Hesperian Family Planning Mobile App

A family planning mobile app to support frontline health workers, peer promoters, and advocates with counseling conversations about contraceptive choices

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Contact

Tawnia Litwin
Digital Projects Manager
Hesperian Health Guides
Email

Implementation Partners

Hesperian Health Guides

Funder

Formative research and initial prototype for the Swahili version of the Family Planning app was developed with support from K4H. 

Funding for the development and testing of the multilingual Family Planning app came from the following sources:
The Edith and Erik Bergstrom Foundation 
Bancker-Williams Foundation
Virginia Wellington Cabot Foundation 
Anna Lalor Burdick Fund of the Lalor Foundation

Implementation Dates

2019 - 2020

Geographic Scope

137 countries and territories across all continents but Antarctica, with the highest use in Africa and Latin America.

Target Users

Client, Health Care Provider

Enabling Environment Building Blocks

Services and Applications, Workforce

Family Planning Program Classification

Service Delivery

Introduction

Despite impressive increases in contraceptive use worldwide, each year, more than 200 million women have an unmet need for contraception (Darroch et al., 2016), and account for 84 percent of all unintended pregnancies, often resulting in unintended pregnancies and unsafe abortions. High rates of maternal and child mortality are often associated with lower rates of contraceptive use. Frontline health workers (FLHWs) are well suited to deliver contraceptive services to women and adolescents; however, they often lack confidence and experience in discussing these stigmatized topics. The expanding geographic reach of mobile technologies and the growing number of users of mobile devices is creating new opportunities to disseminate vital family planning and reproductive health information. Analytics of the use of the free online health information from Hesperian Health Guides, a nonprofit health information and health education source, shows that more than 90 percent of user-traffic to reproductive health topics comes from cellphones.

The Family Planning app is a practical tool to support contraceptive counseling. It features an interactive method chooser, with accessible, unbiased information about contraceptive methods and their use, as well as stories and suggestions to develop and improve counseling skills. Hesperian conducted multiple iterations of medical review and user testing—starting with an online prototype and then testing fully functional versions of the app.

Project/Digital Health Solution Overview

Hesperian’s Family Planning app is a portable, discreet, and accessible tool for FLHWs and peer promoters to utilize when counseling women and adolescents about contraception and family planning. Employing clear, non-judgmental language, the app seeks to increase the capacity and comfort level to discuss sex, sexuality, and family planning. As promoters and other community health workers are often peers that operate outside of formal health systems, they may be the best suited to provide appropriate, sustainable, and effective counseling that will help connect underserved and hard-to-reach adolescents and women to family planning, with a greater likelihood that they remain engaged with these programs.

Available for both IOS and Android phones and tablets, the Family Planning app works offline and does not require a data plan once downloaded, making it accessible to those who face economic and/or location limitations. The accurate and unbiased information in this app can help FLHWs or peer promoters to counsel women and adolescents anywhere, making it particularly useful in underserved and marginalized communities, no matter how far away.

This multi-lingual app is currently available in English, Spanish, French, and Swahili (the user can select the language) and is accessible in the different regions of the world with documented needs for increased contraceptive use, such as Africa and Latin America.

The Family Planning app was designed to be easily adaptable into local languages and contexts, making it easy to scale it globally for greater reach and impact. Given Hesperian’s deep experience with translating resources into multiple languages and keeping them up-to-date across translations, the expectation is to translate the app into additional languages in the near future.

Evaluation and Results Data

After receiving initial feedback from community partners and medical experts in 2018 who reviewed the online prototype of the app, a mobile version of the Family Planning app was tested by health providers, peer promoters, health educators, and community advocates in Latin America and Africa during 2019. The Spanish, English, French, and Swahili versions of the app were tested (in their respective languages) in Burkina Faso, Cameroon, Côte d’Ivoire, Dominican Republic, Ghana, Guatemala, Kenya, Liberia, Mali, Mexico, Tanzania, and Uganda, reflecting different degrees of accessibility to methods and social stigma around the topic. User feedback was received through focus groups, in-depth interviews, and iterative reporting of practical counseling experiences.

Analysis of feedback led Hesperian to make several modifications to the app, including: continued improvements to navigation in general and specifically, of the interactive method chooser feature, the revamping of the counseling section to include in-depth explanations of counseling skills and broader variety of counseling stories, among other changes. Hesperian will continue to update the app in response to user feedback, changes in medical criteria, changes in the availability of contraception methods, or to include technological improvements to enhance its use.

Through Google Analytics, Hesperian is able to see the number of people actively using the app, which country they are using it from, and what pages are being accessed. During the last six months, 5,554 people used the app in 151 countries, led by Colombia, Ethiopia, Ghana, India, Kenya, Mexico, Nigeria, the Philippines, Uganda, and the United States. During this same period, the app’s most used features, measured in the number of times the page was accessed, included: What birth control is best (15K), How each method works (15K), General information about contraceptives (7.1K), Method Chooser Questionnaire (3.7K) and Frequently Asked Questions (2.2k).

Lessons Learned

  • User testing with diverse partners demonstrated the importance of adding new translations—information is most effective when available in local languages.
  • User feedback led to the use of warmer colors and localized images to invite more use.
  • Iterative user testing enabled the development of multi-tiered strategies for reaching lower literacy populations (for example, type and size of letters and images, organization of information).
  • Feedback led to inclusion of counseling examples to model communication and dialogue to support more difficult counseling cases (for example, people with highly traditional or religious views, adolescents, transgender people, etc.).

Conclusion

In order to be helpful, family planning information needs to be clear, accessible, adaptable, and easy to use. The practical information contained in Hesperian’s Family Planning app is supporting frontline health workers, such as community health workers, midwives, and peer promoters to feel more capable of providing quality contraceptive counseling. The iterative design and user testing resulted in the creation of a clear, accessible mobile app that is relevant and useful across cultural contexts. This process validated the content, style, and diverse possible users of the Family Planning app. The multilingual design offers potential for expansion into additional languages.

Continued testing of the Family Planning app by diverse types of FLHWs working in different countries, regions, and cultural settings will be instrumental to ensure the app’s utility. Feedback from testing will allow Hesperian to bring the app to scale in additional languages and localized contexts, so that vital contraception information will reach those who need it most. 

References

Darroch, J. E. et al. Adding it up: Costs and benefits of meeting the contraceptive needs of adolescents. 2016. Guttmacher Institute: New York, USA.

Although all Hesperian materials contain reproductive health information, the following online resources contain more in-depth information:

  1. Where Women Have No Doctor (https://en.hesperian.org/hhg/Where_Women_Have_No_Doctor)
  2. Health Actions for Women (https://en.hesperian.org/hhg/Health_Actions_for_Women)
  3. A Book for Midwives (https://en.hesperian.org/hhg/A_Book_for_Midwives)
  4. New Where There Is No Doctor (https://en.hesperian.org/hhg/New_Where_There_Is_No_Doctor)