By Sunidhi Gupta

Abstract

Reproductive rights, which broadly include sexual health and well-being,  are a very sensitive topic, especially in a developing society where people are not open to discussing all aspects of reproductive health. Additionally, the increasing use of digital platforms not just for increasing awareness but also as intermediaries makes the discussion of reproductive rights in relevance to digitalization even more important. This article focuses on the interplay of technology and digitalization as a medium to provide reproductive rights. Focusing on the positives as well as the negatives through the intersection of technology and healthcare, the article also sheds light on what approach is taken and how it is implemented.

INTRODUCTION

Sexual Reproductive Health and Rights (SRHR) and Sexual Reproductive Health Services are very sensitive matters and any kind of mishandling or breach of confidentiality can cause upheaval in society. Nonetheless, there has been penetration of technological advancements to provide for healthcare and reproductive health facilities through digital channels. The widespread use of mobile technology and the quick development of artificial intelligence have contributed to this trend. Wide coverage, the ability to target specific groups or individuals with messaging, and the opportunity to improve the delivery of information and support for sexual and reproductive health and rights (SRHR) are all provided by digital communication channels.

When SRHR is categorized as sensitive, there is focus on certain information. Certain populations, such as teenagers and men who have sex with men or outside marriage, may feel strong social condemnation towards sexual conduct. Reproductive decisions are heavily impacted by partners and members of the larger family and community, and HIV and other STIs are stigmatized. If SRH service use is not kept private or HIV/STI status is disclosed, it may lead to stigmatization, discrimination, blaming, disagreement with or loss of support from parents, as well as new or increasing verbal or physical abuse. Women are frequently the victims of reproductive coercion, which significantly reduces their autonomy over reproductive choice. This is especially true for women who live in more patriarchal, socially conservative circumstances. Many women fear violence to ‘seek’ reproductive autonomy, and ‘requests’ for contraception might lead to suspicion of adultery. Confidentiality violations are one of the ways that women could be harmed in this situation. The lady may not be allowed to visit medical facilities or receive care if a spouse or family member finds out that she is receiving SRH services.

IMPORTANCE OF SEXUAL & REPRODUCTIVE RIGHTS AWARENESS

It is very important that issues pertaining to reproductive health and rights are addressed so that  women become aware of their rights which would contribute to a general push towards improving access to services for the same to ensure a step towards societal change. To better meet the needs of women in terms of reproductive healthcare, a multifaceted strategy is required. This includes supporting local health workers, many of whom are women, as well as providing access to improved routes for sexual and reproductive health services and abortion and contraceptive options. 

Facts and figures also reflect why awareness of Sexual and Reproductive Rights is important. According to recent data from the World Health Organization, problems during pregnancy and childbirth claimed the lives of almost 808 women every day in 2017. 295,000 women lost their lives during pregnancy and childbirth in total that year. Women from low and middle-income countries (LMICs) face additional dangers, as their chance of dying from pregnancy-related reasons is around 130 times greater than that of women in high-income countries. According to a 2020 study by the Guttmacher Institute, 218 million of the 923 million women in LMICs who are of reproductive age “want to avoid pregnancy,” but they do not have access to contemporary forms of contraception.

The American Heart Association’s New York City headquarters hosted a “Roundtable on Accelerating Equitable Digital Innovations for Women’s Reproductive Health” during the UN General Assembly (UNGA) in 2023. A recurring theme in the debate throughout the day was how important it is to provide women with the means to effect lasting, significant change in reproductive health globally. The significance of empowering women leaders in conversations on funding, access, legislation, and technological innovation was emphasized by both panelists and participants. Additionally, the World Health Organization (WHO) discovered in 2016 that while women in the EU outlive males, they also experience poorer health for a larger portion of their lives. Around the world, the gender health gap is still unresolved despite notable advancements in other areas.

INTRODUCTION AND INCLUSION OF TECHNOLOGICAL ADVANCEMENTS

When tech advancements are discussed, one aspect to be studied is the digital health startups. However the issue with these apps is that they might lose sight of the needs of the people they cater to very often. Businesses must take a person-centered approach in order to increase access to this type of technology, which has significantly grown since the telemedicine boom of the pandemic years. A women-focused healthcare firm should identify the gaps in the market and create products that address those requirements. This means appointing leaders who embody the real-life experiences of the customer. The foundation of a woman-forward, patient-centered, and human-centered design for healthcare goods and policies requires a representative developing for the population they belong to. This position should not be replaced by someone who is not affected by those policies.  

One example of such a successful health-tech app is Tia. It was involved in the fostering of a US-based digital healthcare firm, which is successful because its telehealth services for women’s reproductive health complement current healthcare systems by fusing technological advancements with approved clinical knowledge. Also, interest in “femtech”—that is, tech-enabled women’s health treatments and products—has grown in recent years. Femtech provides tailored contraception and tracks menstrual cycles and pregnancy, among other health needs for women. Femtech businesses have been focused on developing markets in North America and Europe, but their goods have the power to improve lives everywhere, including in low and middle-income nations (LMICs). 

There is another question which has been posed by Dr Olivia Vélez, chief digital health officer at IntraHealth International, a global health nonprofit that works with governments and community members in over 100 countries. She states that an overwhelming majority of health workers worldwide are women, including 90% of community health workers and 70% of nurses. This has consequences for designing digital solutions that adhere to best practices. But she questions how the best interests of women could be upheld, when the men continue to dominate the tech industry, with regards to testing AI technologies with no experience of being a woman.  

INTERSECTION OF WOMEN & TECH IN HEALTHCARE

There are various ways to include women in the designing and functioning of healthcare applications especially when something concerns their needs and bodies explicitly. There are examples such as the app ‘Aya Congito’, a digital healthcare companion by a Venezuelan company that is accessible in both Spanish and English. It provides users with information on medical abortion and contraceptive treatment. It is emphasized that if these tools are not designed keeping in mind the community they are meant to serve, they will eventually fail. The way the design of the app is based on getting the locals to tell us what is going on there. What are the necessary resources to obtain information about abortion or contraceptives? What is the status of access? 

They collaborate to provide information and take part in the creation of a progressive online application with resources available in Spanish. This was crucial since everything that was discovered online was translated to “bad Spanish,” making it difficult for people to understand or obtain the required information. Stigma can be greatly reduced by using programs like Aya Contigo that actively involve local communities to prioritise person-centred approach. 

Women in the field of research still remain underpaid and underrepresented. There are obvious biases in the study on erectile dysfunction, which affects roughly 19% of men, compared to premenstrual syndrome, which affects 90% of women. Five times as much money has been allocated to the former as the latter. More women in leadership roles in this field are necessary for real advancement. 

RISKS OF DIGITAL AVAILABILITY OF REPRODUCTIVE RIGHTS INFORMATION

Although the collaboration of technology and healthcare involves inevitable evolution and is strongly accepted by the people, it has its own drawbacks. ​​While there are opportunities to promote and provide services for  Sexual Reproductive Health, due to the widespread use of digital technology, interventions that intrude into users’ homes and personal spaces may also carry a higher risk. Interventions aimed at improving antiretroviral medication adherence among HIV-positive patients, for instance, may unintentionally lead to HIV status revelation. 

There are features on mobile phones that can be utilized to improve privacy. Sensitive personal information sent via digital media in SRH circumstances may be private, particularly if passwords are kept private and alarms are disabled. However restrictions on using a mobile phone and privacy notions differ depending on the person and the situation. Families may share phones, which reduces the possibility of transmitting private information. Digital media, in an abusive household, may be regulated by the partners,  family members or guardians, and may be exploited as a tool to abuse.

Author’s Bio

Sunidhi Gupta is a fourth-year BA.LLB (Hons) student at Jindal Global Law School.

Image Source: https://privacyinternational.org/campaigns/protecting-privacy-digitalisation-reproductive-healthcare