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

In low- and middle-income countries (LMICs), reproductive health programs use mobile health (mHealth) platforms to deliver a broad range of SRH information and services to young people in rural areas. However, young people's experiences of using mobile phone platforms for SRH services in the rural contexts of LMICs remains unexplored. This review qualitatively explored the experiences and perceptions of young people's use of mobile phone platforms for SRH information and services. This qualitative evidence synthesis was conducted through a systematic search of online databases: Medline, Embase, CINAHL, PsycInfo and Scopus. We included peer reviewed articles that were conducted between 2000 to 2023 and used qualitative methods. The methodological quality of papers was assessed by two authors using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) and Confidence in Evidence from Reviews of Qualitative research (CERQual) approach with the identified papers synthesized using a narrative thematic analysis approach. The 26 studies included in the review were conducted in a wide range of LMIC rural settings. The studies used seven different types of mHealth platforms in providing access to SRH information and services on contraception, family planning, sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) education. Participant preferences for use of SRH service platforms centred on convenience, privacy and confidentiality, as well as ease and affordability. High confidence was found in the studies preferencing text messaging, voice messaging, and interactive voice response services while moderate confidence was found in studies focused on phone calls. The overall constraint for platforms services included poor and limited network and electricity connectivity (high confidence in the study findings), limited access to mobile phones and mobile credit due to cost, influence from socio-cultural norms and beliefs and community members (moderate confidence in the study findings), language and literacy skills constraints (high confidence in the study findings). The findings provide valuable information on the preferences of mHealth platforms for accessing SRH services among young people in rural settings in LMICs and the quality of available evidence on the topic. As such, the findings have important implications for health policy makers and implementers and mHealth technology platform developers on improving services for sustainable adoption and integration in LMIC rural health system.