Improving adolescent sexual and reproductive health through digital health in Jimma, Ethiopia: a quasi–experimental study

BACKGROUND: Investing in adolescents' sexual and reproductive health (SRH) yields great benefits, as this period marks a crucial transition from childhood to adulthood. Many young people face SRH challenges due to limited knowledge and inability to make informed decisions about their sexual and reproductive health rights (SRHR). This study aimed to assess the effectiveness of digital health interventions in improving SRH among school adolescents and youths in Jimma, Ethiopia. METHODS: A quasi-experimental design was employed and data were collected from school youths. Analysis was conducted using EpiData version 4.6 and Stata version 17.0. Propensity score matching was applied to estimate average treatment effects and sensitivity analysis was conducted using a difference-in-differences approach. RESULTS: There was a significant improvement in SRH outcomes between baseline and the end line. Knowledge of SRHR increased by 26.8 percentage points (95% confidence interval [CI] 14.5 to 38.6), knowledge of SRH by 11.5 percentage points (95% CI 1.7 to 21.4) and positive attitudes toward SRHR by 27.4 percentage points (95% CI 17.5 to 37.3) following the digital intervention. CONCLUSIONS: The digital health intervention significantly enhanced knowledge and attitudes related to SRHR among school adolescents. Further studies should explore whether improvements in knowledge and attitudes translate into longer-term reproductive health outcomes, such as contraceptive uptake, teenage pregnancy and unmet need for family planning.