E-Health Counsellor (EHC), a Smartphone Application to Fight
Cervical Cancer
Kiki Awalul Chasanah
Faculty of Public Health, Universitas Airlangga, Mulyorejo, Surabaya, Indonesia
Keywords: EHC, Cervical Cancer, Technology, Mobile Phone, Knowledge.
Abstract: Cervical cancer is one of the most deadly diseases for women. Based on data from the Health Ministry,
cervical cancer is the highest disease among developing countries and the fifth in the world. In Indonesia,
cervical cancer is the second of the ten most prevalent cancers. One of the causes of the high incidence of
such cancer is the lack of knowledge about it. This writing aims to show how knowledge can be so
important to increase degree of health and EHC is such a media can be used to access knowledge simply in
digital era. This research focuses on literature review. EHC is a mobile phone application that focuses on
cervical cancer disease and is available for all society, especially for women. EHC includes the definition
and means of prevention of cervical cancer and is also integrated to health workers and health facilities to
facilitate the public in enhancing their own health. EHC provides private counsellors who connect members
of the public with an expert and the goal is that people know more about cervical cancer and how it can be
eliminated. So, result is may EHC can facilitate society to prevent cervical cancer by increasing knowledge
and having private councellor.
1 INTRODUCTION
The World Health Organization (WHO) has stated
that cervical cancer is one of the most deadly in the
world and one which occurs mostly in developing
countries. However, this disease is preventable.
However, being preventable does not mean it is easy
to handle. There are many factors that cause cervical
cancer and lead to many casualties. There are several
risk factors that can lead to cervical cancer,
including unsafe sex, frequent couples and having
multiple sex partners (Bosch et al., 2002). In
addition to those risk factors, according to the theory
proposed by L.W. Green, there are three factors that
affect health, predisposing factors, enabling factors
and reinforcing factors. Of these three factors,
predisposing factors play a very big role, especially
in terms of knowledge. Several studies have proven
how knowledge plays an important role in the
occurrence of a disease.
Research conducted in Ghana found that there
are significant differences between women who
have a higher level of knowledge than other women
in the incidence of cervical cancer (Opoku, 2016). It
proves that knowledge can be a tool to prevent
cervical cancer. Moreover, a study conducted by the
National Health Interview Survey showed that that
women with high knowledge tend to be healthier
(Mamon, 1990).
In Indonesia, as a developing country with
257,912,349 people, cervical cancer is one of the
most dreaded things, especially for women.
According to the Ministry of Health, in 2013, the
percentage of cervical cancer reached 0.8% and was
the highest compared to other cancers. Riau Islands
Province, North Maluku Province and D.I
Yogyakarta Province have the highest prevalence of
cervical cancer that is 1.5%. By 2014, more than
92,000 Indonesian women die from cancer with
10.3% of them due to cervical cancer. One factor of
the high numbers is due to the absence of early
monitoring process (CNN Indonesia, 2017).
Clearly this is problematic for the country. An
integrated effort from all stakeholders is required to
reduce the incidence of cervical cancer. Moral and
financial support from the government is urgently
needed, and a thorough improvement of knowledge
should be strengthened to create community
awareness. The literature review aims to document
the importance of knowledge in the fight against
88
Chasanah, K.
E-Health Counselor (EHC), a Smartphone Application to Fight Cervical Cancer.
In Proceedings of the 4th Annual Meeting of the Indonesian Health Economics Association (INAHEA 2017), pages 88-91
ISBN: 978-989-758-335-3
Copyright © 2018 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved

cervical cancer as well as the next step that may be
applied. It addresses how such knowledge becomes
easily accessible to all levels of society in all corners
of Indonesia.
2 METHODS
This is qualitative research and all data obtained by
secondary data. The literature includes journals,
proceedings, theory and previous research available
on the Internet. The first thing to do is to identify the
keywords in the literature that may be in line with
this research of cervical cancer, technology, mobile
phones and applications. The publishing year is also
a consideration in the selection of sources or
references to obtain the latest data. The several
websites used include WHO and NCBI websites.
After collecting the references, researcher then
read the entire article in order to gain a point of
view. The final step was to review the references
that had been downloaded. Therefore, the structure
of writing in the sub-section results is divided into
two parts, the importance of knowledge and
technology which is specific to mobile phones.
3 RESULT
3.1 The Importance of Knowledge
Knowledge is the right thing and can be justified.
Knowledge is specific, relational and dynamic.
There are two types of knowledge, tacit knowledge
and explicit knowledge. Tacit knowledge is
subjective and experiential and cannot be expressed
in sentences such as crafts, beliefs, images and
mental models. Whereas explicit knowledge is
objective and rational and can be expressed with
sentences, formulae and numbers, as in
mathematical models such as databases and
theoretical approach (Nonaka. 2006). Knowledge is
an important aspect of health. Many models and
theories are developed to transfer knowledge to be
easily understood by the wider community (Kontos
and Poland, 2009).
In health, there are many statements concerning
the importance of knowledge in obtaining high
degrees. One of the most famous theories is by
Lawrence Green, who mentions that there are three
factors that affect health, predisposing factors,
enabling factors and reinforcing factors. Below is
the model of theory described.
Figure 1: Model of Lawrence Green Theory
The existence of knowledge enlightens the
community. Some of the benefits of knowledge in
the health sciences can be a driving force to take
positive steps in preventing disease, have a better
understanding of the existence of system alteration
and how to use them effectively and efficiently;
good knowledge allows everyone to learn and make
efforts to handle disease independently. In addition,
the knowledge that may be provided through health
education can also provide an understanding of the
beliefs and traditions of society, both harmful and
beneficial to health (Notoatmodjo, 2007).
3.2 Technology
The Department of Health states that health
promotion has an understanding as an effort to
empower the community to maintain, improve and
protect the health of themselves and their
environment through learning from, by, for and with
the community, to help themselves and develop
community-based activities in accordance with local
culture and supported by sound public policy.
Based on its function as a distributor of health
messages, the media is divided into three, as
follows: print media, electronics and boards
(Notoatmodjo, 2012). 1) Print media as a tool to
convey health messages varies widely, such as
magazines, rubrics and so on. 2) Electronic media as
a target to deliver messages or health information is
of different types, such as television, radio and
mobile phones. 3) Media boards (Billboard) posted
in public places can be filled with messages or
health information. Media boards here also include
messages written on zinc sheets attached to public
vehicles (buses and taxis).
Today, the world is developing and technology is
becoming inseparable. However, a thing to keep in
mind is that the existence of technology was created
with the aim to facilitate humans in meeting their
life needs. Technology is changing and technology
will definitely change the pattern of a person's
activity. For example, television presence; there will
be a new agenda of viewing every day as well as the
Reinforcing Factor
Predisposing Factor
Enabling Factor
Health
E-Health Counselor (EHC), a Smartphone Application to Fight Cervical Cancer
89

arrangement of the location of the home furnishings
that are adjusted to the television placement.
Technology is progressing, and now anyone can
access technology, almost all people have mobile
phones and some individuals have more than one.
Nobody will miss information when technology is in
their grip. Technology makes it easy; technology
means it is not difficult for people to contact other
people who are in distant places. Technology
produces productivity; large companies use
technology for efficiency reasons and productivity
improvements rather than having to hire more
money-consuming people. Technology promises
speed’ a variety of jobs can be completed quickly by
utilising the technology optimally, such as the
existence of a computer can facilitate a person in
doing bookkeeping. Technology is showing
popularity; today, many people are famous by
uploading their performance on YouTube sites such
as Canadian singer Justin Bieber (Martono, 2012).
The modern era is happening and synonymous
with the digital community. Every human activity
will be driven through a series of digital
technologies and everyone has their respective
numbers, such as ATM numbers and telephones,
currently all digital.
4 DISCUSSION
Knowledge of cervical cancer becomes a very
important thing to have, not only in the basics but in
the details, not only about the definition of cervical
cancer, but more about how steps can be taken to
prevent it. As we now identify with technology and
the digital community, so we need an information
tool that can be accessed anytime and anywhere by
anyone. Research conducted by Nasihah shows that
there is a relationship between knowledge on early
detection of cervical cancer disease (Nasihah et al,
2013). Furthermore, through research conducted by
Mirayhasi, it stated that there is a meaningful
relationship between knowledge of the participation
of cervical cancer examination (Mirayashi et al,
2014).
Prevention and early detection of cervical cancer
should be done to reduce mortality and morbidity
caused by the disease. To do that, one of the things
that can be done by continuously improving the
knowledge of the community because however
knowledge is very influential on the behavior of
early detection of cervical cancer (Syahputra et al,
2016). By taking advantage of technological
developments, there are things that can be done to
improve the knowledge of the public that is to say
that the prevention of cervical cancer has a great
distance with the community just in hand.
E-Health Counsellor (EHC) is a service provided
to a community-based Smartphone application. EHC
facilitates the public to access information related to
cervical cancer, not just limited to the definition of
cervical cancer, but includes preventive measures
and online counselling services that connect people
with health workers.
EHC is designed simply to be easy to understand.
Content in the EHC includes: accounts that contain
the user's personal data, settings that include
language settings, notifications and so on,
descriptions of cervical cancer complete with video,
preventive measures, treatment steps and online
counselling services. Preventive measures will detail
what can be done to prevent the occurrence of
cervical cancer, such as the use of condoms and
injecting HPV along with a price so that people can
be prepared. Similarly with the treatment step,
explaining about the treatment that can be done
along with a list of hospitals as well as the price of
each treatment. Online counselling services allow
people to choose their own health personnel who
want to be a counsellor for the sake of comfort. This
service is not limited by time and place.
EHC is expected to reach the entire community
and make access to information easier. In order to
access the EHC, everyone first sets up an account,
the goal is to facilitate counselling with health
workers. If you do not create an account then you
still can access the EHC, you just cannot do
counselling. Data on online counselling will be kept
confidential and not be published.
This online information and counselling service
requires Internet access and, therefore, needs support
from several parties to make this real. There are
several strategic steps that can be done, such as
submitting a proposal to a sponsor as a development
partner, in collaboration with the Department of
Health and Communication and a hospital. What is
really needed is the presentation to all parties
involved regarding the urgency and benefits of EHC.
Easy access to knowledge about cervical cancer is
very important to be realised and plays a big role for
people to be more introspective and enhancing of
society’s health. However this application is still in
the design and experiments so it cannot be known
exactly how the rate of decline in cervical cancer.
Moreover, in the millennial era where people have
always relied on gadgets, the authors believe that an
EHC application on mobile phones can help improve
people's knowledge of cervical cancer, and more
recently developed similar applications to help
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people realize the importance of health, physical and
psychological.
5 CONCLUSIONS
This paper has documented how knowledge can be
very important to health, especially cervical cancer.
The literature review highlights the relationship
between knowledge and disease incidence in some
countries given the many deaths caused by cervical
cancer, especially for developing countries like
Indonesia.
Based on the literature, it is important to develop
a tool that facilitates access to health knowledge,
primarily cervical cancer. An E-Health counseling
service is conceived to accomplish this and includes
information not only about definitions, but actions,
steps that can be done by the community
independently, and online counselling with health
personnel. It is simply designed to integrate some
aspects and the parties involved to prevent or treat
cervical cancer. This paper documents an art of
knowledge in technology that can improve public
health.
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