"Now I feel like I can": exploring e-commerce for self-care contraception in Kenya

In Kenya, the growing e-commerce market presents new opportunities to expand access to self-care contraceptives. However, we know little about women's experiences and attitudes toward purchasing such products online.

We used a two-phased approach to explore Kenyan women's perspectives on e-commerce and its potential as a platform for contraceptive access. In the formative phase, we conducted 61 in-depth interviews with a diverse sample of reproductive-aged women to assess general perceptions of e-commerce and attitudes toward using it for contraceptive purchases. We analyzed formative data through an iterative coding process followed by thematic analysis of relevant codes reports. In the second phase, using a human-centered design (HCD) approach, we observed a smaller group of Nairobi-based women of reproductive age (n = 8) as they navigated the website of a women's health-focused digital commerce platform to explore products, access information and make purchases. Post-website use interviews captured participants' reflections on the experience. Research assistants compiled detailed notes from observations and interviews that the analysis team used to identify themes and build out analysis insights.

While some participants in the formative phase noted the convenience of online shopping, many were skeptical of e-commerce due to concerns about fraud or their own limited digital literacy and internet access. Similar issues with digital accessibility surfaced in the HCD phase; however, after a brief tutorial and direct experience using the website to browse and make purchases, HCD participants reported more positive perceptions of e-commerce. They emphasized the privacy, convenience, and autonomy that online purchasing offered, noting that these features were especially beneficial for accessing contraception.

Findings from the HCD phase highlight the potential for e-commerce to lessen the burden of external pressure from providers or family members on contraceptive decision-making and to help circumvent stigma-related barriers, especially for younger women. While HCD participants' increased confidence in and comfort with e-commerce after exploring the digital commerce platform indicates promise for this self-care contraceptive access pathway, barriers to use identified by participants in both phases underscore the need for such digital interfaces to be implemented with in-person introductions that can build trust and offer technical guidance.