Barriers and facilitators to the implementation of cell phone interventions to improve the use of family planning services among women in Sub-Saharan Africa: a systematic review

Abstract

BackgroundMobile health (mHealth) interventions are being tested to improve contraceptive uptake in SubSaharan Africa (SSA). However, few attempts have systematically reviewed the mHealth programs aiming to improve family planning (FP) services among women in SSA. This review identifies and highlights facilitators and barriers to implementing cell phone interventions designed to target women FP services.MethodsDatabases including PubMed, CINAHL, Epistemonikos, Embase, and Global Health were systematically searched for studies from January 01, 2010, to December 31, 2020, to identify various mHealth interventions used to improve the use of FP services among women in SSA. Two authors independently selected eligible publications based on inclusion/exclusion criteria, assessed study quality and extracted data using a pre-defined data extraction sheet. In addition, a content analysis was conducted using a validated extraction grid with a pre-established categorization of barriers and facilitators.ResultsThe search strategy led to a total of 8,188 potentially relevant papers, of which 16 met the inclusion criteria. The majority of included studies evaluated the impact of mHealth interventions on FP services; access (n = 9) and use of FP outcomes (n = 6). The most-reported cell phone use was for women reproductive health education, contraceptive knowledge and use. Barriers and facilitators of the use of mhealth were categorized into three main outcomes: behavioral outcomes, data collection and reporting, and health outcomes. mHealth interventions addressed barriers related to provider prejudice, stigmatization, discrimination, lack of privacy, and confidentiality. The studies also identified barriers to uptake of mHealth interventions for FP services, including decreased technological literacy and lower linguistic competency.ConclusionThe review provides detailed information about the implementation of mobile phones at different healthcare system levels to improve FP services; outcomes. Barriers to uptake mHealth interventions must be adequately addressed to increase the potential use of mobile phones to improve access to sexual reproductive health awareness and family planning services.Systematic review registrationPROSPERO CRD42020220669 (December 14, 2020)

The Role of Digital Health Tools in Improving Contraceptive Use Among Reproductive Age Women

“…In addition, they may provide instructional materials, assistance in managing side effects, and facilitate access to telemedicine services for contraceptive advice and prescription renewals. Mobile applications provide the capacity to enhance the adherence to contraceptive methods, augment user understanding, and enable people to make well-informed choices about their reproductive wellbeing (Barro et al, 2022).…”