Social Media and Technology Use

Abstract

The use of social media is an under-studied topic with huge potential to affect healthcare. It can improve access to healthcare by minimizing the need to travel a long distance for costly hospital visits. This chapter reviews the coverage of mobile phones, the internet, the use of social media, and the opportunities, such as virtual meetings and online information portals, it may provide to the healthcare system in the future.

Geographic disparity in the allocation of healthcare resources can be identified in many African countries. Rural communities across the continent typically have restricted access to fewer resources. Not only are these regions faced with a limited supply of medical facilities, services, and healthcare professionals, but they are also more likely to be at a social, educational, and financial disadvantage. In addition, resources are unevenly distributed between urban and rural areas. Members of rural communities often have to travel long distances to urban areas to seek medical treatment or assistance. In addition, poverty and education levels may also affect patients' ability to access, communicate, and understand medical information. Given all the barriers and inequalities in real life, the internet and social media serve as critical alternative avenues for people to access basic healthcare services regardless of their physical location. A survey conducted by the Pew Research Center in 2017 indicated that 41% of respondents in sub-Saharan Africa used the Internet to access health and medical information. The percentage of online engagement is significant and demonstrates the enormous potential of online platforms in providing equitable access to information and ease of communication. Hence, understanding Internet use can tremendously benefit the development of telemedicine and health monitoring applications in Africa.

This chapter explores the most recent data on internet coverage, mobile phone use coverage, and social media coverage. It also reviews the specific social media platforms people use for work, school, social connections, and healthcare services. The impact of COVID-19 on the use of the internet is also examined briefly. A discussion of the possible opportunities of using digital platforms and media in the healthcare field is also concluded in the end.

6.1 Internet and Social Media Coverage

Internet and social media use has grown vigorously in Africa. Between 2008 and 2012, internet bandwidth availability has grown 20-fold. By the end of 2015, 46% of the overall population in Africa had access to mobile services. However, only 22% of the population has access to the internet (World Bank, 2017). North Africa has the highest internet penetration at 56%, followed by South Africa at 45%, Western Africa at 16%, Eastern Africa at 10%, and Central Africa at 8% (Statistia, 2022). However, Nigeria has the highest number of internet users (109.2 million), followed by Egypt and South Africa (Statistia, 2022). This section reviews the internet and mobile coverage and its trend in Algeria, Côte d’Ivoire, Ghana, Kenya, and Nigeria. It also explores the social media tools used by people for school, work, social connection, and healthcare.

Algeria reported 25 million social media users as of January 2021, an increase of 3 million (14%) between 2020 and 2021, which now covers 56.5% of the total population (Fig. 6.1).

Fig. 6.1

(Source Statcounter)

Social media use in Algeria.

In Côte d’Ivoire, between January 2020 to January 2021, mobile connections increased by 8.5% (2.9 million), internet users by 2.5% (0.31 million), and active social media users by 20.4% (1.0 million). Total internet users reached 12.50 million, or 46.8% of the total population, and are expected to increase by 2.5% (0.31 million) annually. The vast majority (5.82 million or 98.6%) of internet users access the internet via mobile devices. The top three websites are Google.com, Youtube.com, and Jumia.ci, and the top four social media platforms are Facebook, Instagram, Twitter, and LinkedIn (Fig. 6.2 and Table 6.1).

Fig. 6.2

(Source Statcounter)

Social media use in Côte d’Ivoire.

Table 6.1 The number of people who can be reached with online advertising. (Data source Datareportal. Table source Fofana Daouda)

The total number of internet users in Ghana is 15.70 million, or 50% of the total population. Internet users increased by 6.4% (943,000) between 2020 and 2021. Among all the internet users, 92.3% of whom access the internet through mobile devices. The mobile device user population in 2021, was approximately 14.47 million. On average, users aged 16–64 spend 4 h and 20 min on the internet per day. The top three visited websites are Google.com, Betway.com.gh, and Youtube.com. The total number of active social media users in Ghana is 8.20 million (26.1% of the total population), which is a 36.7% increase. Eight million (98.2%) of them access social media via mobile devices (Figs. 6.3, 6.4, 6.5, 6.6, and 6.7).

Fig. 6.3

Popular social media platforms in Ghana. (Data source Datareportal)

Fig. 6.4

Social media users in Ghana. (Data source Datareportal)

Fig. 6.5

Social Media Usage over the Years in Ghana. (Data source Datareportal. Graph source Gilbert Gadzekpo)

Fig. 6.6

Most used social media platforms in Kenya. (Data source Datareportal. Graph source Beatrice Birir)

Fig. 6.7

Most popular social media platforms in Nigeria. (Data source Datareportal. Graph source Ademola Olokun)

Ghana Health Service mostly uses print media for health information dissemination (e.g. leaflets, posters, and billboards). Many people also receive information through interpersonal channels (e.g. doctors, community health workers, family, and friends). MoTech is a mobile technology for community health and telehealth that is being piloted in rural communities. In this way, social media offers effective tools for health-related messaging while the functionality of traditional media dwindles.

In Kenya, 28.2% of its population lives in urban centers, and 71.8% live in rural areas. In January 2021, 21.75 million people were recorded as internet users, with 40% internet coverage. The number of social media users increased by 25% (2.2 million) from 2020, totaling 11 million, or 20.2% of the total population. Most Kenyans access social media using mobile apps, but they increasingly use mobile browsers, which are presumed to offer more privacy than standalone mobile apps. There were 59.24 million mobile connections in Kenya in January 2021, an increase of 11% (5.9 million) from January 2020. The number of mobile connections in Kenya in January 2021 was equivalent to 108.9% of the total population, indicating that some people had more than one mobile connection.

Few Kenyans use Microsoft Teams or Zoom outside the corporate setting. However, with the COVID-19 pandemic, the use of video conferencing and web conferencing platforms has become more common (Fig. 6.7).

Nigeria has a population of 208 million people, 52% of whom live in urban areas. According to DataReportal, in 2021, 90% of Nigerians have mobile phones, 99.2% of people aged 16–64 use smartphones, and 14.6% use non-smartphones. Around 50% of the total population are internet users, and 15.8% are active social media users. The top three most used social media platforms are WhatsApp, Facebook, and YouTube. Social media use increased substantially between 2018 and 2019 and continues to grow. However, social media platforms focusing on professional development, networking, and communication, such as LinkedIn, WhatsApp, and Facebook, experienced declines in use between 2020 to 2021, whereas those focused on entertainment and videos, such as YouTube and Instagram, continue to increase (Fig. 6.8). This change may be due to the impact of COVID-19.

Fig. 6.8

The growth of social media use in Nigeria. (Data source Datareportal. Graph source Ademola Olokun)

Nigeria mainly uses uLesson, Pass.ng, Gradely.ng, Zoom, Google Meet, LinkedIn Learning, and YouTube for educational purposes. The uLesson app offers junior and senior secondary school students a holistic learning experience in mathematics, English, science, technology, business, physics, chemistry, and biology while also preparing senior school students for the West African Senior School Certificate Examination, the Joint Admissions and Matriculation Board exam, and the General Certificate of Education exam. Pass.ng is a web, desktop, and mobile examination preparatory and testing platform that helps users excel in all major Nigerian Examinations and tests. Gradely offers personalized learning resources for parents to help their children progress and succeed in school and in life. Zoom, Google Workspace, Microsoft 365, LinkedIn, Slack, and YouTube are also used for work.

Nigeria also has some unique platforms for patient-doctor and healthcare-related communication. OTRAC is an e-learning platform that provides tailored training and courses for public and general health practitioners. 247Medic is an online (subscription-based) medical care consultation and advisory service providing patients the ability to call or chat with a doctor, request onsite laboratory services, and have medications delivered. Mamalette provides first-time African parents with information on fertility, pregnancy, birth, and babies with online courses, expert advice, active online forums, live events, and other useful tools. Babymigo is a parenting community, and OMOMI provides mothers and pregnant women with lifesaving maternal and child health information while connecting them to doctors in real time. MyPaddi gives young people access to much-needed sexual and reproductive health information and products while ensuring complete anonymity.

In South Africa, the most used platform is Whatsapp, which is used to make voice calls, video calls, share media, and send messages. The five most popular social media networks in South Africa are Whatsapp, YouTube, Facebook, Facebook Messenger, and Instagram (HelloYes Marketing 2020; Fig. 6.9).

Fig. 6.9

Most popular social media platforms in South Africa. (Data source: HelloYes. Graph source: Funani Mpande)

Facebook, Twitter, Skype, Microsoft Teams, and Google Meet are used for educational purposes, and Skype, Google Meet, Microsoft Teams, LinkedIn, YouTube, Twitter, Instagram, Pinterest, Quora, Facebook, and WhatsApp are used for work purposes. People tend to use Twitter, LinkedIn, Instagram, and Facebook for medical and health-related communication.

6.2 Impact of COVID-19

The COVID-19 pandemic has boosted the use of the internet globally. During lockdowns, some governments developed their own applications and software to share COVID information, and others use existing platforms, such as Twitter. Survey data show that Kenyans, Nigerians, and South Africans got much of their news and information about COVID-19 from social media, with 47% of respondents saying that social media was a primary source of information about the coronavirus. South Africa developed a free exposure notification app called COVID Alert South Africa to let people know when they have been in close contact with someone who tested positive. Tik Tok, Twitter, and Telegram trended during the pandemic. Twitter is mostly used by the government to share information about COVID cases. Some social media platforms (e.g. TikTok, IMO, Likee, Vskit, Telegram, and Vimeo) gained significant popularity during 2020, leading to a surge in penetration and acceptance of other lesser-known social media sites and apps. Youths especially used TikTok to interact with others and complete online challenges. Telegram users increased as people grew concerned about the WhatsApp privacy policy (Fig. 6.10).

Fig. 6.10

Social media use during the coronavirus pandemic in South Africa. (Data source HelloYes. Graph source Funani Mpande)

This boost in social media usage has had some troubling outcomes, such as a rise in “fake” news containing incorrect, biased, and deliberately misleading information. As this misinformation is shared online, many people can be exposed to it. For example, misinformation around COVID-19 included inaccuracies about how the disease spreads, vaccination safety, and ineffective and dangerous “cures.” Vaccine misinformation in particular has led to fears and anti-vaccination movements promoting misperceptions and unsafe behaviors. Online harassment is also common and causes emotional distress.

6.3 Summary

The number of mobile users reached 46% by the end of 2015 in Africa. However, only 22% of the population has the access to the internet in 2018. The high coverage of mobile phones and the gap between mobile coverage and internet coverage imply that text messages may be a more suitable communication medium now. However, there is a growth in internet coverage, indicating that in the future there will be more opportunities to share information through online platforms. The COVID-19 pandemic boosted the use of online platforms and the internet in Africa. Internet users are more familiar and comfortable using online tools such as zoom and google meetings for work and school, Facebook, WhatsApp, and Twitter for social networking, and Youtube, and TikTok for videos and entertainment. A number of online healthcare platforms have also been built for providing patient-doctor communication, health-related courses, and between-patient help groups.

The use of social media remains an under-studied topic with huge potential to affect healthcare. Africa has substantial geographic disparity and inequality in the distribution of medical resources. Social media can improve accessibility to healthcare by minimizing the need to travel a long distance for costly hospital visits. Currently, the use of the internet and social media in healthcare in Africa is limited due to low coverage of the internet, and the lack of information collection systems. Information collection systems such as electronic health records are still at their initial stage. Up to this time most hospitals use hand-written paperwork to keep their patient's records, which is causing difficulties in storing patients’ information as well as transferring them to other healthcare providers. The high mobile coverage helps health providers to connect the patients regardless of the geographic distance. However, the low-literacy rate in some countries limits the method of communication further and demands that health providers connect with their patients via phone calls.

As internet and mobile coverage becomes increasingly available in Africa, it introduces more flexible forms of healthcare, such as virtual meetings and online information portals. The use of pictures and videos can make healthcare information more vivid and simple to understand. It can also increase the accessibility of low-literacy populations, which is essential in countries like Cote d’Ivoire, where the literacy rate is below 50%. Along with the growth of internet usage, the spread of fake news and misleading information, such as vaccine misinformation, will also become a concern for users.