Type of studies: We will include all published observational studies to investigate the usage of digital media by adolescents in sub-Saharan Africa for SRHR purposes. In addition to these, qualitative studies that explore the study interests will be included. However, reviews, comments, randomized control trials, clinical trials and case studies will be excluded.
Type of Participants: The participants for this study are adolescents (10 – 24 years). According to the World Health Organization (2014), the age category for individuals who are considered adolescents is 10 – 19 years. However, in this review we will extend this to those aged 20 – 24 years since some individuals experience late adolescence (Sawyer, Azzopardi, Wickremarathne, & Patton, 2018) and have similar SRHR experiences as those in the 10 – 19-year age group (Curtis, 2015).
Setting: We will include studies that have been conducted in countries in sub-Saharan Africa. These countries include Angola, Benin, Botswana, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Cote d'Ivoire, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mauritius, Mozambique, Namibia, Niger, Nigeria, Rwanda, Senegal, Sierra Leone, Somalia, South Africa, United Republic of Tanzania, Togo, Uganda, Zaire, Zambia and Zimbabwe.
Type of exposure: Only studies that report on the use of digital media will be included. Digital media encompasses social networking sites (social media), podcasts, vodcasts, and text messaging. Studies to be included must link the use of digital media to sexual and reproductive health and rights issues.
Information sources: A search for published peer-reviewed articles on digital media and its use for SRHR by adolescents in Sub-Saharan Africa will be performed in the following databases: PubMed, ScienceDirect, Scopus, EMBASE, PsychINFO, Web of Science, and Google Scholar. Studies will be included if they were published from 2000 to 2021. Search strategies that employ medical subject headings (MeSH) will be used in identifying studies to be included. The reference list of included studies will be screened to identify additional potential studies that might be useful. We will also contact experts in the field for additional peer-reviewed documents that will be essential for this review. Only studies published in English will be considered since all authors are proficient in this language.
Search strategy: Specific search strategies will be developed by two authors, and afterwards, a Librarian at the University of Cape Coast Library Services will be consulted for confirmation. This will further be reviewed by the remaining authors and concluded upon. Medical subject headings pertinent to each of the databases will be used in the search. In general, the following search terms will be considered: “digital media”, “social media” , “text messaging”, “internet”, sex, sexual, reproductive, “sexual and reproductive health” “reproductive health”, “reproductive rights”, types, kinds, challenges, reasons, experiences, access, affordability, availability etc. Boolean operators such as ‘AND’ and ‘OR’ will be used to define how search terms will be combined. Search strategy that will be used in PubMed will be adapted for other databases (see Additional file 2).
Data management: Studies that will be retrieved from the database search will be managed using Mendeley. Mendeley was chosen as a reference management software for this review because authors are familiar with its use. Furthermore, it has in-built tools that facilitate effective collaboration among reviewers on decisions to include or exclude articles. Justification for excluding studies will be provided by reviewers (JAA, WA, GT) and later discussed to be approved by the group. To ensure consistency, the reviewers will be guided by the eligibility criteria stated above to facilitate the selection process, and calibration will be carried out before starting our review.
Selection process: At least, three review authors (JAA, WA, GT) will independently screen titles and abstracts against the inclusion criteria. Full reports of all titles that meet the inclusion criteria will be obtained. Where there are uncertainties, an additional reviewer (KE) will arbitrate and drive a discussion to arrive at desired conclusions.
Data collection and items: A standardized data extraction form will be designed to collect the needed information from included articles. Two reviewers (APA, VBB) will spearhead the data collection process. Information to be included are: article information (authors, date, title, journal, publisher, funding etc.), population characteristics (age groups of participants, sex), study setting, study design, type of digital media, SRHR issues, reasons for using digital media, challenges, projects and any other useful information. Any dissensions will be addressed by a third party (KE).
Outcomes: In this review, we aim at addressing five main issues with regard to the use of digital media by adolescents in Sub-Saharan Africa. They include (1) types of digital media that adolescents use for SRHR communication (2) reasons for using digital media; (3) specific SRHR issues that adolescents use digital media to access (4) the limitations associated with using digital media and (5) their experience with accessing digital media; specifically, availability and affordability.
The quality of included studies will be assessed using standardized checklist tools designed by the Joanna Briggs Institute (JBI). They can be accessed at https://jbi.global/critical-appraisal-tools. JBI has thirteen different study-specific checklists to assess their methodological quality such as the design, conduct and analysis of respective studies. The JBI checklists will be chosen because they are standardized and suitable for the appraisal and assessment of most types of studies (Ma, et al., 2020). For this review, five checklists will be explored - checklists for analytical cross-sectional studies, case control studies, cohort, prevalence and qualitative studies. Generally, the areas that are covered in the checklists for quality appraisal include sampling, measurement of exposure and outcomes, completeness, and aptness of statistical analysis (Lockwood, Munn, & Porritt, 2015; Munn, Moala, Riitano, & Tufanaru, 2015; Moala, et al., 2020). The quality assessment will be done by four reviewers (JAA, KE, APA, GT)
Both descriptive and narrative summaries will be used to appraise evidence from the sampled studies. We will provide frequencies of the types of digital media adolescents in sub-Saharan Africa use as well as the SRHR issues they use these media to access. We will use graphs and tables to illustrate our descriptive results. For the narrative summary, we will adopt a thematic analysis approach to identify similar and contrasting themes that run across the included studies (Snilstveit, Oliver, & Vojtkova, 2012; Baxter , Killoran, & Goyder, Public Health). Findings from this review will centre around four main themes: types of digital media, reasons for using digital media to access SRHR issues; specific SRHR issues, limitations associated with using digital media and accessibility (e.g. affordability and availability) associated with digital media use. All authors will be involved in the data synthesis of included papers.