BACKGROUND: Most women within reproductive ages living in Low- and Middle-Income Countries, have limited or no access to education on sexual and reproductive health and contraception, yet about 1.9 billon women in LMICs own a mobile phone. The exposure to digital health services has the potential to contribute to improving awareness, influencing positive perceptions, beliefs and promoting SRH and contraception.AIM: To explore user views and perceptions on the Grace Health’s (a digital health service) ability to improve awareness on sexual reproductive health and contraception among Ghanaian, Nigerian and Kenyan women aged 18-35.METHODOLOGY: A qualitative design using phenomenography to interview women remotely on women’s perception of digital health services through their own experience with using the Grace health chat bot and app. Also, their views were sought on how other women are gaining awareness and impacts on sexual reproductive health and contraception from the digital health services.RESULTS: Seven categories on digital health services emerged, with key findings presented as Safe days, ovulation as contraception, impacts on SRH, Avoiding or seeking pregnancy and influence on perception.CONCLUSION: This qualitative study gives insight for research community, public health professionals, app designers, health care providers, stakeholders and civil society organisations in making decisions regarding the use of digital health service as strategic, innovative instruments for interventions in major key indicators of Sexual Reproductive Health and Rights.

The increasing demand for female-centred services and devices in the digital era has challenged traditional notions of privacy. This thesis explores how users perceive privacy issues in period- tracking applications provided by various developers. By utilising mixed-method research and adopting an ethnographic methodology within the framework of Actor-Network Theory, this study examines the trade-off of sensitive data in exchange for predictions through agential roles in the use of period-tracking applications. The results reveal that users desire control over whom they share their menstrual information with and feel confident doing so with non-human actors, the period-tracking application. Users are unaware of the developers' access to their data and the potential selling of it to third parties. The study highlights the power dynamics between users, period-tracking applications, and developers and their impact on perceived privacy. The research emphasises the mediating role of the period-tracking application in trust and power dynamics as users perceive privacy differently in the digital and physical worlds. The thesis proposes a podcast prototype that demonstrates the impact of technology on user behaviour and their willingness to compromise their privacy. The prototype aims to evokes emotions and encourages reflection on how non-human actors can influence decision-making. The podcast prototype emphasises user's need for more awareness of how data is used and highlights the potential dystopian future. Through this demonstration, the thesis aims to contribute to a deeper understanding of the complex interplay between human and non-human actors in the digital world and their effect on individual privacy.

This thesis brings period tracking apps into the discourse of menstruation. How we speak of and communicate around periods contribute into building the idea of the menstruation and, by extension, the female body and femaleness. This is also true for visual communication, which is why this thesis analyses the form, function and representation of three of the most popular period tracking apps. The questions posed are: What are the most important characteristics of the general visual appearance? How are the apps meant to be used? In what ways can form and function be placed into a cultural historical context with focus being on symbolic representation? To answer these questions a method of semiotic analysis paired with case studies are used. Previous research has shown that period tracking apps in some ways play into the idea of menstruation as a taboo. This essay shows that the notion of menstruation as something to be kept and handled in private is present in the design of the apps.

Artificial intelligence (AI) in mobile applications has grown in popularity, changing the way people engage with technology. AI improves functionality, personalization, and efficiency across a wide range of mobile applications. One specific group of apps powered by AI is period-tracking applications, which is the focus of this master thesis. These apps utilize AI for features such as cycle predictions, fertility windows, symptom predictions, health insights, and chatbots. The aim of this project was to evaluate the performance of these advanced features, leading to the research question: “How do users perceive and experience the AI features in period-tracking applications?” To address this question, an observational mixed-method approach was employed. The research began with a survey, shared via social media platforms from February 19th, 2024, to April 2nd, 2024. The questionnaire included 20 open-ended and multiple-choice questions centered on AI features. By the end of the survey period, 61 responses were collected and analyzed. During the survey period, four participants were chosen for follow-up interviews, but three users’ responses were used in the analysis. The survey results underwent statistical tests to explore the relationship between monthly app usage, duration of app use, and satisfaction with cycle predictions. Later, interview results analyzed by using thematic analysis were integrated to the walkthrough method while assessing the functionality, interface, and user experience of AI features. The mixed-method study offered comprehensive insights into users' practices and experiences with AI features in period-tracking apps, revealing the need for future work to enhance the performance of these AI features for better user satisfaction.

<p dir="ltr">FemTech is a booming subset of mHealth applications that was worth $51 billion in 2021 (Stewart, 2022b). FemTech largely focuses on menstruation, pregnancy, and fertility tracking. As with any technology, it comes with privacy and security risks for users, but these risks are more acute due to the sensitive nature of the data being collected. While privacy and security shortcomings have been highlighted for years, concerns were discussed widely in the United States after the Supreme Court released its <i>Dobbs v. Jackson</i> decision on June 24, 2022, which overturned <i>Roe v. Wade</i>, a 1973 decision that protected abortion as a constitutional right and limited states’ abilities to place restrictions on abortions. With abortion no longer a constitutional right, many states have outlawed or heavily restricted the procedure, and individuals expressed concern about their digital data being used in investigations as it has been in select previous cases (e.g., <i>State of Indiana v. Purvi Patel</i>, 2015; <i>State of Mississippi v. Latice Fisher</i>, 2018; <i>The State of Nebraska v. Celeste Burgess</i>, 2023; <i>The State of Nebraska v. Jessica Burgess</i>, 2023). While Big Tech has been scrutinized for turning user data over to law enforcement, many have more heavily questioned the protections offered by period tracking app companies due to the abundant amount of health data these companies possess about their users (e.g., Basu, 2022; Bradley et al., 2022; Cole, 2022). These apps have historically fallen short in protections for their user data in general (e.g., Beilinson, 2020; <i>Developer of Popular Women’s Fertility-Tracking App Settles FTC Allegations That It Misled Consumers About the Disclosure of Their Health Data</i>, 2021; Quintin, 2017). Clue is one of the most popular FemTech apps with millions of downloads across the Apple App Store and Google Play Store, and the company has spoken out widely about their privacy protections in the wake of the <i>Dobbs v. Jackson</i> decision (<i>‎Clue Period Tracker & Calendar</i>, n.d.; <i>Clue Period Tracker & Calendar</i>, n.d.; <i>Clue’s Response to Roe vs Wade Decision</i>, 2022). This research presents a forensic analysis of Clue on both iOS and Android after two months of data population, finding that some user-entered data was available in the app cache or .db-wal files on both iOS and Android but was entirely erased after the deletion of the app on the phones. This research also presents results from a survey of 31 menstruators in the United States, finding that online privacy in general is a concern for many users, and most find it unacceptable for period tracking applications to share user health data with advertisers or law enforcement.</p>