Healthcare in the Palm of her Hand

by Rehema Mugeta, IPC Coordinator PSI Tanzania

At age 17, I longed to have my own mobile phone.

A Tanzanian mobile service provider had just introduced a promotion to make free night time phone calls. I deeply wanted my own phone to talk to friends and relatives all night. But my parents wouldn’t buy one. For them, a mobile phone wasn’t a priority. So I got creative: I asked my sister, who had a job, to get one for me.

That first phone was a luxury, but now mobile technology is an essential part of my day-to-day life. I use it to pay bills and to shop online. When I have a question but am too afraid to ask anyone, I just Google it.

The smartphone revolution is drastically changing the lives of young African women like me. But in Tanzania, it hasn’t yet reached a group that also has questions they’re afraid to ask: adolescent girls.

There are over 43 million mobile phone owners in Tanzania—72 percent of the population. PSI’s youth-powered sexual and reproductive health project, Adolescents 360 (A360), found that while 77 percent of girls ages 15-19 use a phone, only 25 percent own their own phone. And despite the continuous growth of mobile technology in Tanzania, a large gender gap in internet use remains: 35 percent of Tanzanian men use mobile internet compared to only 17 percent of Tanzanian women, according to a 2019 Global System for Mobile Association report. A360’s study found similar results: 84 percent of Tanzanian girls reported using the internet less than once monthly.

In Tanzania, where many girls and women share a device with friends and family, discreet access to health education and information is essential. That’s why PSI Tanzania uses USSD (Unstructured Supplementary Service Data) to provide girls with information about their bodies. USSD is free and allows users to navigate through information using a menu and leaves no trace on the mobile device, unlike calls or texts. With a pre-populated list of information about sexual and reproductive health (SRH), USSD gives girls and women a discreet way to access information about their chosen contraceptive method on a shared smartphone.

PSI also uses the Connecting with Sara (CwS) platform, named for PSI’s archetypal user, to power healthcare for women by tracking and engaging with them through their mobile phones using calls, texts and social media. With her consent, the platform tracks her throughout her continuum of care— not just when she visits the clinic — sending referrals and using client satisfaction surveys. CwS isn’t just used in Tanzania; it integrates with apps in Zimbabwe, Mozambique, Kenya, Nepal and Honduras, too.

I’m 31 now. The world has changed a lot in the 15 years since I got my first mobile phone. We must continue to explore the possibilities of digital technology as more women gain access to mobile technology. With programs like USSD we can overcome gender and age barriers to ensure that girls, no matter where they are, have access to the health information they need—right in the palm of their hands.

For me, that’s not a luxury. It’s a priority.


Hear more from Rehema about using technology to advance adolescents’ access to SRH at the Women Deliver 2019 concurrent session, “The Global Digital Health Divide: A Debate” on Tuesday, June 4 at 3:00pm in VCC West 221-222.

This article appears in PSI’s Impact magazine, released in tandem with Women Deliver 2019, as part of an ongoing conversation about putting #PowerInHerHands.

Banner Image: ©PSI/Benjamin Schilling

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