Development of a mHealth pathway to expand and enhance comprehensive sexual and reproductive health services for young people in Zambia

Adolescents and young people in Zambia are disproportionately affected by HIV and sexually transmitted infections (STI) and have limited access to convenient, non-judgmental, and confidential sexual and reproductive health services including HIV/ STI testing and contraception. We will use community-based, participatory research to design and develop with AYP a service specification for a youth-friendly, digitally-supported pathway of care to overcome barriers to service access by offering increased convenience, privacy and confidentiality. The pathway will include: a mobile phone app for receiving health information and sexual health test results; vending machines located in-community dispensing a range of products including HIV self-testing kits, sampling kits for STIs (Gonorrhea, Chlamydia, Trichomonas, Syphilis, HIV) and contraceptives; and a web application for medical review of test results and treatment prescription.? A service specification and prototype versions of the app, vending machine interface, and web application will be completed in this project, ready for implementation in a future trial.?

Adolescents and young people aged 15 to 24 (AYP) in Zambia are disproportionately affected by HIV and STIs and have limited access to convenient, non-judgmental, and confidential sexual and reproductive health (SRH) services including HIV/ STI testing and contraception. Addressing these needs requires services that overcome barriers at individual, social, geographic and system levels. Existing research in sexual health has shown that digital technologies (such as vending machines and mobile phone applications) are acceptable to users and effective at overcoming barriers to service access, by offering increased convenience, privacy and confidentiality. However, there is limited evidence on how these digital technologies can support access to comprehensive SRH in AYP.?The aim of this project is to co-produce with AYP a community-based, digitally-supported care pathway that includes: a mobile phone app for receiving sexual health test results; vending machines located in-community dispensing a range of SRH products including: HIV self-testing kits; sampling kits for STIs (Gonorrhea, Chlamydia, Trichomonas, Syphilis, HIV) and contraceptives; and a web application for medical review of test results and treatment prescription.?The project will utilise a whole systems, socio-ecological approach to develop a human-centred digital SRH care pathway for AYP. The data collected through focus groups workshops and individual outreach interviews will be analysed using social science expertise in organisational analysis, digital innovation, human-centred, user experience design (UXD) and co-production. ?Functional prototype versions of the app, vending machine interface, vending machine products, web application and data integration software developed in this project will be ready to be implemented in a future trial.?