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Adolescent health and wellbeing check-ups in LMICs: Developing and evaluating digital innovations within Y-Check, Zimbabwe

Title of PhD project / theme

Adolescent health and wellbeing check-ups in LMICs: Developing and evaluating digital innovations within Y-Check, Zimbabwe

Supervisory team

LSHTM

Lead: Dr Ona McCarthy (Ona.McCarthy@lshtm.ac.uk, Faculty of Epidemiology and Population Health)
Dr. Aoife Doyle (aoife.doyle@lshtm.ac.uk)
Professor Caroline Free (Caroline.Free@lshtm.ac.uk)

Nagasaki University (Tentative)

Professor Christopher Smith (christopher.smith@lshtm.ac.uk)
Dr Miho Sato (mihos@nagasaki-u.ac.jp)
Professor Satoshi Kaneko (skaneko@nagasaki-u.ac.jp)

Brief description of project / theme

Y-Check is an innovative strategy for health check-up visits during adolescence in low and middle-income countries (LMICs). The approach is innovative and novel, because, in most low-income countries, including Zimbabwe, few adolescents have any promotive or preventive contacts with the health system. The strategy will involve the screening and treatment/referral adolescents for common conditions through health check-up visits in younger (10-13y) and older (16-19y) adolescents. Adolescents will only be screened for conditions with an accurate and acceptable test and a locally accessible effective intervention e.g. mental health, HIV, vision and hearing, anaemia. The effectiveness and cost-effectiveness of the intervention will be evaluated through a prospective intervention study in communities and schools in Chitungwiza, Zimbabwe through a UKRI-funded 4-year Future Leaders Fellowship to Aoife Doyle (Feb 2021- Jan 2025) with additional funding from Fondation Botnar (2022-24).

The proposed PhD project will focus on the development, implementation, and evaluation of two digital components to improve the efficiency and impact of the intervention.

Improving adolescent health and well-being will contribute to achievement of Sustainable Development Goal 3 ‘ensure healthy lives and promote well-being for all at all ages’. Early and sustained engagement with health services could reap a triple dividend for human development by improving the health and well-being of adolescents, their health and well-being in adulthood and the health and well- being of their offspring.

Project objectives

  1. Review of digital referral systems used between health service providers in LMICs and select a system to adapt for use in the Y-Check intervention (Y1 Sept 22- Aug 23)
  2. Review of online digital health forums for adolescents in LMICs (Y1 Sept 22- Aug 23)
  3. Adapt, implement, and pilot test a digital system for supporting and tracking referrals from Y-Check to accredited service providers (Y2, Sept 23- Aug 24)
  4. Adapt, implement and pilot test a digital health club for adolescents who participated in the Y-Check intervention to facilitate sustained engagement with health information and services (Y2, Sept 23- Aug 24)

Techniques to be used 

  1. Intervention design using participatory co-design methodologies and youth engagement
  2. Digital intervention adaptation to new context and/or population
  3. Implementation and evaluation of interventions

References

McCarthy, Ona L; Wazwaz, Ola; Osorio Calderon, Veronica; Jado, Iman; Saibov, Salokhiddin; Stavridis, Amina; López Gallardo, Jhonny; Tokhirov, Ravshan; Adada, Samia; Huaynoca, Silvia; +4 more... (2018) Development of an intervention delivered by mobile phone aimed at decreasing unintended pregnancy among young people in three lower middle income countries. BMC public health, 18 (1). 576-. ISSN 1471-2458 DOI: https://doi.org/10.1186/s12889-018-5477-7

Chingono et al Designing Routine Health Checkups for Adolescents in Zimbabwe J Adolesc Health. 2021 Aug 3:S1054-139X(21)00342-6. doi: 10.1016/j.jadohealth.2021.07.002. Epub ahead of print. PMID: 34362647.

Doyle AM et al Mobile Phone Access and Implications for Digital Health Interventions Among Adolescents and Young Adults in Zimbabwe: Cross-Sectional Survey. JMIR Mhealth Uhealth. 2021 Jan 13;9(1):e21244. doi: 10.2196/21244. PMID: 33439136; PMCID: PMC7840276

Doyle AM et al Primary healthcare and school health service utilisation by adolescents and young adults in KwaZulu-Natal, South Africa. BMC Health Serv Res 19, 905 (2019) doi:10.1186/s12913-019-4559-2

Berendes, Sima; Gubijev, Anasztazia; McCarthy, Ona L; Palmer, Melissa J; Wilson, Emma; Free, Caroline; (2021) Sexual health interventions delivered to participants by mobile technology: a systematic review and meta-analysis of randomised controlled trials. Sexually Transmitted Infections, 97 (3). pp. 190-200. ISSN 1368-4973 DOI: https://doi.org/10.1136/sextrans-2020-054853

Smith,C et al; (2015) Mobile phone-based interventions for improving contraception use. The Cochrane database of systematic reviews, 6 (6). CD011159-. ISSN 1469-493X DOI: https://doi.org/10.1002/14651858.CD011159.pub2

The role of LSHTM and NU in this collaborative project

This PhD project will build a new global health collaboration between McCarthy, Doyle and Free at LSHTM and Smith, Sato and Kaneko at NU. McCarthy and Free are experts in the development and evaluation of digital health interventions for adolescents. Doyle is leading the Y-Check project in Zimbabwe and will provide support and training for the student in the areas of adolescent health and youth engagement. Smith and Kaneko have extensive experience leading digital innovations for data collection and health systems in Kenya and will advise on the Y-Check digital innovations. Sato is an expert in health systems in LMICs and will advise on the design of the interventions so that they are appropriate for the health system and meet the needs of health workers. Smith works jointly across LSHTM and NU. He will advise on digital components drawing on his expertise in developing and evaluating mobile health interventions in the UK and Cambodia. This new collaboration will bring together LSHTM and NU expertise in digital innovations and health systems to improve the efficiency and impact of health promotion and healthcare services.

Particular prior educational requirements for a student undertaking this project

MSc in Public Health, Epidemiology, or other relevant discipline

Skills we expect a student to develop/acquire whilst pursuing this project

  • Digital health
  • Implementation science
  • Evaluation of complex interventions
  • Multidisciplinary collaborations
  • Multicultural collaborations
  • Youth Engagement