The importance of mobile health apps for sexual reproductive health, rights (SRHR)

Mobile health (mHealth) is described by the World Health Organization as the "use of mobile and wireless technologies to support the achievement of health objectives." Smartphones are currently one of the most important media platforms for democratizing mHealth. Health applications can be a useful tool for improving health habits (WHO).According to the online websites like Atlantic, there are numerous mobile health devices and applications available to the general public today, including fitness trackers, diet apps, sleep monitors, and sleep checkers and so forth. The mobile health market is expected to rise to about $12 billion by 2018, with nearly half of physicians now using mobile health apps on a daily basis. At the moment, the push toward interoperability should result in more successful mobile health efforts, with more mobile health devices and applications capable of exchanging information with one another.

In the last decade, there has been a noticeable technological advancement in the health sector of Bangladesh. Though the progress was gradual at first, during the last two years, especially during COVID-19 pandemic, there has been a boom in digital health services, which have recently become increasingly accessible to many more individuals. However, the digital health platform has the potential to provide better services for some specific culturally sensitive health needs, for instance, sexual and reproductive health (SRH). Despite Sexual and reproductive health (SRH) being an integral part of our lives, especially during the adolescent period, our social and cultural context does not encourage discussions on these topics publicly or even between family members, as the word "sex" itself is taboo.

According to a research conducted by UNICEF, adolescents are curious about periods, masturbation, orgasms, opposite gender's sexual interests, pregnancy, family planning, among other health and body issues. To appease this curiosity, many young people turn to the internet for answers. Government data indicates that adolescents and young adults make up the highest proportion of mobile and internet users. Aligned with this user behavior, multiple applications on the Google Play Store provide information regarding adolescent sexual and reproductive health. Research conducted by BUET in 2021 in Bangladesh, on different adolescent health queries asked by teenagers using a Chatbot revealed that most of the participants, regardless of gender, asked questions about adolescent health issues as well as mental and behavioral problems.

The fear of identity theft and data privacy breaches, however, prevent them from using such digital services due to the sensitive nature and negative culture surrounding it. Additional setbacks include perpetuation of myths or superstitions regarding SRH. Numerous apps require registration prior to utilizing services, the gender options are limited to male or female there. The gender diverse community members in turn, are skeptical to avail services in those particular apps because they are under the impression that the services offered are catered only to males and females.

Moreover, most apps lack interactive features, which makes them dreary and monotonous, causing users to seek out apps which have a more appealing interface and contain activities users can participate in. Some such activities include but are not limited to quizzes, interactive Q&As and educational games based on SRH. Also, an SRH app aimed at adolescents, needs to take an all-encompassing approach to address both the psychological (i.e physical and mental) transformations experienced during the adolescent period.

James P. Grant School of Public Health, BRAC University's (BRAC JPGSPH) "Amra Jante Chai" (We Want to Know) app is designed to address the different issues and questions young people have regarding sexual and reproductive health. This app has 5 different sections, each containing different features. There is a section for sex education, called "Know Yourself" where information about adolescence, self-reflections, nocturnal emissions, masturbation, menstruation, family planning, sexual harassment and violence, gender, and consent are provided.
 
There are many myths surrounding SRH, to provide information with the hope that misconceptions will be debunked, a section is available in the app called "Let's Break Down Misconceptions". A rotary dial is seen upon entering this section, numbered 1 to 11. Selecting a number will take the user to a myth/misconception, below which an icon exists. Clicking the icon reveals an explanation on why it's a myth. It is designed in a way that keeps the user intrigued while being informative. There are some other interactive features that are also available within this app, such as some informative animations and also a game on SRH.

The game is designed to reduce stigma around SRH and make users feel less apprehensive talking about sexual and reproductive health. A section on mental health called "Mechanisms to Cope with your Inner Feelings "also exists and is the most engaging feature. It combines two sessions to understand the coping mechanisms of the users for different types of emotions.

In addition, "Amra Jante Chai" is small in size (about 40MB) so doesn't take much space in the device and once downloaded, can be shared via offline sharing methods such as Bluetooth. Users do not have to type-out their queries in this app because the contents are already on display organized into sections. Hence, users can peruse through SRH content with ease. While there are several SRH (Sexual and Reproductive Health) apps available on the Google Play Store, many of them have not proven to be particularly helpful for users. This lack of effectiveness may leave users and society in a state of ambivalence. In contrast, the newly developed app called "Amra Jante Chai" stands out as a user-friendly solution. One noteworthy feature is that it does not require users to provide login information, addressing concerns regarding data privacy among users. This approach enhances the overall user experience and contributes to a sense of trust and security.

Overall, Teenagers need an open space to discuss SRH issues. The app will raise awareness among them. These kinds of SRHR apps should be made and promoted more through different campaigns and programs, including national and international partners and stakeholders and hopefully through the Education Ministry. Widespread use of SRHR apps will yield a more confident and self-aware generation who will pave the way to a better future.  
The writer is a Research Assistant, BRAC James P Grant School of Public Health, BRAC University