This presentation will share Hesperian Health Guides’ experience testing and releasing a scalable mobile app on Safe Abortion. The format and content of this app was shaped through multiple iterations of field testing with diverse representatives of potential users across the globe. Hesperian is a non-profit organization that develops and disseminates heavily illustrated, easy to understand health information in multiple languages on its free, online HealthWiki. The Safe Abortion app responds to user demand (over 2,000 visits to safe abortion content daily), coming largely from mobile devices (over 85%). With a user-centered design, the app’s features include a gestational age calculator, medical abortion how-to, and postabortion and emergency care information. The Safe Abortion app was designed in consultation with representative end users (women and their allies in low resource settings) and is easily navigable for those with less fluency using digital resources. Testing has been conducted with groups across Latin America, Africa and the United States, providing feedback about design, content and functionality. Since its public release in February 2019 it has been used in over 130 countries.

The presentation during the panel discussion will showcase Tuneme.org. UNFPA through its flagship youth programme called “Safeguard Young People” (SYP) in collaboration with Praekelt Foundation, Ford Foundation and DFID developed and rolled out Tune Me, a mobile site (mobisite) designed for low- and high-end devices in environments where high data charges and poor network coverage combine to limit access to online services. Through social features and content designed to engage users rather than lecture, Tune Me aims to equip adolescents with the information and motivation they need to make better choices. Adolescents access Tune Me through the internet browser on their mobile phone or through Facebook’s Internet.org platform. The Tune Me site is also available on Free Basics which allows any young person with a mobile phone to access the platform without the limitation of data or wifi connectivity. TuneMe is live in Zambia, Malawi, Zimbabwe, Namibia, Botswana, Eswatini and Lesotho. Already more than 200 stories exist on the site, covering subjects as diverse as menstruation and gender-based violence. Adapted from a global standard in sexuality education content, the stories are adapted and translated for local audiences to ensure relevance and improve engagement. Tune Me’s newest feature finds youth-friendly clinics by geo-location, including feedback mechanisms to track quality of care. Since December 2015, Tune Me has carried out 219 Facebook campaigns, one radio campaign, and many mobile web banner campaigns. The Facebook page has had over 1 million 300 thousand unique users, over 50 million impressions, over 60,000 likes and more than 345,000 clicks. The majority of fans are 18-24 years old. With more than 1 million unique users on the site and 7750 registered users, Tune Me is well underway to become the ‘to go to’ mobisite for sexual and reproductive health information.

Improvements in phone access, particularly among women, is increasingly being highlighted for its transformative potential to accelerate social and economic development and potentially improve health outcomes. Yet a dearth of evidence exists linking technology directly to improvements in careseeking or practices for reproductive maternal newborn and child health, and increasing concerns are emerging about the potential for inequities in the implementation, use, and funding of digital interventions. While women’s mobile phone access has increased significantly over time, mobile gender gaps persist not only in women’s ownership of phones but in their digital literacy and usage. For digital health interventions to attain high population coverage, particularly amongst the poorest and most vulnerable, efforts are needed to address these gaps and ensure that existing inequalities are not compounded. In this pre-formed panel, we draw from secondary analyses of data in India and across 17 countries globally to explore the gender gap between household and women’s access to phones and its implications for health practices and careseeking. We next consider how women’s access is measured, and what factors underpin mobile phone use. As part of the latter, we draw from household survey findings in India to present data on women and health care providers’ digital literacy-- demonstrating their observed ability to perform a series of basic tasks ranging from navigating IVR prompts, opening and reading SMS messages, storing contacts on a phone, to giving a missed call. With less than half of respondents in India able to perform these basic tasks, findings will show that the provision of a device in and of itself is grossly insufficient for yielding change. Rather to optimize the use of technology in the health sector, not only are efforts needed to bridge gaps in technology access, particularly among women, but as well to facilitate device use by enhancing digital literacy and addressing underlying barriers to use.

ZonaSegura is a trauma-informed youth-centered innovative research study and mobile solution to address teen dating violence in Honduras. Led by the YTH Initiative of ETR, in partnership with the Public Health Institute’s GOJoven International Program and GOJoven Honduras, this applied study and mobile solution aims to prevent teen dating violence (TDV) through provision of prevention information, healthy relationship education, and linkages to TDV services and resources using mobile technology. Honduras is consistently ranked as one of the most violent places on earth, particularly for women. From 2005 to 2013, the number of violent deaths of women rose by 263.4% while one woman was killed every 16 hours in Honduras in 2015. With nearly 90 percent of the Honduran population with access to at least one mobile phone, ZonaSegura leverages the high rates of mobile phone usage among young people ages 14-19 to support overcoming individual and structural barriers to access rights-based and gender-sensitive TDV prevention information and services. ZonaSegura includes a mobile-responsive study website, Android mobile application (app), and WhatsApp text messaging campaign. The goal of each technology component provides information around healthy relationships and TDV prevention with activities and messaging to reinforce learnings. The website provides basic information, assesses study eligibility, provides informed consent, and study enrollment for potential participants of the ZonaSegura study. The mobile application and WhatsApp campaign provides primary prevention and health information to teens. The ZonaSegura IRB approved study (launching July 2019) will evaluate the effect of ZonaSegura on teens’ access to and use of information, knowledge and attitudes to teen dating violence and overall self-efficacy in teen dating violence prevention. Preliminary findings and lessons learned from the study will be shared during this session.