As the global fight for reproductive rights intensifies, teenagers around the world face barriers to accessing sexual and reproductive health care, but new research suggests that a youth-led platform in Rwanda could help change that.
CyberRwanda, a digital platform created by YLabs to improve adolescent sexual health, was recently evaluated by researchers at the University of California, Berkeley School of Public Health to examine its impact on secondary school adolescents through a randomized controlled trial. Published this week in Nature Medicine, one of the largest studies of its kind on adolescent sexual health in Africa, found that sexually active Rwandan adolescents ages 12-19 who accessed CyberRwanda at school had significantly higher contraceptive use compared to participants in control schools.
Breaking away from traditional top-down approaches, Cyber Rwanda's initiative engaged over 1,000 Rwandan youth. Youth were involved at every stage, from design to implementation to monitoring and evaluation. In an industry where participation by end users, especially youth, is often nominal, Cyber Rwanda strives to ensure the platform is responsive to their lived experiences, while addressing the real health and wellness needs of Rwandan youth.
A 24-month follow-up of 6,000 adolescents revealed a significant increase in contraceptive use among sexually active Cyber Rwanda participants, with 63% reporting use compared to 53% in the control group. While no significant changes in contraceptive use were observed in the overall intervention sample, other outcomes that may have long-term implications on reproductive health, including family planning knowledge, attitudes, health care-seeking confidence, and behaviors, showed notable improvements among Cyber Rwanda participants. The study also compared two models of Cyber Rwanda: one that only offered a digital platform and one that integrated peer-led club sessions. The study found that participants who had access to peer-led club sessions had better outcomes than those who only had access to the digital platform, indicating that the face-to-face component of the intervention provides added value to Cyber Rwanda.
“Through this groundbreaking research, YLabs and UC Berkeley have rigorously demonstrated the power that youth-led innovation has to drive positive change. By enabling young people to drive the design and implementation and participate in the evaluation of the platform, Cyber Rwanda has become a pioneer in redefining healthcare delivery for the digital age,” said Dr. Chinwe Effiong, CEO of YLabs.
“We found that Cyber Rwanda participants who reported being sexually active were significantly more likely to use contraception than control participants. This is important because we know that young people in Rwanda lack access to important family planning and reproductive health services and have high rates of adolescent pregnancy. This suggests that Cyber Rwanda has the potential to improve access to these services,” said Dr. Rebecca Hemono, Postdoctoral Research Fellow in Epidemiology at the University of California, Berkeley's School of Public Health.
“This multi-year, multi-disciplinary collaboration bringing together designers, implementers, community partners, youth leaders, and scientists demonstrates best practices for policy-relevant, community-participatory research that benefits young people. By thoroughly exploring whether and why Cyber Rwanda works, under what conditions it succeeds, and where there is room for improvement, we have created a roadmap for strengthening and expanding Cyber Rwanda in the future,” said evaluation leader Dr. Sandy McCoy, Professor of Epidemiology at the University of California, Berkeley School of Public Health.
Across cultures and contexts, young people struggle to access accurate, sensitive information about sexual and reproductive health. A 2023 study by YLabs surveyed more than 12,000 young people ages 15-24 around the world, finding that one in four reported never receiving any sex education. Additional research on Cyber Rwanda further shows that young people are often treated with stigma, shame, and even criminalization when they seek access to contraception or HIV testing and services. Digital health platforms like Cyber Rwanda offer new, safe, and private ways for young people to learn about and receive the care they need to prevent unplanned pregnancy and HIV/STI transmission. Timely, accurate care is essential in places where unintended pregnancy can bring an abrupt end to a young person's education. Cyber Rwanda is filling this gap by connecting young people to basic care and providing them with the knowledge they need.
Ready for national expansion, the USAID-funded Cyber Rwanda aims to reach 100,000 young people by the end of 2024 and 300,000 more by 2025. The platform's success in Rwanda has served as a blueprint for similar efforts around the world, with YLabs replicating the model in other locations, from the United States to Tanzania. As one of the first digital platforms to be rigorously studied at scale in sub-Saharan Africa and shown to improve some of adolescents' reproductive health knowledge and behaviors, Cyber Rwanda has the potential to be a game-changer for this increasingly online young generation, the largest in African history.
