Effect of a digital intervention on sexual and reproductive health knowledge, behaviour, and service uptake among university youths in Lagos, Nigeria: a quasi-experimental study.
Chima-Oduko A & Odeyemi K • Reproductive health • 2025
An mHealth comprehensive sexuality education intervention improved SRH knowledge, increased condom use, and enhanced utilisation of SRH services among university students in Lagos, Nigeria, though its effect on risky sexual behaviours was mixed.
Key Findings
Results
SRH knowledge improved more in the intervention group than the control group following the digital intervention.
At baseline, 57.7% of the intervention group and 49.7% of the control group had good SRH knowledge (p = 0.05).
Post-intervention, SRH knowledge improved by 10.2% in the intervention group compared with 2.6% in the control group.
The intervention consisted of weekly live CSE webinars via Google Meets, peer-led WhatsApp discussions, and digital linkages to youth-friendly SRH services.
Data analysis included baseline and end-line comparisons via Pearson chi-square tests and difference-in-differences (DID) analysis.
Results
Condom use during the last sexual encounter increased significantly in the intervention group but decreased in the control group.
Condom use during the last sexual encounter increased by 11.7% in the intervention group (from 32.5% to 44.2%, p < 0.05).
Condom use decreased by 7.5% in the control group over the same period.
At baseline, consistent condom use was low overall: 23.6% in the intervention group and 28.8% in the control group.
At baseline, 41.0% of the intervention group and 37.0% of the control group had ever had sex.
Results
Uptake of SRH services increased significantly in the intervention group following the digital intervention.
SRH service uptake in the intervention group rose by 9%, from 26.0% to 35.0% (p < 0.05).
At baseline, only 26.0% of the intervention group and 23.3% of the control group had access to SRH services.
Post-intervention increases included increased use of teaching hospitals and primary health care centres (PHCs).
Digital linkages to youth-friendly SRH services were a component of the intervention.
Results
Sexual behaviour outcomes were mixed, with some risky sexual behaviour indicators worsening post-intervention.
Some indicators, such as multiple sexual partners, worsened following the intervention.
The abstract describes sexual behaviour outcomes as 'mixed, with some indicators (e.g., multiple sexual partners) worsening post-intervention.'
The authors concluded that the intervention's effect on risky sexual behaviours was mixed.
For greater effectiveness, the authors recommend that digital CSE be integrated with broader SRH services.
Methods
The study was a quasi-experimental design conducted among 600 undergraduate students at two public universities in Lagos, Nigeria.
300 students were assigned to the intervention group and 300 to the control group.
Participants were selected via multistage sampling from two public universities in Lagos, Nigeria.
Quantitative data were collected through self-administered digital questionnaires before and after the intervention.
Youths in sub-Saharan Africa face barriers including limited awareness, confidentiality concerns, restrictive policies, and provider attitudes that contribute to poor SRH knowledge and high rates of HIV infection, unintended pregnancies, and unsafe sexual practices.
What This Means
This research tested whether a digital sexual and reproductive health (SRH) education program could improve knowledge, behavior, and use of health services among university students in Lagos, Nigeria. The program included weekly online seminars via Google Meet, peer-led discussions on WhatsApp, and links to youth-friendly health services. Researchers compared 300 students who received the program with 300 students who did not, measuring outcomes before and after the intervention.
The study found that students who participated in the digital program showed greater improvements in SRH knowledge (10.2% increase versus 2.6% in the comparison group), were significantly more likely to use condoms during their most recent sexual encounter (an 11.7% increase compared to a 7.5% decrease in the comparison group), and were more likely to use SRH services such as hospitals and primary health care centers (a 9% increase). These results suggest that delivering sexual health education through accessible digital platforms like WhatsApp and video conferencing can meaningfully improve some important health outcomes for young people who might otherwise face barriers to accessing this information.
However, not all outcomes improved — some risky sexual behaviors, such as having multiple sexual partners, actually worsened after the intervention among program participants. This suggests that while digital education tools are promising, they may not be sufficient on their own to change all aspects of sexual behavior. The researchers concluded that digital comprehensive sexuality education programs should be combined with broader, in-person health services and support systems to be most effective for university-aged young people in similar settings.
Chima-Oduko A, Odeyemi K. (2025). Effect of a digital intervention on sexual and reproductive health knowledge, behaviour, and service uptake among university youths in Lagos, Nigeria: a quasi-experimental study.. Reproductive health. https://doi.org/10.1186/s12978-025-02201-z