Motivators and barriers to the uptake of digital health platforms for family planning services in Lagos, Nigeria: A mixed-methods study

Area of Science:

• Digital Health
• Family Planning Technology
• Healthcare Access

Background:

• Inadequate access to family planning (FP) services contributes to low contraceptive uptake in Nigeria.
• Digital platforms, including e-pharmacy and telemedicine, present opportunities to enhance access, privacy, and convenience for FP services.
• This study investigates the factors influencing the adoption of digital FP services by both providers and users in Lagos.

Purpose of the Study:

• To examine the factors influencing provider and user adoption of digital family planning (FP) services in Lagos, Nigeria.
• To understand the awareness and usage patterns of e-pharmacy and telemedicine for FP among different user groups.
• To identify barriers and facilitators for the uptake of digital FP solutions from both user and provider perspectives.

Main Methods:

• Employed an exploratory sequential mixed-methods design.
• Conducted 79 interviews with FP providers and users to inform a survey of 1485 digital FP platform users.
• Utilized thematic analysis for qualitative data and descriptive, bivariate, and logistic regression for quantitative data analysis.

Main Results:

• High awareness (78%) but limited usage (24%) of e-pharmacies for FP; very low awareness (30%) and usage (6%) of telemedicine.
• Online FP platform use was significantly associated with age, gender, education, marital status, and higher education levels (p < .01).
• Key provider-identified barriers included regulatory uncertainty, technological challenges, and concerns about privacy and quality assurance. Logistic regression indicated younger age (18-26) and post-secondary education predicted higher digital FP use.

Conclusions:

• E-pharmacy and telemedicine show potential to improve family planning access, particularly for younger, educated, and higher-income demographics.
• Successful adoption of digital FP services necessitates addressing both user-side barriers related to demand and provider-side concerns regarding supply.
• Targeted interventions are needed to overcome regulatory, technological, privacy, and quality assurance challenges to maximize the benefits of digital FP solutions.