- Title
- Improving the use of sexual and reproductive health services for young people in rural Ghana via mobile health (mHealth) technologies
- Creator
- Laar, Alexander Suuk
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2024
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Introduction: In rural low- and middle-income countries (LMICs), including Ghana, conventional sexual and reproductive (SRH) interventions have failed to meet the information and service needs of rural populations especially young people residing in remote rural areas. Gaps still exist in coverage and knowledge as conventional intervention strategies have largely failed to address the SRH information and services needs of young people, especially in hard-to-reach rural settings. Mobile health (mHealth) innovations have been suggested as an effective way to improve young people’s access to, and use of, SRH information and services particularly where multifaceted barriers exist. To bridge the provision and access gaps to SRH information and services for young people in rural settings, mHealth technologies have been introduced in LMICs such as Ghana. Despite the use of mobile phone technologies by healthcare providers (HCPs) in Ghana however, there is still a lack of knowledge regarding their use in providing access to SRH information and services among young people in rural settings. The overarching research question of this thesis is: “What are the barriers to conventional SRH service access and information to young people in rural settings of Ghana and is the use of mobile phone technology a potential mechanism for this population?” Methods: Views and experiences of young people on using mHealth platforms for sexual and reproductive health services in rural low- and middle-income countries: a qualitative systematic review (manuscript 1) and Perspectives of health care providers on delivering mHealth sexual and reproductive health services in rural settings in low- and middle-income countries: a qualitative systematic review (manuscript 2) provided a qualitative synthesis of young people’s and HCPs’ perspectives of the barriers to, and facilitators of, mobile phone based SRH services and information in rural areas of LMICs. Exploring health care providers’ perspectives on barriers to traditional sources of SRH information and services for young people in rural Ghana: are mHealth technologies the answer?(manuscript 3). Investigating use of mHealth to provide sexual and reproductive health services to young people in rural Ghana: health care providers’ and Understanding barriers and facilitators for providing access to mobile phone sexual and reproductive health information among young people in rural Ghana: perspectives of health care providers (manuscript 5) qualitatively explored HCPs’ perspectives of SRH provision to young people using semi-structured in-depth interviews with HCPs in three regions of rural Ghana between May and August 2021. Participants were purposively recruited using the snowballing method for the study. Interviews were conducted via Zoom and audio recorded with the consent of participants. The transcripts were transcribed verbatim and thematically analyzed following the rigorous qualitative approach as outlined by Braun and Clarke. Results: Overall, the findings of the systematic reviews demonstrated the potential and feasibility for the use of mHealth initiatives for a wide range of SRH information and services among young people and HCPs in rural settings of LMICs and Ghana. Evidence for use of mHealth platforms and preference for mHealth SRH services centred on convenience, privacy and confidentiality, as well as ease and affordability and preference for text messaging, voice messaging, and interactive voice response services showed high confidence in the study findings) and moderate confidence in studies focused on phone call (manuscript 1). The systematic review involving HCPs perceptions (manuscript 2), highlighted the positive experiences of using mHealth for SRH provision. In particular, it was noted that the benefits of mHealth included a reduction in consultation time and travel costs, provided easy referrals and follow up of clients, was convenient in communicating health information confidentially, and it provided the ability to consult groups of clients remotely rather than in-person consultations. Manuscript 3, which focused on conventional provision of SRH services multiple barriers to use were identified. In manuscript 4, the benefits of mHealth were identified, including ease and convenience, low cost, anonymity, privacy, and confidentiality associated with socio-cultural norms and religious beliefs, reduced health delivery workload, and reduced pressure on limited health facility infrastructure. In manuscript 5, perceived facilitators for delivering mHealth platforms SRH services included an accessible and stable network and power, community support, ease and convenience, affordability, and youth-friendly services. In general, barriers and constraints for use of mHealth services included poor and limited access to network and electricity, limited technological skills and language literacy constraints. Discussion: The findings of this thesis demonstrated the great potential of using novel mHealth platforms to provide SRH services among young people in rural LMICs and Ghana. The findings provide valuable information on the feasibility of mHealth platforms for SRH services among young people in rural settings. Despite the benefits of mHealth technology initiatives, the identified barriers and challenges need to be urgently and adequately addressed to enable scale-up and integration of mHealth into rural health systems.
- Subject
- access barriers and challenges; health care providers; traditional sources; sexual and reproductive health information; digital health technology; mHealth platforms; young people; rural Ghana; rural LMICs
- Identifier
- http://hdl.handle.net/1959.13/1511479
- Identifier
- uon:56501
- Rights
- Copyright 2024 Alexander Suuk Laar
- Language
- eng
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| Thumbnail | File | Description | Size | Format | |||
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| View Details Download | ATTACHMENT01 | Thesis | 2 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 260 KB | Adobe Acrobat PDF | View Details Download |