Relationships Talk

In many parts of the world, young people lack access to accurate and understandable information on sexual and reproductive health. Myths and misconceptions are common and can lead to unnecessary anxiety, vulnerability to exploitation, and risky behaviour. 

Since 2015, WHO has been supporting the ARMADILLO project, which has been working with more than 1600 young people in Kenya and Peru to pioneer a free text message service that offers confidential, straight-talking advice on relationships and sexual health.

Incorporating fast facts and quizzes, the message content covers topics on ‘love and life’ ranging from contraception to sexually transmitted infections, drugs and alcohol, youth rights, puberty, dating, relationships and self-esteem.

“Youth-friendly services aim to make facility-based healthcare more attractive and accessible for young people. But we also need to reach young people where they are, outside of the facilities,” explains Lianne Gonsalves, who has been managing the project at WHO. “Today, that has to include technology.”

“The appeal of using mobiles for sexual health education is clear,” she adds. You don’t need to have an awkward conversation with an adult or find time to go to the clinic; it is low-cost and discrete – providing immediate info at the click of a button.

The next step, however, is to assess how well such information is understood and retained by youth who use it, and crucially, if it impacts on their knowledge and attitudes in key health areas such as contraceptive use.

Developing youth-friendly health content

A partnership between WHO, Kenya’s International Centre for Reproductive Health (ICRH-K) in Mombasa and the Universidad Peruana Cayetano Heredia in Lima, ARMADILLO targets adolescents and youth who own their own phone, aged between 18 and 24 in Kenya and 13 and 17 in Peru.

Once they sign up, the young people receive a series of different text messages over several weeks in their chosen language. One week, the topic might be relationships – they can choose to receive content on friendship, dating, infatuation, love, communication and self-esteem; the next, they might receive messages on contraception, such as information on different contraceptive types.

In designing the messages, the teams talked to groups of young Kenyans and Peruvians to get inputs on their ideas and concerns, and topics on which they wanted to know more.

^{The ARMADILLO platform provided confidential information relating to relationships and sexual health. Photo: ICRH-K/ J Mwaisaka}

“While they told us they wanted info on sexual health, they were also keen to get advice on dating and relationships,” says Jefferson  Mwaisaka from ICRH-K, who helped coordinate the ARMADILLO study in Kenya.

“For us, it was important to include this, as part of a broader conversation around decision making – knowing how to respect yourself and others, and becoming sexually healthy, protected and confident adults.”

The way forward

With a new global strategy for digital health under development, WHO is playing a leading role in developing evidence and guidance, monitoring trends, and spearheading innovative mobile and other digital initiatives and research into what works.

“Done well, mobile technology could be an invaluable tool for helping young people bust myths around sexual health to get the information they need, when they need it,” explains Mwaisaka. “A major benefit of ARMADILLO will be its contribution to an important, but as yet underdeveloped, evidence base on digital health.”

Results from the study will be published later in the year, with potential to expand the platform in the two countries in the future.