Effectiveness of the Mobile-Money-Shop Approach in Reaching Unmarried Adolescents to Increase Condom Use in Uganda: A...

This study evaluated the effectiveness of mobile-money-shops (vendors) in delivering sexual and reproductive health (SRH) information and male condoms to unmarried adolescents in two municipalities in Eastern Uganda.

This quasi-experimental study implemented a 4-month intervention in 2024 at 60 vendor locations with intervention and control arms. Vendors provided SRH information, condoms, and referrals to other facilities. Unmarried adolescents (aged 15-19 years) who visited vendors were recruited at the baseline and followed at the endline. The primary outcome was condom use; secondary outcomes included SRH-related knowledge and motivation. Effectiveness was evaluated using logistic regression and difference-in-differences analysis.

Among 1,204 participants (585 intervention, 619 control), 52.7% were male, mean age 17.8 years, and 51.1% were students at baseline. Condom use significantly increased in the intervention group (adjusted odds ratio = 1.50, 95% confidence interval = 1.01-2.22) but not in the control group (adjusted odds ratio = 1.12, 95% confidence interval = 0.76-1.66), with a net-effect of 6.7 percentage points (p = .210). The proportion of participants obtaining contraceptives from vendors rose from 0% to 64.6% (p < .001), while reliance on private health facilities declined (p < .001). A shift in preferred condom sources from conventional facilities to vendors, along with improved interpersonal negotiation on contraception, was observed-particularly among boys.

The vendor-based approach effectively increased condom use and motivation for contraception among adolescents. This model demonstrates potential to reach underserved, sexually active, unmarried adolescents-particularly boys-and improve their SRH practice.