IntroductionmHealth as a technical area has seen increasing interest and promise from both developed and developing countries. While published research from higher income countries on mHealth solutions for adolescent sexual and reproductive health (SRH) is growing, there is much less documentation of SRH mHealth interventions for youth living in resource-poor settings. We conducted a global landscape analysis to answer the following research question: How are programs using mHealth interventions to improve adolescent SRH in low to middle income countries (LMICs)?MethodsTo obtain the latest information about mHealth programs targeting youth SRH, a global call for project resources was issued in 2014. Information about approximately 25 projects from LMICs was submitted. These projects were reviewed to confirm that mobile phones were utilized as a key communication media for the program, that youth ages 10–24 were a prime target audience, and that the program used mobile phone features beyond one-on-one phone calls between youth and health professionals.ResultsA total of 17 projects met our inclusion criteria. Most of these projects were based in Africa (67%), followed by Eurasia (26%) and Latin America (13%). The majority of projects used mHealth as a health promotion tool (82%) to facilitate knowledge sharing and behavior change to improve youth SRH. Other projects (18%) used mHealth as a way to link users to essential SRH services, including family planning counseling and services, medical abortion and post-abortion care, and HIV care and treatment. There was little variation in delivery methods for SRH content, as two-thirds of the projects (70%) relied on text messaging to transmit SRH information to youth. Several projects have been adapted and scaled to other countries.DiscussionFindings suggest that mHealth interventions are becoming a more common method to connect youth to SRH information and services in LMICs, and evidence is emerging that mobile phones are an effective way to reach young people and to achieve knowledge and behavior change. More understanding is needed about the challenges of data privacy and phone access, especially among younger adolescents, and the role that mHealth solutions for adolescent SRH should play in health programming for young people.Electronic supplementary materialThe online version of this article (doi:10.1186/s12978-016-0276-z) contains supplementary material, which is available to authorized users.

Evidence on mobile phone interventions for ASRH published in peer-reviewed journals reflects a high degree of quality in methods and reporting. In contrast, current reporting on essential mHealth criteria is insufficient for understanding, replicating, and scaling up mHealth interventions.

S ex workers, injection drug users, men who have sex with men, and transgender individuals shoulder a disproportionate burden of HIV (Wheeler et al. 2015). UNAIDS (2014a) estimates that 40-50 percent of all new HIV infections among adults worldwide occur among these key populations. HIV among these key populations is driven by a myriad of behavioral and structural factors, including drug use, violence, sex with multiple and concurrent partners, inconsistent condom use, stigma and discrimination, and criminalization. Although these factors also increase the risk of poor reproductive health outcomes (WHO 2014), relatively little attention has been paid to the reproductive health needs of key populations.

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Background: Menstruators in low- and middle-income countries struggle to manage their menstruation safely, hygienically, and with dignity. This is exacerbated in humanitarian settings with limited access to products and safe, private spaces for changing, washing, and disposing of menstrual products. To address these challenges, Youth Development Labs (YLabs) used a human-centered design approach to co-design the Cocoon Mini, a safe, physical structure for managing menstruation in the Bidi Bidi Refugee Settlement in Uganda. Methods:The study comprised five phases, including secondary research, design research, rough prototyping, live prototyping, and a pilot study. A total of 340 people participated in interviews, focus groups, and co-design sessions. Solution prototypes were created, evaluated, and iterated upon in each successive project phase. The final intervention design, the Cocoon Mini, was evaluated qualitatively for feasibility and acceptability during a three-month pilot using semi-structured interviews with menstruators utilizing Mini structures, other community members, and Mini supervisors. Results:Our results show widespread desirability and acceptability of the Cocoon Mini among menstruators and other community members. Overall, 95% of menstruators stated the space had made menstrual health management easier, primarily by providing designated disposal bins, solar lights, and additional water sources. The Mini provided an increased sense of physical and psychological safety in knowing where to manage menstruation. Furthermore, the Mini demonstrated that an intervention could be run and maintained sustainably at the household level in humanitarian contexts, without continued external stakeholder intervention. Each Mini structure cost approximately $360 USD to build and maintain and served 15-20 menstruators, leading to a cost per person of $18-$24. Additionally, each incinerator attached to the Mini structure used to dispose of soiled menstrual products cost $2110 USD. Conclusions:Menstruators lack access to safe, private spaces for menstrual health and product disposal in humanitarian settings. The Cocoon Mini provides a solution for the safe and effective management of menstruation. Customizing and scaling up dedicated MH spaces like the Cocoon Mini should be considered a high-priority intervention in humanitarian settings.