Overview #
Promoting family planning via the mAYLA project among vulnerable groups in Lebanon evaluates a co-created Telegram chatbot designed to improve family planning knowledge, attitudes and communication among Syrian refugees and low-income Lebanese women. The research shows how low-cost, private digital tools can reduce barriers to health information and support behaviour change.
Abstract #
Background #
Access to family planning services remains a significant challenge for vulnerable populations in Lebanon, including Syrian refugees and low-income Lebanese women, due to persistent barriers such as cost, stigma, and limited health infrastructure. Digital health solutions offer a scalable, low-cost way to support health behaviour change, especially when grounded in social marketing principles. The mAYLA project aimed to co-create, implement, and evaluate a mobile chatbot intervention to enhance knowledge, attitudes, and communication about family planning.
Methods #
Following the Co-create–Build–Engage (CBE) framework, the intervention was based on literature reviews, expert consultations, and stakeholder workshops. The research team used a Telegram-based chatbot because of its privacy features, low data requirements, and ability to deliver automated, interactive messages. The chatbot sent 42 messages over a month (2-3 messages/week). The messages, delivered in Arabic, covered various family planning topics in text and audio formats, with personalisation options (timing and voice) and feedback mechanisms.
The intervention was piloted in 15 public primary healthcare centres (PHCs) across Lebanon. PHCs were randomly allocated to an intervention or comparison arm. 975 women aged 18–49 were recruited, of whom 607 completed baseline and endline surveys. Telegram usage data was merged with survey data. The primary outcomes were changes in family planning knowledge, attitudes, and self-reported behaviours.
Results #
Of the 277 women in the intervention group with complete evaluation data. 37.5% engaged with the chatbot by reading at least one message. Despite modest engagement, satisfaction among users was high: over 90% reported the messages were clear and increased their knowledge, and more than 80% reported improved attitudes towards family planning. DID analysis showed a significant improvement in attitudes (0.56 standard deviation increase) among the intervention group, but no significant changes in knowledge or behavioural outcomes.
The mAYLA chatbot demonstrated that digital health tools, developed through participatory and context-sensitive processes, can shift attitudes and support family planning communication in fragile settings. Key strengths included audio message delivery, personalisation, and content clarity. Barriers such as digital literacy, limited connectivity, and shared phone access constrained broader engagement.
Access #
Marco Bardus – University of Birmingham (marco.bardus@gmail.com)
Location #
Lebanon, WSMC conference 2025
Key words #
Family planning, vulnerable populations, Chatbot, mHealth, mAYLA
