Digital support for first time self-injectable contraceptive users in Nairobi, Kenya: A design evaluation

Area of Science:

• Reproductive Health
• Digital Health
• Human-Computer Interaction

Background:

• Women in Kenya face unmet needs for contraception.
• Self-injectable contraceptives offer a self-managed fertility control option.
• Initial in-person consultations for self-injection can be a barrier; WhatsApp training is explored.

Purpose of the Study:

• To document the design process of a WhatsApp-delivered self-injectable contraceptive service.
• To evaluate a mixed-methods approach for service design.
• To explore user experiences with remote training for self-injection.

Main Methods:

• Mixed-methods evaluation including observation of design meetings and analysis of design documents.
• Interviews with the design team.
• Interviews with participants testing the remote training component.

Main Results:

• Four key tasks of the digital service were detailed: information provision, technical/privacy checks, eligibility assessment, and observing self-injection.
• Challenges, assumptions, iterations, and learnings were documented.
• Case studies revealed how the digital service altered the timing, space, and medium of clinical interactions, and the negotiation of clinical legitimacy via WhatsApp.

Conclusions:

• Examining digital self-care services offers insights into self-care, digital care, and face-to-face care.
• Digital services can reshape healthcare interactions by extending time, space, and medium.
• Altered interactions necessitate new approaches to establishing clinical legitimacy.