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‘Digital Health’ refers to the seamless integration of digital technologies such as mobile applications, wearable devices, electronic health records, telemedicine, and health information systems with the overriding objective of improving healthcare service delivery, management, and monitoring. Aside from that, it strives to encourage individuals to take control of their own health and well-being. This comprehensive strategy entails a wide range of platforms and applications that leverage the power of information and communication technology to transform healthcare accessibility, effectiveness, and overall results. This transformative global shift has the potential not only to bridge existing healthcare disparities, but also to foretell a promising future in which technology plays a critical role in fostering wellness and ensuring the efficient provision of healthcare services in our interconnected and diverse world.
In today's digitally-driven world, where advancements in technology are reshaping healthcare accessibility and quality, Bangladesh is embracing this transformation with vigor. Social media platforms like Facebook, YouTube, and TikTok have become hubs for health information dissemination, offering a vast array of health-related content. Particularly on Facebook, numerous health-focused groups have emerged, serving as valuable spaces for individuals to share their health concerns, seek advice, and engage with professionals.
Amidst the COVID-19 pandemic, Bangladesh experienced a significant surge in the adoption of digital health platforms, demonstrating substantial progress towards comprehensive digitalization within the healthcare sector. Notably, a multitude of applications such as Surukkha, Prava, Maya, Hello Doctor, Zaynax, and CMED have flourished in Bangladesh, pioneering the healthcare landscape. These innovative apps have effectively facilitated virtual consultations, surpassing traditional in-person visits and revolutionizing in terms of getting primary healthcare. It's a proactive step, leveraging technology to improve healthcare delivery and enhance the overall quality of life for the populace.
Though the use of digital health platforms experienced rapid growth during the COVID-19 pandemic, offering essential primary healthcare to numerous individuals, it also underscored the vulnerability of disseminating health information through digital platforms. Bangladesh, like many other regions, has not been spared from the challenges of misinformation and inaccuracies in the digital health sphere. Accessing reliable health information is crucial for overall well-being. While there are various sources for general health information, obtaining accurate and sensitive details regarding Sexual and Reproductive Health (SRH) can be challenging. This is particularly true for adolescents and young adults, as they often lack access to comprehensive SRH education, information, and services. The scarcity of accessible and available SRH information and services, coupled with a lack of awareness about service availability, can result in adverse health outcomes. These consequences encompass unintended pregnancies, sexually transmitted infections (STIs), instances of gender-based violence (including intimate partner violence, or IPV), heightened anxiety, and even depression.
The BRAC James P. Grant School of Public Health is conducting a research on ‘Effective Digital Health Platform for Sexual and Reproductive Health and Rights (SRHR) Services: A Mixed Method Approach to Understanding User Experiences, Needs, and Rights’ under the Covid-19 Learning Evidence and Research Program (CLEAR) project, which is funded by the UK Government’s Foreign Commonwealth and Development Office (FCDO) and coordinated by the Institute of Development Studies, UK, to support an evidence-informed Covid-19 response and recovery in Bangladesh.
The first objective of this research is to understand the users’ experiences and identify the challenges experienced by adolescents and young adults (18-35 years old) while using digital health platforms. Another important objective is to determine the factors which are influencing the users to opt for digital health platforms for sexual and reproductive health including different communities and marginalised groups. The study will engage a diverse range of stakeholders at every stage to incorporate their valuable feedback. This collaborative approach will help identify opportunities for policy enhancements, ultimately paving the way for the development of a more sustainable and user-friendly digital health system.
In the digital landscape, safeguarding privacy and ensuring security is crucial, especially when it involves sharing information about one's sexual and reproductive health. This topic is often stigmatized, causing many to keep it hidden and avoiding seeking relevant information. For those who do venture into digital platforms for health-related advice or services, concerns about data privacy loom large. Users often lack clarity regarding the storage and accessibility of their data. This concern is amplified for gender-diverse individuals who may continue to conceal their sexual identity or feel uncomfortable about disclosing it publicly.
We have observed varied approaches to content filtering on various platforms while doing our digital ethnography. For example, before broadcasting potentially sensitive health-related content, platforms such as YouTube have created an organized approach incorporating quick questionnaires to determine user approval or disagreement. Platforms such as TikTok, on the other hand, appear to lack a comparable level of explicit content restriction. This is readily apparent in the publishing of graphic photographs, such as those depicting blood and surgical procedures, which may be seen as less appropriate and can evoke conflicting reactions from users.
Some digital health platforms effectively offer transparency about data storage and privacy maintenance. Nevertheless, a common concern lingers, even when platforms and services have well-defined content policies that users seemingly accept. The language used in these policies is not always user-friendly, leaving many users uncertain about the specific terms they are agreeing to. This lack of transparency can pose challenges in ensuring that users have a comprehensive understanding of their obligations when they engage with these services.
While the digital health landscape in Bangladesh holds great promise, it is not without challenges whatsoever. The rapid growth in the use of digital health platforms during the COVID-19 pandemic has depicted the critical importance of safeguarding privacy and ensuring the accuracy of health information. In this journey, addressing the unique needs and rights related to sexual and reproductive health remains central. By ensuring transparency, accessibility, and user-friendly policies, Bangladesh is poised to navigate these challenges and embark on a path toward a more comprehensive and user-centric digital health system – thereby ultimately improving the overall quality of life for its people.
The writers are Research Associate and Research Assistant respectively at BRAC James P Grant School of Public Health, BRAC University
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