Abstract
BACKGROUND: Inadequate access to family planning (FP) services drives low contraceptive uptake in Nigeria. Digital platforms such as e-pharmacy and telemedicine offer potential to improve access, privacy, and convenience. This study examines factors influencing provider and user adoption of digital FP services in Lagos. METHODS: We used an exploratory sequential mixed-methods design. Interviews (n = 79) with FP providers, and current and potential users informed a survey (n = 1485) of digital FP platform users. Thematic analysis was applied to qualitative data; quantitative data were analyzed using descriptive, bivariate, and logistic regression methods. RESULTS: Participants comprised online (FP and non-FP) and brick-and-mortar (FP and non-FP) users. Awareness e-pharmacies for FP was high (78%), yet usage was limited (24%). Similarly, telemedicine awareness was very low (30%), and usage was lower (6%) compared with e-pharmacy. Online platform use for FP (e-Pharmacy/telemedicine) was significantly associated (p < .01) with age, gender, education level, marital status and higher education. Providers identified key barriers including regulatory uncertainty, technological challenges, and concerns about privacy and quality assurance. Logistic regression suggested higher odds of e-pharmacy use among respondents aged 18-26 Respondents aged 27-35 had significantly lower odds of e-pharmacy use compared to those aged 18-26 (adjusted odds ratios (AORs) = 0.33; 95% CI: 0.22-0.48, p < .001), while post-secondary education predicted higher telemedicine use (AOR = 6.54; 95% CI: 2.34-18.31, p < .001). CONCLUSIONS: E-pharmacy and telemedicine can ease FP access, especially for younger, educated, high-income users. However, effective adoption requires addressing demand-side user barriers and supply-side provider concerns.