Flo Health has established a new standard for corporate social impact measurement with the publication of comprehensive research in BMJ Public Health, which quantifies the real-world effects of its Pass It On Project. The study represents one of the most rigorous evaluations of the impact of a digital health intervention on women’s reproductive health knowledge in low- and middle-income countries, demonstrating how evidence-based approaches can drive meaningful health outcomes at scale.
The longitudinal research, involving 6,165 participants across 52 countries, provides concrete evidence that Flo Health’s free premium access program has achieved significant improvements in menstrual health knowledge and related health outcomes. The study’s publication in BMJ Public Health, a peer-reviewed journal, underscores the scientific rigor and credibility of the findings.
Scientific Validation of Digital Health Impact
The research employed a sophisticated methodology, combining a pre-post longitudinal design with repeated cross-sectional analysis, to account for the high attrition rates standard in digital health studies. This dual approach allowed researchers to demonstrate both individual user improvements over time and population-level differences between new users and those with extended app exposure.
Flo Health’s research team developed novel assessment tools in collaboration with external scientific advisors, including a comprehensive menstrual health and hygiene knowledge quiz that addresses critical knowledge areas where global gaps have been identified. The quiz covered topics from typical menstrual bleeding patterns to fertility windows and best practices for menstrual hygiene maintenance.
The study’s findings revealed concerning baseline knowledge levels among adult women of reproductive age. Participants correctly answered only 3.4 out of 10 knowledge quiz questions on average before accessing Flo’s educational content. Most notably, while 83% of participants knew the length of a normal menstrual period, only 38% understood how long a standard fertile window typically lasts.
Quantified Health Improvements
The research documented measurable improvements across multiple health indicators following exposure to Flo’s premium educational content. Women who used the top-rated app for three or more months demonstrated an 18.7% increase in menstrual health knowledge scores compared to baseline measurements. This improvement represents a meaningful advancement in understanding critical concepts related to menstruation, conception, and sexual health.
Beyond knowledge acquisition, the study found significant improvements in health awareness and quality of life measures. Menstrual health awareness increased by 9.0%, while sexually transmitted infection awareness improved by 1.7% in the matched sample and 3.1% in the pre-post sample. Quality of life scores showed meaningful increases of 1.8% and 3.5% respectively.
The research also documented reductions in adverse health outcomes. Menstrual stigma decreased by 8.1% in the matched sample, while menstrual impact on daily life decreased by 6.7% in the pre-post sample. These findings suggest that improved knowledge translates to better management of menstrual health challenges and reduced psychosocial burden.
Advanced Statistical Analysis
A key innovation of the study was its mediation analysis, which quantified how improvements in health knowledge directly translate to better health outcomes. This analysis revealed that between 23% and 66% of observed improvements in select outcomes could be attributed specifically to enhanced menstrual health knowledge, establishing a clear causal pathway from education to improved health and well-being.
The mediation analysis provides crucial evidence for the mechanism through which digital health interventions achieve their effects. For menstrual awareness and stigma, 23% and 43% respectively of the total association from app use were estimated to be attributed to differences in menstrual health knowledge. Statistically significant mediation was also found for communication confidence (32%), sexually transmitted infection awareness (66%), and quality of life (54%).
Global Health Monitoring Contribution
The study provides essential data for global menstrual health monitoring efforts. The research collected data on select indicators across five of seven global menstrual health and hygiene monitoring domains: knowledge, menstrual health impacts, supportive environment, discomfort/disorders, and menstrual materials.
For indicator measurement, the study found that 16% of participants reported not having access to enough menstrual materials during their last menstrual period. For knowledge indicators, 62% of study participants either did not know or incorrectly specified the typical duration of a standard fertile window. In comparison, 38% either did not know or incorrectly specified when unprotected sex would most likely result in pregnancy.
Evidence-Based Content Development
The study validates Flo Health’s approach to developing evidence-based content. The innovative company offers access to a comprehensive library of educational content, created by doctors and health scientists, which draws on peer-reviewed sources and guidelines from internationally recognized health organizations. All educational material undergoes rigorous peer review before publication within the app.
The platform facilitates engagement through various interactive features, including personalized health tips, reminders, and chatbots offering daily health advice. These features aim to enhance users’ knowledge of their menstrual health and guide informed decision-making while reducing stigma often associated with reproductive health topics.
