Since publication, the F1000Research editorial office has been informed of concerns regarding suspected duplicate publication of this article. We have contacted the authors and all editorial activity has been suspended pending further investigation. Further action will be dependent on the outcome of these discussions.

Good reproductive health is important for individuals and also for the development of children. Reproductive health is, or should be, a serious concern for every woman. A nation’s mortality and morbidity are dependent on the reproductive health of its citizens. Knowledge plays an important role in women’s reproduction health. For example, it informs them on how and when to seek health services ¹ .

Mobile health applications (apps) are rapidly proliferating and are widely used around the world to access health information ² . In 2018, more than 50% of people worldwide had at least one mobile health app on their device ³ . There are more than 100,000 smartphone health apps available today. The main goal of internet-based health apps is ready accessibility ⁴ . Mobile health apps have a number of benefits: they enable fast, easy searches of almost unlimited health information ² ; they bring doctors and patients closer together; and they provide health information at any time ⁵ .

The increasing popularity of mobile health apps is due to a number of things. Firstly, people are more comfortable sharing their experiences, expressing emotions, and exchanging ideas on specific topics within a like-minded community. Secondly, people are curious and want more information about their health experiences ⁶ . Mobile health apps have been successful in reducing health costs. Preventive action by internet disseminated information is much more efficient than manual methods such as brochures, leaflets or posters ⁷ . Technology has the potential to alleviate time management issues involved in counselling, treatment waits, and registration ⁷ .

One limitation of mobile health apps is that, due to the lack of quality controls on the internet, they vary widely in quality and accuracy. Providing good-quality, evidence-based health information to patients is an important goal ⁶ .

Due to the increasing popularity of mobile health apps, the Jakarta Reproduction Sehat (Jakpros) smart mobile app was developed in 2018 ( Figure 1). This free app is specifically designed to provide women with a convenient way to improve reproductive health knowledge. Jakpros has a section that shows the nearest hospitals from patients to help them access medical care. Other features include an educational page with general information on reproductive health, which is divided into several sections (e.g. contraception, high-risk pregnancy, cancer). Furthermore, the Jakpros application has a question and answer service supported by obstetrics and gynecology doctors ( Figure 2B).

Currently, the Jakpros app is used in several subdistrict hospitals in Jakarta. The aim of the present study was to examine perspectives and knowledge of reproductive health issues in women who used Jakpros as part of their daily activity. Our results will help us improve the usage and quality of the Jakpros app for women in the community.

This study follows on from our past quantitative research ⁸ . In the previous study, participants used the Jakpros smart mobile app for 2 weeks. During this time, they read the educational page feature to enrich their knowledge ( Figure 2A). They could also consult their healthcare providers about their complaints or for health information ( Figure 2B). We saw an improvement in health knowledge using pre- and post-test questionnaires. In the current study, we explored participants’ opinions and detailed perspectives on reproductive health and the Jakpros application. We used a qualitative method to analyze the main topic.

We explored the different perspectives and behaviors of participants in detail. We adopted phenomenology study as our basic paradigm. The goals of this paradigm are to evaluate participants’ experience to be as factual as possible. Furthermore, it describes the different perspectives of the participants ⁹ .

The discussion forum was conducted with 12 participants from two sub-district hospitals in Jakarta. Most of them were homemakers, 24–38 years old with high school diplomas as their highest educational qualification. All had participated in our previous quantitative study, which included a post-test questionnaire. This current study was a qualitative study, with results obtained using focused discussion.

In this study, we explored participants’ knowledge and perspectives of reproductive health and experiences of the Jakpros application after using it on a daily basis for two weeks. Firstly, they could recognize the early signs of cancer or something wrong with their bodies (e.g. bleeding, bumps in breast). Furthermore, for cancer, they knew about basic diagnostic examinations and treatment. Our results were the qualitative study from our previous quantitative study, which found that women are likely to inform themselves of signs and risk factors for cancer in reproductive systems. They were alert to its signs and risk factors ¹⁰ . According to another previous study, patients search the internet for further information about their symptoms and rely on this information to make decisions about their health ¹¹ . In our study, we found that participants understood about cervical cancer prevention. They told us that to prevent it people have to maintain good genital hygiene, not change sexual partners, and have regular HPV vaccinations. They agreed that sexually active or married people should have routine examinations routinely too for prevention and early detection. In a previous study, social media has been found to be an effective platform for increasing knowledge and awareness of cancer ¹² .

When we asked about contraception, we found that participants were more confident and willing to speak. They could explain what contraception was used for, and also knew about the benefits and side effects of various types of contraception. They involved their husbands and doctors in making their decisions about contraception. They perceived contraception as a way of controlling pregnancy. They told us that family planning was important and required the cooperation of their husbands and consideration of their own bodies and needs. They depended on their social networks for information in making their decisions about contraception. The participants said they were more comfortable obtaining information from their doctors after they read information in Jakpros application. However, they were also interested in further discussion on social media.

For the discussion on pregnancy, we asked participants about anemia, nutrition, and high-risk pregnancy. They knew the definition of anemia, and its early signs, examination, treatment and prevention. They agreed that anemia in pregnancy is a serious condition. Also, they said that nutrition was important in pregnancy, and they could name the nutritional components how they function in pregnancy. They were aware of early signs of high-risk pregnancy. They considered that to prevent pregnancy becoming high risk, women should have regular antenatal care visits and keep a healthy lifestyle during pregnancy. In our past study we found that pregnant women tend to use mobile health applications – for example, to network within communities of people who have the same condition as them. Pregnancy can be stressful, and women can get reassurance by sharing their experiences in online discussion groups. Women also appreciate the convenience of being able to access advice and information any time ¹³ .

The increasing use of digital devices impacts community expectations for accessing health information. All participants agreed that Jakpros provided a service that helped them access information. Our previous study showed that people like to get information as fast as possible and from wherever they are ⁸ . Most of our respondents felt that going to the doctor required too much effort to go to doctor ¹³ .

Previous studies have described how poor-quality information online can lead to health consumers making ill informed decisions ⁶ Our study showed that patients did not hesitate to get information from Jakpros, and they felt this platform delivered reliable medical information. In particular, they appreciated the free advice from doctors about their reproductive problems.

In response to participant comments, there are a number of things we could do to improve the quality of the app. Firstly, to update the educational page more regularly. Secondly, to improve doctor responses to questions, ideally within 24 hours. Lastly, we hope to extend the information on doctor availability from a few sub-district hospitals to all hospitals in Jakarta.

In our previous quantitative study, we found that user knowledge increased after two weeks’ use. This current study demonstrated users’ perspectives on reproductive health after using the app. In addition to basic knowledge of reproductive health, their level of awareness had increased, as was observed in the previous quantitative study ⁸ . The knowledge and awareness provided by Jakpros can help inform women’s important decisions on their reproductive health.

Limitations of this study include the lack of perspective study of the consumers as the references of our qualitative and previous quantitative study of Jakpros application, and the short time allocated to the previous quantitative study.

Respondents felt that Jakpros was a helpful application for daily use. Future development of this application is still needed to improve its features. Our aim for Jakpros is that it will one day be a platform for women to access reliable health information that they can apply in their lives.

This study was approved by the Ethics Committee of the Faculty of Medicine Universitas Indonesia, Jakarta (Committee reference number: 1326/UN2.F1/ETIK/2018).