Mixed-methods, cross-sectional assessment of a client-facing, family planning counseling chatbot in Côte d'Ivoire

Evidence is limited about the feasibility, acceptability and effects on family planning (FP) intentions of digital tools, such as chatbots. To help fill this gap, we assessed a chatbot in Côte d'Ivoire with three components: (i) menstrual health information; (ii) FP information and (iii) method recommendations and referrals. We conducted a cross-sectional study to describe user characteristics and perceptions of chatbot usability, content and relevance, and perceived effects on FP-related self-efficacy. We used a mixed-methods approach, including an online survey and in-depth interviews (IDI) with chatbot users, and chatbot back-end data. Qualitative data were analyzed thematically. Quantitative data were analyzed descriptively. Between 11 January 2022 and 15 July 2022, we recruited 280 chatbot users for the survey, of whom 28 completed an in-depth interview. Survey participants averaged 22 years old, were majority female (96%), resided in Abidjan (71%) and had some university education (61%). Less than half (48%) were currently using a method to delay/avoid pregnancy. Participants primarily accessed the chatbot to get information for themselves (73%) and felt it was 'easy' (29%) or 'very easy' to use (65%). Most respondents somewhat or strongly agreed that the information provided was accurate/reliable (97%) and was useful to them (96%). Respondents reported feeling more confident in discussing FP topics with their partners and providers after interacting with the chatbot. Our findings suggest that chatbots may be a feasible and acceptable approach to sharing tailored FP information with end-users in a West African context, especially for young women in urban areas.