Digital health platform sparks rise in contraceptive use among Rwandan teens

Study Shows Youth-Led Platform in Rwanda Improves Adolescent Sexual Health Outcomes

As the fight for reproductive rights intensifies globally, teenagers worldwide face barriers to accessing sexual and reproductive healthcare. But a new study indicates that a youth-led platform in Rwanda may help change that.

The Impact of CyberRwanda

CyberRwanda, a digital platform created by YLabs to improve adolescent sexual health outcomes, was recently evaluated by researchers at UC Berkeley’s School of Public Health, examining its impact among adolescents in secondary schools through a randomized controlled trial. A study published this week in Nature Medicine, and one of the largest of its kind on teenage sexual health in Africa, showed that sexually active Rwandan adolescents aged 12–19 who accessed CyberRwanda at their schools had significantly higher contraceptive use compared to participants in control schools.

A Youth-Led Initiative

Departing from conventional top-down approaches, the CyberRwanda initiative involved more than 1,000 Rwandan youth in its creation. Young people were involved at every stage — from design, through implementation, and monitoring and evaluation. In an industry where end-user participation is often nominal, especially that of youth, CyberRwanda addresses the real health and wellness needs of Rwandan adolescents, while ensuring the platform is responsive to their lived experiences.

Positive Outcomes

After following 6,000 adolescents for 24 months, the study showed a significant increase in contraceptive use among sexually active CyberRwanda participants, with 63% reporting use compared to 53% in the control group. While there were not significant changes in contraceptive use across the entire intervention sample, there were notable improvements among CyberRwanda participants in other outcomes that can have long-term effects on reproductive health, including family planning knowledge, attitudes, confidence to seek care, and behaviors. The study also compared two models of CyberRwanda — one that offered the digital platform alone and another that integrated peer-led club sessions. The study found that participants who had access to the peer-led club sessions had better outcomes than those who had access to the digital platform alone, indicating that the in-person component of the intervention provides an added value to CyberRwanda.

The Power of Youth-Led Innovation

“Through this groundbreaking study, YLabs and UC Berkeley have rigorously shown the power of youth-led innovation in catalyzing positive change. By equipping young people to drive the design and implementation as well as participate in the evaluation of the platform, CyberRwanda has become a trailblazer in redefining healthcare delivery for the digital age,” said Dr. Chinwe Effiong, CEO of YLabs.

Increasing Access to Critical Services

“We found that CyberRwanda participants who reported being sexually active had significantly higher contraceptive use than control participants. This is important because we know that adolescents in Rwanda lack access to critical family planning and reproductive health services and experience high rates of adolescent pregnancy and this shows us that CyberRwanda has the potential to increase access to these services,” said Dr. Rebecca Hémono, an epidemiology postdoctoral scholar at UC Berkeley School of Public Health.

A Collaborative Approach

“Our multi-year, multidisciplinary collaboration—bringing together designers, implementers, community partners, youth leaders, and scientists—demonstrates best practices in policy-relevant, community-engaged research to benefit young people. By rigorously exploring whether CyberRwanda works, why it works, under what conditions it succeeds, and opportunities for improvement, we have created a roadmap for future CyberRwanda enhancements and expansion,” said Dr. Sandi McCoy, professor of epidemiology at UC Berkeley School of Public Health and evaluation lead.

The Importance of Digital Health Platforms

Across cultures and contexts, young people struggle to access accurate, confidential information on sexual and reproductive health. According to a 2023 study conducted by YLabs, which surveyed over 12,000 youth globally aged 15–24, one in four reported never having received any form of sex education. Additional studies on CyberRwanda further demonstrate that young people often face stigma, shame, or even criminalization when seeking access to contraception or HIV testing and services. Digital health platforms like CyberRwanda offer a new, safe, and private way for youth to learn about and be connected to the care they need to prevent unplanned pregnancy and HIV/STI infection. In a region where an unintended pregnancy can abruptly end a young person’s education, timely and accurate care is crucial—CyberRwanda bridges the gap by linking young people to essential care and providing them with the knowledge they need.

Expanding Impact

Poised for national expansion, USAID-funded CyberRwanda aims to reach 100,000 adolescents by the end of 2024, with a goal to reach more than 300,000 young people by 2025. The platform’s success in Rwanda serves as a blueprint for similar initiatives globally, as YLabs is replicating this model in other regions, from the U.S. to Tanzania. As one of the first digital platforms in sub-Saharan Africa to be rigorously studied on a large-scale and shown to improve some of young people’s reproductive health knowledge and behaviors, CyberRwanda stands as a potential game changer for this young and increasingly online generation—the largest in Africa’s history.

SDGs, Targets, and Indicators Analysis:

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being
• SDG 4: Quality Education
• SDG 5: Gender Equality
• SDG 10: Reduced Inequalities
• SDG 17: Partnerships for the Goals

The article addresses the issues of adolescent sexual and reproductive health, access to healthcare, and the importance of youth-led initiatives. These issues are connected to the Sustainable Development Goals (SDGs) mentioned above.

2. What specific targets under those SDGs can be identified based on the article’s content?

• SDG 3.7: By 2030, ensure universal access to sexual and reproductive healthcare services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs.
• SDG 4.7: By 2030, ensure that all learners acquire the knowledge and skills needed to promote sustainable development, including, among others, through education for sustainable development and sustainable lifestyles, human rights, gender equality, promotion of a culture of peace and non-violence, global citizenship, and appreciation of cultural diversity and of culture’s contribution to sustainable development.
• SDG 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Program of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.
• SDG 10.2: By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion, or economic or other status.
• SDG 17.17: Encourage and promote effective public, public-private, and civil society partnerships, building on the experience and resourcing strategies of partnerships.

The article’s content aligns with these specific targets under the SDGs, as it discusses the need for universal access to sexual and reproductive healthcare services, education for sustainable development, gender equality, social inclusion, and partnerships for achieving these goals.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Contraceptive use among sexually active adolescents
• Family planning knowledge, attitudes, confidence to seek care, and behaviors
• Increased access to critical family planning and reproductive health services
• Improved reproductive health knowledge and behaviors

The article mentions indicators that can be used to measure progress towards the identified targets. These indicators include contraceptive use among sexually active adolescents, family planning knowledge, attitudes, confidence to seek care, behaviors, and increased access to critical family planning and reproductive health services.

SDGs, Targets, and Indicators Table:

Source: publichealth.berkeley.edu