Digital Health Education Needs for Women with Urinary Incontinence in Kigali , Rwanda

Background:
Urinary incontinence (UI), characterized by involuntary urine release, is a prevalent pelvic floor disorder affecting 20-30% of young, 30-40% of middle-aged, and up to 50% of older women globally, with a 21% prevalence in Sub-Saharan Africa. Contributors to UI include genetic factors, childbirth, and chronic conditions, leading to daily challenges such as leakage fears and social isolation. Despite its high impact, many affected women lack awareness of UI and available treatments, and significant knowledge gaps exist coupled with misconceptions among affected women. Treatment options include medication, surgery, and pelvic floor muscle training (PFMT). Across Africa, healthcare systems are enhancing governance frameworks and adopting digital solutions like WhatsApp and social media for professional collaboration, patient support, and health guideline dissemination. A scoping review demonstrates that women experiencing UI can effectively manage symptoms through digital technologies (DTs), particularly for PFMT.

Aim:
This study investigated the digital health educational needs, facilitators and barriers, and preferred digital health platforms for women with UI in Kigali.

Method:
It was a phenomenological qualitative study conducted across four hospitals in Kigali; Masaka Hospital, Rwanda Military Hospital, Kibagabaga Hospital, and King Faisal Hospital. IRB approvals were sought from the four hospitals and UGHE (Ref: UGHE-IRB/2024/295). Purposive sampling was used to select 20 women aged 20 to 70. Deductive and inductive coding were used, and the data was analyzed by thematic analysis.

Result:
The analysis identified four key themes: first, there are significant knowledge gaps about UI that necessitate multimodal education to address misinformation, misconceptions, and myths. Second, participants regularly use digital devices and the internet, appreciating their value, benefits, and affordability for accessing digital health information. Third, women with UI face barriers to digital health education due to distrust in the accuracy of online information and financial constraints in maintaining digital devices and internet services. Lastly, women with UI expressed a strong interest in receiving information through multimodal digital health education platforms.

Conclusion:
Many women misunderstood UI, confusing it with other conditions or believing it to be a normal part of aging, leading to delayed diagnosis, and treatment, and increased feelings of embarrassment and isolation. UI severely impacted their quality of life, causing social withdrawal, limited physical activities, financial strain, and emotional distress. Despite being digitally literate, they rarely sought digital health information about UI due to a lack of knowledge and limited understanding, financial constraints, and distrust of online sources. This study emphasized the need for accessible, trustworthy digital health education to bridge the knowledge gap, providing necessary information and support