Using mobile phones to improve young people sexual and reproductive health in low and middle income countries: A systematic review

Abstract Background: Globally, reproductive health programs have used mHealth to provide sexual and reproductive health (SRH) education and services to young people, through diverse communication channels. However, few attempts have been made to systematically review the mHealth programs targeted to improve young people SRH in low-and-middle-income countries (LMICs). This review aims to identify a range of different mHealth solutions which can be used for improving young people SRH in LMICs and highlight facilitators and barriers for adopting mHealth interventions designed to target SRH of young people. Methods: Databases including PubMed, CINAHL Plus, Science Direct, Cochrane and grey literature were searched between January 01, 2005 and March 31, 2018 to identify various types of mHealth interventions that are used to improve SRH services for young people in LMICs. Of 2,181 titles screened after duplication, 207 potentially relevant abstracts were obtained. Out of 207 abstracts, 70 abstracts were shortlisted. Full text of 70 studies were reviewed using a pre-defined data extraction sheet. A total of 11 full text studies were included in the final analysis. Results: The final 11studies were categorized into three main mHealth applications including; client education and behavior change communication, data collection and reporting and financial transactions and incentives. The most reported use of mHealth was for client education and behavior change communication [n = 10, 91%]. This categorization provided the understanding that the potential of other mHealth applications has yet to be explored. Most studies showed, that mHealth interventions have proven to be effective in improving SRH services and outcomes through addressing barriers of provider prejudice, stigmatization, discrimination, fear of refusal, lack of privacy and confidentiality. Yet, the review also identified barriers to uptake of mHealth interventions for SRH including decreased technological literacy, inferior network coverage, and lower linguistic competency. Conclusion: The review provides detailed information about the implementation of mobile phones at different levels of healthcare system for improving young people SRH outcomes. This systematic review recommends that barriers to uptake mHealth interventions be adequately addressed to increase the potential use of mobile phones for improving access to SRH awareness and services.