Period Tracker App: scoping and landscape review (MARKET REVIEW: PERIOD…
Period Tracker App:
scoping and landscape review
From Swedish App
The App will:
provide accurate MHM information and education enabling girls to manage their periods more efficiently and hygienically through reminders and information
provide SRH information supporting safe and informed choices to address teenage pregnancy and STIs including HIV through communicating evidence-based information on personal hygiene, diet, and SRH
Be localized into national languages and local contexts
Use a girl-centred design process based on adolescent girls’ requirements
: increase girls’ agency and empower them to make choices that can have a long-term impact on their health and well-being.
From MHM draft ToC
Address stigma and discrimination
Activity: Community and school mobilisation of girls, women, men and boys.
Monitor attitudes, belifs, norms
Build evidence base, evaluate intervention
Activity: deliver information about managing periods to girls
deliver teaching and learning materials, deliver information to parents and community leaders and boys (e.g. in schools)
From MHM Innovation PPT
Lack of knowledge:
Girls lack knowledge and are unprepared for menarche (45% in Indonesia)
Lack of family/school support
Parents and teachers believe it is each others' responsibility
Taboos and misconceptions
PNG: Menstruating women cannot touch food or water for men/boys
Indonesia: Washing hair can prevent menstrual flow
Negative consequences fir girls:
physical and psychological and educational
Stress, anxiety, shame, fear of teasing
Negative impacts on girls’ participation and concentration - Girls often take back seats in class
INTERNET & MOBILE PHONE USERS
Internet: 88 million (34%), Mobile: 326 million (126%)
Internet: 1.6 million (53%), Mobile: 3.5 million (114%)
Internet: 0.9 million (12%), Mobile: 3.4 million (44%)
Informs girls about their menstrual cycle and appropriate MHM
Enables girls to track and plan for periods and fertile days
Dispels myths & misinformation
Provides evidence-based information on personal hygiene, diet, sexual & reproductive health
Localized to the country’s cultural context and Language
Links to local websites, counselling, services
Links to local services & websites
Open source code
Simple and smart phone solutions
Dispels myths & misinformation
Will not reinforce traditional gender stereotypes
Results measured using real-time monitoring and impact evaluation methods:
Reach and uptake (# of girls benefitting from the tool): app downloads and SMS messaging subscriptions
Usage and user satisfaction: app usage and engagement, direct feedback
Impact on knowledge, skills and behaviours: in-app surveys; analysis of chatrooms; quantitative and qualitative research
Tracking & information provided via
text messaging and/or
automated voice messaging
SMS peer group
Links to websites
Girls in early adolescence:
most challenging time for menstruation Life and body changes: become sexually active or face pressure to marry; require support and education, to learn about puberty and how to manage it; and a time when they need accurate SRH information to help them negotiate relationships, avoid risk behaviours, and early pregnancy.
Boys in early adolescence. Face similar body and life changes, can learn positive SRH behaviours benefitting themselves and girls, and tackle gender stereotypes by supporting girls
Parents, family members
Community support: teachers
Increasingly, young people are using the internet to find information about health, including SRH.
Toolkit for mainstreaming gender in health programs
ACCESS, USE, LITERACY
Population without a phone: 65%
low awareness of mobile functions and services contributed to low perceived value in investing in a mobile phone
16% women owned their own handset or SIM, and almost half of women surveyed (45%) had no access to a mobile phone at all.
87% rural population, 88% without electricity 50% without clean drinking water or access to sanitation facilities.
ICT & GENDER Resources
GSMA Connected Women: Indonesia
female-specific data on country summary
The Web Foundation: women's use of the internet in Indonesia
BOP Women's lives in PNG (2014)
Includes Mobile usage findings.
on how mobile in PNG offer new ways for companies and consumers to give and receive care.
GSMA Connected women, Mobile Gender Gap report, 2018.
GSMA Mobile Technical Literacy Toolkit
to determine literacy and mobile needs of women and girls. Based on women's access to and use of mobile in
Alliance for Affordable Internet: affordability indexes
ICT Gender Survey Toolkit
for USAID and FHI360 to support ICT4D Gender landscape assessment in programming
Only 20% of women have Internet access.
While this figure increases to 31% among poor women in Jakarta, few who are connected use the Internet to express views (5%) or find critical information about their rights (26%).
52% of Indonesia’s secondary schools are connected to the Internet
Number of users aged 10-19 years using mobile phones: 10% (121,574) Smart phone Users: 5%, Data users 6%.
In UB Mobile Phone Users: 4%, In Provinces 5%. In UB and Provinces, Smart phone and Data users all 3%.
1,378,000 Facebook users in Mongolia, making it the most popular social media platform to be accessed via mobile data. 96 per cent of all Internet users have Facebook profiles.
19.6 per cent of Facebook users in Mongolia are aged 13-17 years and 40 per cent are aged 18-24 years.
(Source: MobiCom, unofficial report, 2016, From Mongolia Adolescents Situation Analysis Report 2016. ICT Access Page 53-54)
PERIOD TRACKER APPS
Period timing, length, reminders
Alert to next period
Track irregular cycle by monitoring symptoms: temperature, moods, sleep quality, menstruation history
Alerts to predicted fertility window
Birth control method/medication monitoring:
method tracking, reminders
other medication monitoring
Symptom, Body & Mood monitoring:
Period related/Health/Body characteristics/feelings:
cramps, tender breasts, cervical fluid, exercise, happy, irritated
General health/body/activity or feelings/characteristics: sleep patterns
Menstrual flow characteristics (spotting, light, heavy flow)
User logs symptoms for each day of cycle
Menstruation history. Year-long calendar view - review past cycles for changes.
Record-keeping: monthly review of activity and symptoms
to prepare for doctor visits.
Monthly flow analysis, bar graphs, charts, summaries, timelines
Menstruation, Health, Beauty, Life, Information
Daily health insights, articles based on the amount of info you track. The more data you enter the more information you receive.
General life, health, beauty advice, life coaching
Cross-device integration, links with health-trackers
e.g. Fitbit, Apple Health App.
Forums, exchange questions and tips with fellow users, discussion threads
Tips for partner: health, sex life, menstruation information
Partner information sharing e.g. via Facebook connect with period calendar, reminders
(providing sexual health information, making period jokes)
Biometric hardware components:
Thermometer (for fertility apps), bluetooth connected tampon/menstrual cup.
Other: Goody bag
Sends a monthly bag of tampons, pads and bar of chocolate.
Customizable symptoms and period related body effects
**Other App features:
Targeted Ads: Beauty, Health, Baby-related products.
Linked to In-app purchases
Push notifications: e.g. when cycle is shorter or longer than usual-
The promise of increased accuracy with increased use
previous cycle data used to provide up-to-date alerts for next-period.
KEY FEATURE LIST MOST APPS OFFER:
Prediction: periods and fertile days
Birth control method monitoring/reminders
Tracking symptoms, mood, body, activity
Documentation/recording/history calendar views
APPS IN ASIAN LANGUAGES
Made by girls: GirlsSecret
MULTI_LANG PERIOD TRACKERS:
Period Calendar/My Calendar iOS
50,000,000 - 100,000,000 installs.
Wide variety of Asian languages:
Hindi, Indonesian, Japanese, Korean, Malay, Bokmål, Persian, Russian, Simplified Chinese, Thai, Traditional Chinese, Urdu, Vietnamese.
Hong Kong based developer: Simple Design Ltd.
5,000,000 - 10,000,000 installs. Japanese, Korean, Russian, Simplified Chinese, Tamil, Hindi, (sleek website design).
User Forum Questions
re. pregnancy, periods, bodies, pain, contraceptives.
5,000,000 - 10,000,000 installs Android.
Available in Filipino, Hindi, Indonesian, Japanese, Korean, Malay, Persian, Polish, Portuguese, Romanian, Russian, Serbian, Simplified Chinese, Swahili, Thai, Traditional Chinese, Vietnamese
Ovulation Calendar available in Vietnam (
) only 10,000-50,000 installs
Top Apps in:
Indonesian versions of popular apps:
Flo Period Tracker
My Period Calendar
Hawa – Indonesian version of Eve
MeetYou accused of data fraud
Its e-commerce business works like this: its users buy products on the app from Alibaba’s Taobao, China’s largest e-commerce platform, and the app gets commission as profit.
Dayima business model:
Going beyond the period tracking function, Chai turns Dayima into i
ts own social network
, community and content creator. Female users can discuss issues from health to family, fashion or even gossips via the app. The site also features a range of articles where women can find fitness advice and beauty tips.
Dayima seemed to have checked off all the boxes of value creation: It’s an “high-frequency app” – typical users come back for it at least once a month; it targets women from teenagers to the baby boomers, who with have immense purchasing power and are highly sociable; it addresses a big physiological need.
Characteristics of most popular apps:
All inclusive: bundling the most features together. For the majority 'More is More.'
The majority are flowery, pink designs or a deliberate opposition to that with cleaner designs, based on graphic shapes in more neutral colours.
Apps popular in Asia feature cartoon style, pink, pastel and character-based designs, or with emojis.
the trend appears to be in interconnecting the apps as much as possible (for increased data sharing); to social networks, shopping platforms, community forums, health tracking apps (fitbit etc.)
Regular user interaction and feedback (see Maya for example), quick response to user comments.
Most popular Apps:
What Users like
Users like tracking lots of body, mood, symptom information and being able to look back and forward for patterns.
From Spot On: people want period prediction. From user feedback on popular apps: people talk about wanting accurate prediction of periods and fertile days.
Users like the 'medical', 'scientific' promise:(hence analysis,charts,promises of medical research links)
Privacy and Security trends:
Never seen before amounts of women and girls health data being commercialised with unknown consequences
Lack of knowledge and awareness from users about how much and where their data is going and for what purposes it is being used.
Lack of open source apps (which is linked to -->)
Lack of transparency of companies behind the app and their revenue models
Disingenuous encouragement that entering more data will improve accuracy of period , fertility and overall health predictions
Implications for UNICEF
Open source development
Promoting gender-positivity and counter heteronormativity in front end and back end (i.e. data protocols)
A responsibility to encourage and promote digital security amongst women and girls
Encouraging a critical view of what is deemed to be 'scientific' app knowledge regarding predictions and other period/fertile days, despite this being the opposite to what people like
Not promote as a stand alone product but as part of an healthy SRH set of life habits
Women's health apps have an ethical responsibility to put the focus on user privacy and security
The focus on adolescent SRH/CSE is important and will be a challenge. The competition is with a huge market of already popular Apps run by big business who are integrating and interconnecting with other digital applications including social networks and commercial platforms at a rapid rate.
Requisite privacy characteristics
app will be ad-free
data will never be sold or shared. Include this promise in the app when people sign up
don’t collect names
require a high level of access for user, e.g consider not just password but pin, or security question, 2 step verification
Never send unencrypted data to another server, to prevent data leakage and account hijacking.
Certificate pinning is desirable to prevent attackers intercepting data traffic.
Use open source framework for developing in-built privacy in the app. E.g. 'Secure Distributed Aggregation’ (SDA). Keeps private all user inputs for analytics purposes, combined with data storage on the user's device as is the case for apps that work offline, (to prevent app developers amassing and selling personal data).
Limiting the number of features, as simple as possible
Gender issues with current Period Track App trends:
Most apps are dominated by a commercial purpose - they exist to make money and are therefore driven by and reinforce dominant gender stereotypes in order to generate more revenue: i.e. encouraging impossible beauty standards to sell more beauty products targeted at women, assuming heteronormativity and women's purpose to reproduce to sell more fertility and baby products
SRH information is, except for Spot On, not of a CSE standard and can veer towards reinforcing gender stereotypes
-Most are targeted at Western women
Nearly all assume partners are male and take a hetermonormative approach, in language and sexual health advice/information
Most advice and information
Most apps are led by Men and teams of men
All actively promote gneder stereotypes in terms
Nearly all take a negative view of periods as shameful, to be hidden, avoided, as a bad time of the month
Many inviting partner involvement reinforce gender stereotypes: encouraging men to buy products to make girls feel better and be understanding towards their difficult girlfriend/wife
Nearly all contribute to a commercialisation of women's health and understanding of female bodies
Many data practices are potentially risky for digital security of women and expose them to risks of surveillance and other threats
Responsibility still placed on woman to monitor SRH and protect men from the 'work' around SRH in healthy relationships
Data generated by these contributes to a meta-data based on the dominant experiences of heteronormative, economically privileged, Western women from which decision about related women's health from health and medical researchers, scientists and institutions are being made about other decisions - both commercial and non-commercial re. product marketing but also re. R&D of future health services. Unknown consequences
The psych-social consequences of bio-metric monitoring (including quantified self) are unknown. Do these habits promote empowerment? Do they promote a technology-media-image-body culture and take the focus away from healthy relationships? Do they promote unhealthy self-obsession in accordance with unrealistic ideals influenced by profit-motivated corporations?
There is a lack of critical debate about the commercialisation of women's health , particularly data. It shouldn't be applauded amongst the tech (and particularly young entrepreneur scene) for App developers to set out to make money from monetising women's health needs.
Trends in Period Tracker Apps
Risk: increasing cases of unwanted pregnancies from Period/fertility app predictions going wrong. See:
Guardian - NaturalCycles controversy
) "In Contraceptive Tech, the App’s Guess Is as Good as Yours"! identifies motivation of using period tracking apps. as the "feeling" or actual experience of pressure re. economic situation or poor health/medical care and/or lacking access to information abt reproductive health. And (Western) trend of going off the pill or other hormonal contraceptives.
Articles about Period Tracker Apps and fertility Apps:
German Consumer report on Fertility and MenstruApps - Stiftung Warentest
Found most current popular menstruapps are inaccurate
Scored: highly for user-friendliness and functionality
Conversation with Spot On - key lessons
Spot on good practice:
don't stipulate total accuracy - give 5 day window
don't provide fertility prediction if not using a birth control method
Start very simple and stripped back in terms of functions and build on as per user feedback.
Don't start with community functions, wait until a heavy , wide user -base
Consider doing a web-app first to test features and functionalities and create code/algorithms and test with audiences
Need a devleoper to be in for the long haul
Need long term financial investment
Need a team of developer, UX design, medical/biological expert, SRH education expert, project manager
focus on design (UX/UI) and user experience before desired functionality and SRH requirements of org
intense back and forth process of many iterations
Spot On would prefer to go in-house with updates now they have scaled and designed the main app infrastructure
Design and development process
• Using a gender sensitive girl-focused HCD process
• A design and development process that considers existing gender/tech resources (e.g. Girl Effect’s ‘Girl Safeguarding Policy’ 2016)
• Privacy by Design: limited data collection, meaningful consent;
• Platform content and design: ensuring content doesn’t put people at risk;
• Partnerships: managing partner service providers who may want to monetize data;
• Monitoring, evaluation, research and learning: collecting and storing data for these purposes only.
Social-tech Accelerator South Asia
is an accelerator working with growth-oriented businesses on innovations that can transform the lives of adolescent girls aged 10-19 living across East Africa and South Asia. We work with world-class experts to support these businesses to create innovations with purpose and commercial potential.
CONTENT REVIEW: SRH, MHM, CSE
DIGITAL SEX-ED CONTEXT
UNICEF Digital Sex-Ed review finds few digital CSE initiatives meeting standards of providing non-judgemental information.
Examples from Asia Pacific:
Digital Sex Ed in East Asia and Pacific p11-14:
Love9 - Cambodia; Love Matters -China; The World Starts with me - Indonesia, Thailand, Vietnam, Bangladesh, Pakistan; Sobat Ask - Indonesia; Youth Chhlat - Cambodia; Love Care Station - Thailand; Teenage Mom - Thailand.
workshops, info and products (menstrual cups and pads).
promoting positive attitude and information about periods on Facebook. Both started by young women.
Nugget - India
: a mobile phone game, 78-episode TV drama, a radio show, IVR content, graphic novels, activity
Awareness about different aspects of menstruation for adolescent girls and women. This is achieved by talks and workshops designed and delivered, primarily to adolescent girls
Maya Apa is an anonymous messaging platform that connects users with expert advice, available on web, wap and android.(internet.org/freebasics app by facebook).
(No Simple Phone)
- In simpler terms we digitally connect subject matter experts to user queries with our intelligent platform.
and other issues: Medical, Health & Well-being, Legal Psychological, Social, Lifestyle & Fitness. Includes rapid
based on date of last menstruation and cycle length.
Period Q&A on mobile
Other - non-digital:
Pakistan feminist art and clothing
recommended by Katie Highet for their approach to radio
A social movement of girlfriends providing menstrual hygiene kits.
Hong Kong, workshops, info and products (menstrual cups and pads)
Crowdfunding for an E-Book: ‘Things You Never Knew About Your Period’
– by Zoe Chan, to get printed for distribution in schools. It aims to break the taboo around menstruation and celebrates from biological, historical, environmental, social policy, and gender perspectives. Practical exercises to open conversations.
Using Facebook to share information about menstruation to promote a positive attitude towards periods. Aims to challenge the menstrual status quo of shame, silence and secrecy. Love it and embrace it.
UNICEF DIGITAL SEX-ED/SRH:
- WASH/GENDER results of user experience of Gender and MHM content hosted on IoGT and
Report on Adolescents HIV outcomes
'Schnet' (SRH/CSE app with programme to use to improve SRH in education and public health system)
arising from UPSHIFT. Contact Hana Sahatqija, Adolescent Development Officer/ Innovations Lab Programme Manager
Menstrual Hygiene Innovation Challenge
calling for U-Reporters to submit ideas; piloting MHM helpline to provide MHM info to U-Reporters' queries on MHM & SRH. Contact Ann Rosemary Arnott (Gender & Development Specialist), Hira Hafeez ur Rehman (U-Report Manager), and Gloria Lihemo (MHM Specialist)
(chatrooms) Peer SRH chatroom using Rapidpro. Contact Nelson
Dating game website
HIV testing campaign. Anna Sukhodolska, C4D Specialist.
LiveHack - SRH counselling a friend mobile game
(Belarus) – key NGO partner: online “Risk Calculator” Adolescents can assess their own risk score based on the actual their sexual behaviours.
Relatable SRH apps
Pakistan - UNICEF SRH advice bot, and in Indonesia
Indonesia - UNFPA SRH services location app
Mongolia - UNFPA Menstruation and SRH advice app
GLOBAL/NOT ASIA PACIFIC:
Period tracker journal stickers and products - Etsy
IDS Bulletin 2017 - Sex Education in the digital era
Oh my body
, App w Animated stories, FAQs, games, myth busters. Tech used:
who do low-cost social Ed-Tech. See Mobile App development with USAID/FHI 306 in
Agency doing Mobile Education projects:
GBV West Africa
Juicy Peach (Thailand)
OPEN IDEO: Amplify challenge winning ideas -
Digital SRH in conflict
And Blog explaining
(UNOPS) works globally with national and local governments to integrate MHM in national policies across sectors.
Success in India, Senegal, Kenya, Nepal, Niger, Pakistan, Malawi, Tanzania and Madagascar.
1pg MHM in schools
Report 2016 MHM Adolescent schoolgirls
Focus group discussion questions/themes.
MHM schools Bolivia report 2016
launch revised Technical Guidance on comprehensive #sexualityeducation
Happy periods: period track app development - India
HCD process for specifications:
+31 (0)88 313 15 74
Project background & funding:
Social - Tech Landscape