Pretesting a two-way SMS/USSD messaging component among adolescent girls in South Africa

DETAILED SUMMARY

Importance

• Literature suggests that mobile phones offer effective communication with people across socioeconomic backgrounds. Mobile technology may provide a way to connect with and support adolescent females in South Africa within pre-existing health programming.

Objective

• To use SKILLZ Street among girls aged 11-14 years in Soweto, South Africa, to
  • empower girls to make informed, autonomous sexual choices
  • build self-esteem and self-confidence through skills development and intimate conversations with powerful female role models
  • increase access to and uptake of services, including HIV counseling/testing, HIV and sexually transmitted infection (STI) treatment, contraception and unplanned pregnancy care, and gender-based violence support

Study details

• Study design: Mixed methods study; prototype of Coach Tumi SMS/USSD platform will inform future piloting.
• Data collection tools: 10-item questionnaire; focus group discussions with coaches (n=1) and parents (n=1); participant observation.
• Participants: Adolescent girls aged 11-14 years (n=72), coaches, parents.
• Implementation setting: SKILLZ Street Holiday camp in Soweto, South Africa.
• Study period: 5 days in July 2013 (prototype informs a subsequent pilot program planned for September-December 2013).

Intervention

• SKILLZ Street builds self-esteem and informed decision-making through female coaches and connection to services. This version of the program used a Unstructured Supplementary Service Data (USSD) line, a data management application, to evaluate the effectiveness of a two-way messaging service allowing participants to continue the conversation about sexual and reproductive health between in-person coaching sessions.

Results

• 55% of participants reported owning a mobile phone.
• 68% of participants reported being “very interested” in the USSD prototype and 62% reported being “very comfortable” interacting with it.
• Coaches say the USSD model offers girls a safe space to ask private questions about their sexual reproductive health and rights outside of SKILLZ Street: “[The participants] say that [the SMS campaign] would be much more easier for them to actually ask questions…’maybe my coach isn’t here so I would do that through USSD.'”
• Coaches felt that the topics presented are consistent with key messages within the SKILLZ Street curriculum and are appropriate for girls age 11-14.

Conclusions and implications

• Results will inform delivery of a USSD line in a programmatic pilot and assessment to be carried out in six primary schools (approximately 600 participants) in Soweto, separated between control and intervention groups, beginning in September 2013.