Saathealth - Healthy mothers & children

Maternal and infant mortality and morbidity continue to be pressing health concerns in many developing countries. Pregnant women and new parents struggle with the lack of information required to ensure they and their newborns have access to the best information. The COVID pandemic is limiting the ability of health workers to support populations who most need their support, further exacerbating the current situation. Saathealth is a digital platform that already uses entertaining, scientific, gamified health and nutrition content to support more than 200,000 parents of children between 0-6 years of age. We propose to extend Saathealth to serve the pregnant women and new mothers. Our platform is already deployed in more than 25 Indian cities and is building strong state government partnerships. Given its inherent scalability, we have the ability to scale rapidly globally to ensure better health for our pregnant women, new mothers and young children.

Indian cities are home to 37% of the country’s children, 120 million of whom live in informal urban settlements. This number is estimated to reach around 180 million by 2030. The double burden of low awareness and inadequate access to health and sanitation infrastructure leads to poor health outcomes for these residents. In this segment of urban children, over 60% are not completely immunized, and 47% are undernourished.

This cycle of poor health outcomes begins with the health of mothers. Maternal mortality has made positive strides in the last two decades, with a decline of 130 per 100,000 live births to 122. However, recent national surveys show that India’s anemia burden is widespread, with over half of all pregnant women being anemic. Prioritizing interventions to enhance nutrition for adolescent girls and mothers represents a crucial window of opportunity to improve the maternal and child health burden. A third of women of reproductive age in India are undernourished, and an undernourished mother inevitably gives birth to an undernourished baby, perpetuating an intergenerational cycle of undernutrition. Addressing malnutrition before women become pregnant is the most effective exit to malnutrition within the life cycle.

Our primary assets are two mobile applications and a 1000+ library of behavior change content:

1. A web and android application for parents of young children (0-6 years of age) provides vital, behavior change information in local languages, in an entertaining format. Users receive new content pieces daily in multiple, consumable formats that include videos, infographics, podcasts and interactive quiz questions. The content and the mobile app have been designed and tested to engage with the low income emerging mobile users. The user interface is largely interactive, video-led, visually dominated with a points system that incentivises content viewing, sharing as well as engaging with the quiz functionality. Users get a personalized experience based on user characteristics like geography and stage in their journey. Users receive targeted notifications that reinforce key messaging and nudges them towards targeted behaviors.

2.      A partner mobile application allows supply side partners (health workers, clinics) to onboard users, capture user data and encourage uptake of health products and services.

3.      A real-time dashboard tracks user engagement and behaviour.

Our team is leveraging the more than 600k app sessions to build machine learning algorithms, that we are using to predict user engagement and  automated targeted interventions.

Our solution serves low-income families living in urban settlements. These families generally live on INR 20,000-30,000 (USD 300-350) monthly household income. Most men are employed in blue-collar jobs or informally as drivers, plumbers or carpenters. Women employment is entirely informal and varies by community (10-50%). Many of these families have migrated to cities for better opportunities, but struggle with access to basic health and nutrition services. Our initial surveys show that families spend approximately INR 1500 a month on health services and medicines, almost all of it out of pocket. As a proportion of income, our target users spend far more on healthcare than most other income classes. Anemia in women, and child malnutrition rates are as high as 50%. Inadequate child nutrition, compounded by the poor health and status of women, the prevalence of household poverty and lack of government service delivery centres are the major drivers of poor health among these urban families. 

It is vital to engage and empower pregnant women and parents of newborns with the behavior change information that can support their ability to make positive choices.  The data revolution in India has made it possible to reach low and middle income communities with richer, interactive interventions than was possible earlier. By engaging with health consumers directly on content designed to engage and entertain, using digital platforms and the power of real time data analytics, we are empowering pregnant women, new mothers and parents of newborns to demand and access positive products, services and behaviors.  

Saathealth is a digital platform designed and freely available for emerging mobile users in India. The mobile and web user interface uses original, scientifically sourced, interactive behaviour change content in Hindi to provide young Indians access to critical health and nutrition information in a gamified fashion. The platform offers a library of 1000+ original, video led, health content pieces focused on health and nutrition, and expanding to COVID related content. Our content is designed to be video-led and gamified, and is gender inclusive, focusing on the role of both parents in children’s upbringing. The platform sources community questions and concerns, and runs mass, targeted health messaging campaigns. User feedback loops in the form of quiz questions allow actionable, real time research insights into issues of prime importance to communities. We are building machine learning algorithms that allow us to deepen engagement with our users and drive them towards target behaviors.

Some unique aspects of our intervention include:

1. Using a mobile-led digital platform reach new mobile internet users

2. Using original behaviour change content to address parenting issues across health, nutrition, early development and learning

3. Building AI algorithms to deepen engagement with parents around targeted content consumption and specific positive behaviors

Many solutions that focus on behavior change communication have limited reach and high costs, calling into question the long-term sustainability of these solutions. They also lack a holistic approach, focusing on narrow deliverables along either health, or nutrition, missing an opportunity to deliver holistic health solutions.

Our core products are an android and a web application that are loaded with multi-format and gamified content in the form of quiz questions. We have the ability to personalize content for users, based on their specific profiles and interests. Our real time dashboards track user behavior and engagement with the application, and provide real world, real time data based on community behavior of the users. These are vital to iterate interventions and to provide users dynamic, updated content on a daily basis.  

Our mobile-led platform has reached over 200,000 people across 25 cities in India in 18 months, crossing over 105,000 app downloads. Over 70% of the installs accrued from users sharing the app with friends and family across the country. Users have cumulatively consumed over 2.25 million pieces of health, nutrition, parenting and early learning content. An average family spent 7 minutes/ session across more than 500,000 sessions recorded.

The median 30-day retention rate of 18% compares favourably with the 3.4% reported for health and fitness apps globally. 70.2% of surveyed users (n=692) reported an increase in the weekly consumption of protein-rich foods for their children, 64.2% reported considering positive changes in their children’s diet (n=513) and 80.95% users reported a better understanding of the importance of protein in their children’s diet (n=2174). There were signs of positive behavior change with as little as 90 days of using the platform.

More details can be found in our2019 annual report as well as the following publications –Stanford Social Innovation Review,Sight and Life,The Better India,The Asian Age

Current scenario

1. 37% of Indian children under five years are underweight
2. Over 50% of women are anemic
3. Information deficit on good health and nutrition practices for young families
4. Parents are eager to learn and take charge of their children's health but may lack the skills to do so effectively

Our intervention

-  Health and nutrition content for pregnant women, new mothers and parents of children aged 0-6 through a digital platform

-  Gamified journey with behavior-change focused nudges towards healthier choices

- Iterative design based on data analytics, user feedback and engagement metrics to maximize user retention

Outcomes

- Improved nutrition and health knowledge for pregnant women, new mothers and parents of young children 

- Improved nutrition choices and health-seeking behavior target populations

- Positive changes in home environment 

Impact

- Improved health metrics among pregnant women, new mothers and children 

- Lower rates of malnutrition, anemia, stunting, and wasting in mothers and children Young families empowered with the tools to raise healthier children

We are currently reaching more than 200,000 people across India. Over the next year, we aim to reach 1 million people (women and children) and 10 million over the next 5 years. Our platform is scalable and the partnerships we are building will allow us to scale so we can serve pregnant women, new mothers and newborns across India. We are also exploring partnerships to launch our platform in other countries, however, those discussions are not included in our current outreach estimates.  

Over the next one year, our goals are -

1. Content: To expand our content library (within our team and with partnerships) to include scientifically sourced, engaging content for pregnant women and new mothers.

2. Platform: We will adapt the current platform journey to offer users a choice of content focused on women's health. Based on user group testing and ethnographic research, we will add elements of gamification that appeal to young pregnant women and new mothers.  

3. The 200k users we have already include many pregnant women and new mothers. We will scale our acquisition approach via partnerships with non-profits, UNICEF and state governments to reach 1 million users by the end of 2020.

4. Impact: Generate data to monitor, measure and report our impact on knowledge and behavior change within pregnant women and new mothers. 

Over the next five year, our goals are -

1. Content: To continue to expand our content library (within our team and with partnerships) to expand scientifically sourced, engaging content for pregnant women, new mothers and young children.

2. Platform: build supply side partnerships to ensure that target groups are connected with recommended and government approved products and services. Use AI algorithms to improve the productivity and efficiency of the intervention. 

3. Expand to serve the needs of at least 10 million users across India. Build partnerships to launch the platform and content interventions in other global geographies. 

4. Impact: Continue to generate impact data for publication and advocacy

While our core platform and content has been funded and we are building distribution partnerships, access to financial support is one of the key barriers for us. This is particularly important for three things-  

1. to continue to innovate on communication so we continue to offer engaging behavior change content to our users. This will require us to invest in the latest ethnographic and design research as well as in innovative content types.  

2. To innovate our platform so we can apply the latest technologies and ML algorithms to enhance user experience and improve the productivity and efficiency of our platform. This will require us to invest in product design research, analytics and in building and testing ML algorithms. 

3. To invest in advocacy of our intervention with stakeholders within and outside India

We are in discussions with UNICEF and state governments to raise funding for our intervention. Already, state governments promoting our intervention cover more than 40% of our existing distribution costs. We are also looking for financial support from other partners to invest in innovation around content and our digital platform. Our application to MIT Solve is part of our outreach effort to garner support so we can continue to scale our intervention. 

Saathealth is part of Swapnadarshak Health Pvt Ltd, an impact focused digital health organization. 

10 people - 4 people in content, 4 people in platform+ analytics and 2 in distribution

We are a diverse team of doctors, scientists, innovators, former consultants, engineers, researchers and designers. Our CEO is a physician who has worked at the intersection of health and technology for over 10 years, including with mobile solutions for pregnant women and new mothers. Our team integrates our expertise in digital technology, user centred design and communications to nudge users towards target health goals. Our work has been published in leading academic journals globally. 

For our expansion in maternal health, we are delighted to partner with Thrive:Words that Change Lives’, whose team has researched and written  six evidence based behaviour change programmes  on maternal and child health. Their behaviour change phone programmes in India, South Africa, China, Uganda, Nigeria and Mexico reach more than 8 million people. Thrive has extensive experience writing behavior change messages for urban and rural pregnant women and new mothers across India and we believe their content expertise will complement our digital platform reach and allow us to impactfully serve the needs of pregnant women and new mothers. We have worked closely with Thrive on their previous maternal messaging programs in India as well. 

We are delighted to be building partnerships with some of the leading organizations in India. 

We are partnering with UNICEF and through this partnership, our platform was formally launched in the State of Jammu and Kashmir in June 2020. We are also in active discussions with at least 3 other state governments who have expressed explicit interest in launching our platform. 

We also have ongoing partnerships with Sesame Workshop, Central Square Foundation, Pratham, Lifelabs and the Foundation for Mother and Child Health in India. These partnerships allow us to collaborate on content and distribution so we are able to reach a wider audience of users with our intervention. 

Our primary business model is to provide valuable health related content to users in a format that engages them. We leverage our engagement, notifications, in-app nudges, gamification and ML algorithms to personalize and optimize the journey for individual users. 

Our in-app engagement increases knowledge and shifts user behaviors to positive target outcomes. 

The ability of our platform to scale and impact, without incurring linear costs is an attractive value proposition for key stakeholders, especially given limited resources to positively impact mother and child health. 

Our current state government partnership already demonstrates the potential to reduce our distribution costs by integrating with the government infrastructure. We are continuing to explore other value generating propositions for key stakeholders.     

We intend to fund the next phase of growth via grants and donations. We are already demonstrating the potential of reducing distributions costs by integrating with government infrastructure. Since our platfrom costs are non-linear, they will become more attractive for funders as we scale users and geographies. Our AI algorithms will provide more targeted and efficient interventions. Over 5 years, our goal is to integrate with government infrastructure to eliminate distribution costs, while solicit grants and donations to continue with content and product innovation. 

We are applying to solve to connect with like-minded multi-disciplinary, innovators who are applying the latest technologies for social good. We believe passionately in integrating the role of user centred design and the latest technologies to solve large health problems and believe that working with like minded teams will push us to raise the bar on innovating for the underserved. 

We would like to continue to apply the latest innovations on our technology platform and are looking for advisors on our technology solution.

We are also looking to invite advisors that have a global, inter-disciplinary outlook to support our global deployment strategy. 

We are looking for advisors experienced in the intersection of design and technology who are passionate about solutions for underserved populations. 

Our team brings rich experience from the deployment of technology led maternal and children's health programs. We believe we can integrate the latest in behavior change communications expertise with digital platforms to reach and serve the needs of women, especially at a critical juncture in their lives. We will use this award to add additional women's health content, focusing on gynecological and menstrual health issues.