Digital health education needs for women with urinary incontinence in Kigali Rwanda, a phenomenological qualitative study.

Abstract

Urinary incontinence (UI), an involuntary loss of urine, is a widespread pelvic floor disorder affecting 20-50% of women worldwide, with a 21% prevalence in Sub-Saharan Africa. Contributing factors include genetics, childbirth, and chronic conditions, leading to significant physical, social, and emotional challenges such as fear of leakage and isolation. Despite its impact, many affected women lack awareness of UI and available treatments, which include medication, surgery, and pelvic floor muscle training (PFMT). Knowledge gaps and misconceptions persist, hindering timely diagnosis and management. In response to these challenges, healthcare systems in Africa are adopting digital technologies (DTs), including WhatsApp and social media, to facilitate patient education and professional collaboration. Studies indicate that digital platforms can support women in managing UI, particularly through PFMT. However, little is known about women's digital health education needs, barriers, and platform preferences. This study explored these aspects among women with UI in Kigali through a phenomenological qualitative approach across four hospitals: Masaka, Rwanda Military, Kibagabaga, and King Faisal. Using purposive sampling, 20 women aged 20-70 were selected. Data analysis was conducted through thematic analysis using deductive and inductive coding. The findings revealed four key themes. First, there are significant knowledge gaps about UI, necessitating multimodal education to address misinformation and misconceptions. Second, participants regularly use digital devices and the internet, recognizing their benefits and affordability for accessing health information. Third, barriers to digital health education included distrust in the accuracy of online information and financial constraints in maintaining digital devices and internet services. Lastly, participants expressed a strong interest in multimodal digital health education platforms to receive UI-related information. Many women misunderstood UI, often confusing it with aging or other conditions, leading to delayed diagnosis, emotional distress, social withdrawal, financial strain, and reduced quality of life. Although digitally literate, they rarely sought digital health information on UI due to knowledge gaps, financial limitations, and skepticism about online sources. The study underscores the urgent need for accessible and trustworthy digital health education to bridge knowledge gaps, provide support, and enhance UI management among affected women.