in-person FGDs. Using WhatsApp as a methodological tool to facilitate FGDs has practical implications for data collection, data quality and data analysis. This paper reports lessons learned as well as the advantages and disadvantages of using WhatsApp to conduct FGDs in a low-resource setting. It also calls for developing guidelines and an ethical code of conduct for the future use of mobile applications for conducting qualitative research with vulnerable populations.

Health sector strategic plans are health policies outlining health service delivery in low-and middle-income coun

In September 2018, India launched Pradhan Mantri Jan Arogya Yojana (PM-JAY), a nationally implemented government-funded health insurance scheme to improve access to quality inpatient care, increase financial protection, and reduce unmet need for the most vulnerable population groups. This protocol describes the methodology adopted to evaluate implementation processes and early effects of PM-JAY in seven Indian states. The study adopts a mixed and multi-methods concurrent triangulation design including three components: 1. demand-side household study, including a structured survey and qualitative elements, to quantify and understand PM-JAY reach and its effect on insurance awareness, health service utilization, and financial protection; 2. supply-side hospital-based survey encompassing both quantitative and qualitative elements to assess the effect of PM-JAY on quality of service delivery and to explore healthcare providers’ experiences with scheme implementation; and 3. process documentation to examine implementation processes in selected states transitioning from either no or prior health insurance to PM-JAY. Descriptive statistics and quasi-experimental methods will be used to analyze quantitative data, while thematic analysis will be used to analyze qualitative data. The study design presented represents the first effort to jointly evaluate implementation processes and early effects of the largest government-funded health insurance scheme ever launched in India.

To understand dynamics surrounding adolescents’ access to and use of contraception, perspectives of youth themselves must be considered. Methods of data collection leveraging technological solutions may provide avenues for increased anonymity for adolescents to share their experiences with contraception. With the use of WhatsApp and other smartphone-based messaging applications as platforms for qualitative methodologies, public health researchers may find increased access to adolescents through utilizing mediums that adolescents already engage with in their daily lives. This article describes the methodology of using WhatsApp for conducting focus group discussions with adolescents in Malawi, including lessons learned around data collection, data use, and data quality. In June 2018, VillageReach used WhatsApp to conduct focus group discussions (FGD) to collect qualitative data on contraceptive use from Malawian youth. WhatsApp FGD participants were male and female adolescents, aged 15-19 representing rural and urban populations across three geographic regions of Malawi (northern, central and southern). Youth researchers (YR), aged 22-25, were trained and facilitated fifteen WhatsApp FGDs, as in-person (12) and remote (3) sessions. WhatsApp FGDs consisted of a YR sharing fictitious but contextually realistic ASRH scenarios, and managing the virtual discussion with questions and probing. Youth indicated comfort using WhatsApp to express their opinions and experiences related to contraceptive use and preferences. Based on the data collected, the researchers felt that use of the technology may increase willingness to provide additional levels of information during anonymized WhatsApp FGDs vis à vis traditional, in-person FGDs. Using WhatsApp as a methodological tool to facilitate FGDs has practical implications for data collection, data quality, and data analysis. This paper reports lessons learned and advantages and disadvantages of using WhatsApp to conduct FGDs in a low-resource setting. It also calls for developing guidelines and an ethical code of conduct for future use of mobile applications in qualitative research.