JMIR Publications

ABSTRACT

Background:

Young women in Lesotho face myriad sexual and reproductive health problems. There is little time to provide health education to women in low-resource settings with critical shortages of human resources for health. This study aimed to determine the acceptability and usability of a conversational agent system, the Nthabi Health Promotion Application that was culturally adapted for use in Lesotho.

Objective:

In this paper, we report the results of a survey designed to assess the perceived usability and acceptability of the Nthabi among the first 160 young women who used the system.

Methods:

We conducted a descriptive quantitative study, using a 21-item Likert scale survey to assess the perceptions of the usability and acceptability of 160 young women aged 18–28 years in rural districts of Lesotho, who used the system on either smartphones or tablets for up to six weeks. Descriptive statistics were used to calculate the averages and frequencies of the variables. Inferential statistics, such as chi-square tests, were used to determine any associations among variables.

Results:

Overall, participants responding to the survey perceived the usability and acceptability of the system very positively. Most respondents were satisfied with Nthabi and perceived it to be effective, efficient, and culturally appropriate for delivering sensitive sexual and reproductive information. Respondents agreed that Nthabi helped them make decisions and could improve the delivery of health education. They reported it was easy to use and well organised. Most respondents intend to use it beyond the study period and they would encourage others to use the app. Younger women had slightly more positive perceptions of Nthabi.

Conclusions:

These results support further study of conversational agent systems as alternatives to traditional face-to-face provision of health education services in Lesotho, where there are critical shortages of human resources for health.