Khetha: Giving young people choices over their sexual health

By
SAMU
for on 05/08/2019

MSF and Aviro Health recently launched Khetha, an innovative web platform made for young people with their close involvement. MSF’s eHealth Activities Manager Damian Hacking explains what Khetha is and why young people need new ways of receiving health information, including on HIV testing.

What is Khetha?
Khetha is a web app specifically designed for young people to make HIV education easy-to-understand, accessible and connected to the realities of youth today. The web application – which was developed through a partnership between MSF and Aviro Health - also guides users through the HIV testing process, giving young people more choices over how they manage their health.

‘Khetha’ means ‘choice’ in isiXhosa, one of the most widely spoken languages in South Africa, as the app aims to give young people more autonomy to choose how they manage their own health.  The decision to take an HIV test, to practice safe pleasurable sex, to take PrEP or get circumcised are all choices facing young people, yet they often feel under-prepared or uninformed to make these decisions. Khetha seeks to empower youth by giving them the choice to make their own decisions.

Khetha
The young cast members from the Khetha videos, which were scripted with close youth involvement  © Musaed Abrahams

Why is Khetha aimed at young people?
Young people face some of the highest risks of contracting HIV, and have very low rates of HIV testing. In a 2016 UNAIDS study of 19 low and middle income countries, only 50% of youth 15-19 years had ever tested for HIV. Of those who had tested, less than 12% had tested in the last 12 months.

Aviro and MSF have been working in the space of young people and HIV testing for some time as they have seen the real challenges young people face in receiving health services. Youth often find clinics and health staff intimidating and unapproachable, which may lead them to simply not accessing health services.

It was clear that younger, digitally savvy audiences needed more creative ways to understand the HIV testing and counseling process that were more attuned to their lived realities. Aviro had already developed HIV education animations aimed at adolescents, and drawn valuable insights through youth user workshops and their HIV self-testing app called Ithaka. MSF had also been using digital tools, like Mxit and Whatsapp to help reach young people in Western Cape and KwaZulu Natal.

MSF saw the potential for technology to bridge the gap in HIV testing and approached Aviro to work with us on creating a digital education platform for younger audiences.

How was Khetha developed?
Khetha was designed using extensive feedback from young people gathered through user design workshops with participants recruited through MSF’s youth programs in Western Cape and KwaZulu Natal.  The interactive sessions sought to understand young people’s needs and desires, their concerns with current health services, and the stigma and misconceptions around HIV affecting them.

Solutions were brainstormed in follow-up workshops. The themes, storylines, and scripts for the videos were developed in vernacular language during these sessions. The multimedia content was run by MSF’s medical team, and shot using young actors in Khayelitsha, Western Cape. Young people were invited to give feedback on the rough cuts, before the final versions were released.

How does the Khetha platform work?
The user simply visits www.mykhetha.co.za on any device with a web browser, and creates their own password protected profile, which asks for their age, gender, and language. Once registered, users have access to the content and videos, which are available in English, Xhosa and Zulu, with male and female versions depending on the user.  Topics like PrEP, condom use, and visiting the clinic are covered by animations and videos. There are four longer story videos using fictional stories based on real issues that young people face, like negotiating safe sex or the struggle of taking antiretrovirals daily. All the videos are also available through Aviro’s Youtube page.

Khetha also has an ‘HIV Testing Journey’ feature which aims to give young people the confidence to go to the clinic for an HIV test, and make the testing experience quicker, more efficient and adapted to them. Using step-by-step videos and infographics, the user receives all the information given during a standard pre-HIV test session with a counselor or nurse, which means they can start their HIV testing journey before entering the testing site. Users show their progress to the counselor or nurse who then performs the HIV test. The app facilitates the process for the nurse by adapting the language into youth-friendly terms and providing useful openers for challenging topics. The platform further guides users on their next steps, depending on their HIV result.

What about data costs and accessibility?
Data costs are a real issue for users, particularly in South Africa. Video file sizes have been reduced as much as possible, and while users would ideally watch the videos, all the information is also available in text. The content is also freely available to be screened on clinic televisions and other broadcast platforms.  

MSF is also piloting the Khetha platform on a data-free model at two sites in Khayelitsha. For wider implementation, a mobile provider would need to step forward and fund the data costs to make this platform more widely available for youth.

What if I want to use Khetha in my context?
All the multimedia content is available for use under a creative commons license, meaning anyone can request the videos – which are available in English, isiXhosa and isiZulu- at https://khetha.avirohealth.com/ for use in their context. Partners wishing to get the content out there, or anyone interested in using the platform, can contact us through the website (https://khetha.avirohealth.com/about/#partner).