Sexual Health

From Taboo to Touchscreen: A Qualitative Study of Digital Sexual and Reproductive Health Intervention for Bangladeshi Adolescents.

TL;DR

The Mukhorito peer-led mobile app showed strong potential as a culturally relevant digital SRH education tool for Bangladeshi adolescents, enabling knowledge gains and greater openness in SRH discourse, while facing adoption barriers including limited smartphone access and unreliable internet connectivity.

Key Findings

The Mukhorito app was perceived as a valuable tool to meet adolescent SRH needs due to its well-structured, easily navigable content with relatable stories.

  • Data were collected from 19 participants across 3 secondary schools in the Feni district of Bangladesh
  • Schools included a boys' school, girls' school, and coeducational school
  • Participants included students, peer leaders, teachers, and government representatives
  • Qualitative data were collected through 6 in-depth interviews, 3 key informant interviews, and 1 focus group discussion
  • Thematic analysis was conducted using NVivo software under Braun and Clarke's guidelines

Participants reported increased awareness of critical SRH issues after using the Mukhorito app.

  • Increased awareness covered topics including reproductive health, nutrition, early marriage, violence against adolescents, and drug addiction
  • Users reported sharing acquired knowledge with their families and communities, extending reach beyond the individual user
  • The app was described as a peer-led, mobile-based digital platform targeting ninth-grade students
  • Interactive sessions were noted to strengthen decision-making skills and leadership qualities

The Mukhorito app was seen as creating a safe space to discuss previously taboo SRH topics, reducing cultural reluctance to communicate.

  • Many users reported feeling more comfortable discussing SRH issues without shyness
  • The app promoted peer-to-peer communication about SRH topics
  • Cultural taboo, limited accessibility, and poor communication channels were identified as significant pre-existing challenges for Bangladeshi adolescents accessing SRH information
  • Traditional adolescent-friendly approaches had shown limited effectiveness in addressing these challenges prior to this intervention

Significant barriers to app adoption were identified, particularly in rural settings.

  • Challenges included limited smartphone access, unreliable internet connection, and economic factors
  • These barriers were described as especially hindering adoption in rural settings
  • Adolescents in Bangladesh represent approximately one-fifth of the total population, indicating the scale of the access problem
  • Participants suggested enabling offline access as one solution to connectivity challenges

Participants proposed several recommendations to improve the app's effectiveness and reach.

  • Suggestions included integration of the Mukhorito app into school curricula
  • Participants recommended aligning the app with the government adolescent health program
  • Adding visually rich and interactive content such as short dramas, videos, and animations was suggested
  • Enabling offline access was recommended to address connectivity challenges and maximize effectiveness

What This Means

This research suggests that a mobile phone app called Mukhorito, designed to teach sexual and reproductive health (SRH) topics to teenagers in Bangladesh, was well-received by students, teachers, and school officials in a small pilot study. Bangladesh has a large adolescent population that historically has had very limited access to accurate SRH information due to cultural taboos, lack of educational resources, and poor communication channels. The app, which uses relatable stories and interactive content and is guided by peer leaders (older student mentors), helped young people learn about topics like reproductive health, nutrition, early marriage, and drug addiction — subjects that are often considered too sensitive to discuss openly. The study found that students who used the app reported feeling less shy and more comfortable talking about SRH topics, and many shared what they learned with their families and communities. The app appeared to open up conversations that would normally not happen due to cultural stigma. However, the research also identified real-world barriers: many students in rural areas lacked smartphones or reliable internet access, and economic hardship made these issues worse. These factors limited how widely the app could be adopted. This research suggests that digital tools like Mukhorito could play an important role in improving adolescent health education in settings where traditional approaches have struggled. To reach more young people, the researchers and participants recommend integrating the app into official school programs, aligning it with national government health initiatives, adding more engaging visual content like videos and animations, and making the app work without an internet connection. The study was small and qualitative in nature, meaning findings reflect participants' perceptions rather than measured health outcomes, but it lays the groundwork for broader implementation and evaluation.

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Citation

Hasan K, Mahmood H, Ether S, Hayder T, Zannat S, Sayeed A, et al.. (2025). From Taboo to Touchscreen: A Qualitative Study of Digital Sexual and Reproductive Health Intervention for Bangladeshi Adolescents.. Journal of medical Internet research. https://doi.org/10.2196/78514