From Taboo to Touchscreen: A Qualitative Exploration of a Digital Sexual and Reproductive Health Intervention for Bangladeshi Adolescents (Preprint)

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BACKGROUND Bangladeshi adolescents face significant challenges accessing relevant sexual and reproductive health (SRH) information, with the added burdens of cultural taboo, limited accessibility, and poor communication channels. Traditional adolescent-friendly approaches have shown limited effectiveness in addressing these challenges. In response, Mukhorito was developed as a peer-led, mobile-based digital platform to facilitate SRH, education, and communication among ninth-grade students. OBJECTIVE This study explored the feasibility and constraints of piloting the Mukhorito app to enhance adolescent SRH education in Bangladesh. It also sought to determine the self-reported usage, usability, and effect on knowledge and peer communication of the app, as well as to identify implementation and adoption challenges. METHODS Qualitative design was applied in the context of a broader mixed-methods study. Data were collected through six In-Depth Interviews (IDIs), three Key Informant Interviews (KIIs), and one Focus Group Discussion (FGD) from 19 participants, including students, peer leaders, teachers, and government representatives, across three secondary schools in the Feni district. Thematic analysis was conducted using NVivo software under Braun and Clarke's guidelines. RESULTS The Mukhorito app was received positively for its structured material, interactivity, and easy peer-to-peer communication. Almost all participants shared improved SRH awareness and leadership skills, as well as reduced stigma when discussing delicate topics. The main challenges were limited smartphone access, poor internet connectivity, and affordability. Potential ways to improve the app’s usability were integrating the application into the school curriculum, improving offline functionality, and adding visual material such as short dramas or videos. CONCLUSIONS Mukhorito possesses strong potential as a culturally relevant, digital SRH education tool for Bangladeshi adolescents. The app enabled knowledge and openness in SRH discourse. Alignment with national health programs and enhanced app functionality may promote greater and more sustainable adolescent health.