As Ruth Nabembezi, a 25-year-old social entrepreneur, was growing up in an orphanage in Uganda, she became increasingly frustrated about the lack of sex education for African women. After losing her parent to HIV/AIDS, her sister developed severe skin rashes and died after being taken to a witch doctor, who was tasked with cleansing her sister of demons.

In 2015, Nabembezi founded Ask Without Shame, a non-profit organization that delivers sexual health information from medical experts to young people via mobile technology to break myths and taboos on sexuality in Africa. Ask Without Shame answers over 200 questions a day from throughout Africa including Ghana, Kenya, Nigeria, and Tanzania.

“Those in the development sector come from an educational perspective and are cautious about sex-tech being used from a pleasure or dating perspective” - Amanda N. Gesselman, Indiana University

The organization uses a website, app, phone call, and SMS service to provide sex-related information to anonymous users.

However, Nabembezi told SciDev.Net, many of the queries are from women asking how to please their partners.

How African women use health apps

Experts believe that African women tend to use mobile technology to improve sexual relationships rather than to find health-related information.

“Women think that if they please their men, then they’ll keep them. For example, when the man says he doesn’t want to use a condom, she makes the choice for him,” Nabembezi says.

This disempowers the woman, Nabembezi says. “We give them information that shows her the advantages and disadvantages of her choice, so she can make her own decision. We don’t tell the woman what to do.”

Ask Without Shame app.

More than half of Ask Without Shame’s users are men. According to Nabembezi, men often get in touch with questions about their partners, which offers a gateway to connect with the woman herself.

“We find men are asking on behalf of a woman, and often we’ll be able to get him to hand the phone to her so we can speak to her,” she says.

In her experience, however, not all women are interested in learning about their reproductive health. “As much as we want to give this education, some women are just after how to please their man,” she says.

Study backs the trend

A new study published in PLOS ONE (11 September 2020), reflects Nabembezi’s experience with how African women use the internet to seek information.

Researchers surveyed more than 130,000 women from 191 countries and found that one in five women in Africa and Asia, one in four women in Oceania and the Americas and one in three women in Europe had used mobile phones to seek sexual partners. Short-term partnerships were the most sought, followed closely by long-term partners and partners strictly for chatting and sexting.

“While it is important to teach women about their own bodies and specific sexual health issues and risks, our data suggest these women aren’t going to the internet to learn, but to improve,” says study author Amanda N. Gesselman, an associate director for research at the Kinsey Institute at Indiana University in the United States. “That’s an important distinction we should think about when providing interventions.”

Gender inequality the reason?

According to the study, the findings differed among women in regions with greater gender inequality, such as Africa.

“In nearly all regions and subregions, staying connected when apart was the most commonly selected reason for app use with a sexual partner,” the study says. “However, in middle Africa, the most commonly selected reason (10.9%) was helping the user to feel more comfortable with their partner’s body (an option that ranked quite low in all other locales).”

Sub-Saharan Africa has the world’s highest gender disparity, according to the 2019 Gender Inequality Index from the United Nations Development Programme.

“Women think that if they please their men, then they’ll keep them.” - Ruth Nabembezi, Ask Without Shame

Considering the relationship structures within these regions, compared to the sexual autonomy women may have in more gender-equal countries, Gesselman says the findings make sense.

“Women in these regions tend to get into relationships at a younger age and for the long-term. They may be focused on improving that relationship rather than learning about new types of partners,” she says.

Using apps to learn about their bodies and how to improve their own sexual satisfaction was uncommon among African women. “It’s likely that these women don’t have the freedom to explore and are less informed about [what] will give them satisfaction,” Gesselman explains.

Insights into sexuality interventions

“We know women in areas of inequality are using these apps to ask how to improve, and that may be missing from interventions,” she says. “Having a focus on or advertising the focus as being about improving relationships can be used as a bridge to get their attention,” Gesselman says.

That may be a hard sell for those who fund sexual health initiatives. According to Isabelle Amazon-Brown, a consultant with UNICEF who specializes in the development of digital tools for sexual health in Africa, there is discomfort around pleasure-driven sex education.

“Those in the development sector come from an educational perspective and are cautious about sex-tech being used from a pleasure or dating perspective,” she says, adding that this means pleasure-based sex education is not taken seriously by authorities in Africa.

This reflects a detachment between the products being developed and what research, such as this study, says users want. “What kind of information do women want to know and what information do the development and public health sector want them to know?” she asks.

“Local content makes all the difference from a user perspective,” she says, adding that addressing consent [privacy] issues in countries such as Uganda and South Africa may have challenges.

“That has nothing to do with the recognized definition of consent, but the examples you use and the way in which you acknowledge the social norms and dynamics of the user’s background,” she adds.

Amazon-Brown also identifies the barriers women face in accessing technology in countries with high gender inequality.

Sub-Saharan Africa has the second-largest gender gap in mobile internet users in the world, according to the GSMA Mobile Gender Gap Report 2020.

“That has a big impact on how these programs can realistically be delivered,” Amazon-Brown says.

Striking a balance with sex-tech’s potential to give pleasure-based sex education may not be easy. But, Gesselman sees an opportunity that could have far-reaching effects.

“The sheer volume of responses we received from around the world gives us a good indication that women are open to apps that give support, rather than specifically sex education,” she says. “It speaks to the importance of the sexual lives of women regardless of their culture or location.”

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This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.

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