Improving digital access to reproductive care for migrants

Globally women are suffering from or dying of unsafe abortions, which are entirely preventable. 1 in 3 women experience an abortion in their lifetime. 73 million abortions occur every year, and 45% will be unsafe. Those living in rural, isolated, low-resource, humanitarian crises, or where abortion is restricted and stigmatized face insurmountable inequities in achieving their sexual and reproductive health (SRH) goals. Unintended pregnancies and unmet contraceptive needs are at an all-time high for Venezuelans due to the protracted humanitarian crisis. 

About 97% of all unsafe abortions and related deaths occur in developing countries in Africa, Latin America and Asia. When a woman is determined to end her pregnancy she will, regardless of the safety and legality of the procedure. Human Rights Watch reports that women in Latin America face multiple barriers to free exercise of their reproductive rights, including some of the most restrictive abortion legislation in the world.

There is an urgent need to support women’s sexual and reproductive health journeys in Latin America where restrictive policies limit safe access to abortion services, both for women and girls who live within the host country, as well as refugees and migrants seeking safety. According to the Health Ministry of Venezuela, maternal deaths surged 65% between 2015 and 2016, and then the government stopped releasing data. 

Venezuelans continue to face an ongoing humanitarian crisis in their own country and many seek  refuge in neighboring countries. Colombia hosts the largest number of migrants from Venezuela where 1 in 47 people is a Venezuelan migrant. [1] Venezuelan migrant/refugee women are facing significant SRH challenges which includes greater risk of sexual violence and reduced access to SAC and contraception. [2,3] Furthermore, there are dynamics at play between the host and recipient communities including a redistribution of resources that can lead to complexities and an overstretched health system.  

While abortion in Colombia has been decriminalized and is legally available up to 24 weeks of gestation, the reality is that access to abortion services remains limited, in large part due to stigma, but also in more rural areas and among Venezuelan refugees and migrants who are not able to effectively navigate the healthcare system.

Sources: 

1. Evaluation of the unmet sexual and reproductive health needs of the Venezuelan migrant population in four cities on the Colombia-Venezuela border: Arauca, Cucuta, Riohacha and Valleduparin. Bogota: Profamilia and IPPF/WHR. 2019

2. Rivillas-Garcia, J.C., Cifuentes-Avellaneda, A., Ariza-Abril, J.S., Sanchez-Molano, M., Rivera-Montero, D. Venezuelan migrants and access to contraception in Colombia: A mixed research approach towards understanding patterns of inequality. Journal of Migration and Health. 2021.

3. Calderon-Jaramillo, M., Parra-Romero, D., Forero-Martinez, L.J., Royo, M., Rivillas-Garcia, J.C. Migrant women and sexual and gender-based violence at the Colombia-Venezuela border: A qualitative study. Journal of Migration and Health. 2020. 

Vitala Global Foundation developed the digital application Aya Contigo in response to the emergent need for improved access to safe abortion care in Venezuela. Officially launched in April 2021 via web URL and in March 2022 on the Google Play Store, Aya Contigo is a digital platform with offline capability and live virtual chat support. The World Health Organization endorsed Aya Contigo as one of the top 5 innovative and evidence-based solutions for comprehensive abortion care.

Aya Contigo is a highly effective digital support platform because of these three interconnected key pillars:

1. Aya Contigo App: contains reliable up-to-date harm reduction information to self-manage an abortion safely and personalized contraception decision-making

2. Aya Care Team: a team of local staff that provides virtual accompaniment that is trauma-informed and healing-centered, and connects users to trusted referrals 

3. Aya Community Engagement Team: a team that represent youth and the rural communities to support mobilizing a network of trusted SRH partners 

Aya Contigo takes users through a 7-step process: 

Step 1: A user seeking information about abortion learns about Aya Contigo through social media, word of mouth or through a trusted partner.

Step 2: A user downloads Aya Contigo and is directed to self-assess for eligibility (how far along in the pregnancy and whether there are any medical conditions that would prevent a self-managed abortion with pills). They are also given an option to chat live with an Aya Care Support Team of local Venezuelans.

Step 3: Aya then explains what the actual pills should look like and what to expect after the user takes them, and how to take them safely.  

Step 4: Aya takes the user through the possible side effects and highlights when the user should seek medical attention.  

Step 5: Throughout, Aya offers self-care strategies and the opportunity to access further support through Vitala Global’s established and trusted referral networks.

Step 6: Users can choose to have personalized support by opting into SMS notifications that include timed reminders of when to take the next pills, and weekly check-ins with the user to see how they are doing and to provide ongoing emotional support. They are also able to connect with the virtual support through the app directly at any time of the day and at any stage of their process. 

Step 7: Aya provides users with a validated questionnaire for them to self-assess if their abortion is safely completed and then gives the option of going through a contraception journey where several questions are asked in order to find a contraceptive method that best suits the users’ needs. 

In addition to the 7-step guide for safe self-managed abortion care, Aya Contigo includes a personalized contraception decision-making tool, referrals to service providers, virtual real-time psychoemotional support, and basic self-care content. 

Vitala Global will work with our Colombia-based partner, Profamilia, to adapt and scale Aya Contigo to Venezuelan migrants and refugees, as well as other vulnerable women and girls in Colombia. 

Vitala Global and our partners will work to scale Aya Contigo to Venezuelan refugees and migrants, as well as other vulnerable women and girls struggling to access safe sexual and reproductive health in Colombia. The humanitarian crisis in Venezuela has exacerbated gender inequities. Unsafe abortions and consequently, maternal mortality and morbidity rates are at unprecedented levels, the highest in the region. As a result of the crisis, millions of Venezuelans have migrated to neighboring countries, including Colombia. Venezuelan migrants are vulnerable and marginalized, facing disproportionate sexual and reproductive health inequities due to limited resources and access to health services tailored for their specific needs in the host countries.

In Colombia, legalization of abortion has not directly translated to ease of access and decrease in stigma. It remains a sensitive aspect of healthcare especially among migrants and refugees who might not be familiar enough with Colombia’s health landscape to navigate the complexities. This is a unique opportunity to leverage what Vitaal Global has learned through Aya Contigo’s initial scale in Venezuela to benefit Venezuelan migrants and refugees, as well as vulnerable Colombia women and girls. 

Colombia has high rates of smartphone usage and digital literacy, which opens up the opportunity for a digital tool to address gaps in healthcare access. Furthermore, digital solutions that address sexual and reproductive health are very limited in the Latin American region, which means Aya Contigo will be filling an important gap. 

Our target user/beneficiary for Aya is any pregnant Venezuelan migrant or Colombian individual seeking access and support for safe medication abortion and/or contraception guidance that has access to a computer, smartphone or tablet. Based on WHO statistics for Sexual Reproductive Health (SRH) and Sexual and Gender-Based Violence (SGBV) it is expected that primary user groups of Aya will be teens/young adults, survivors of sexual violence, survivors of gender-based violence, women and girls living in extreme poverty, and rural and migrant women. 

Averting maternal disability or death benefits all: the women, their children (both in improved life expectancy and educational attainment), and society in general, as women are important (albeit undervalued) contributors to the stability of any country’s economy. Therefore, we expect Aya Contigo to be cost-effective by providing women with an option to avoid potential disability or death from an unsafe abortion while increasing their self-determination. There is ample evidence to show that an abortion with pills is safe and effective. By scaling Aya we also want to empower women and girls to have a safe abortion experience and receive the necessary attention and support, ultimately allowing women and girls to exercise the full potential of their reproductive autonomy

Our female-led multidisciplinary team of women’s health experts, medical professionals, sexual and reproductive health activists, and public health and technology specialists brings the diverse expertise and experiences needed to implement this project successfully. The core Vitala Team, Dr. Roopan and Dr. Genevieve are OBGYNs with human-centered design research skills, and field experiences in humanitarian/challenging settings.

Roopan Gill is the Co-Founder, Executive Director and the Community, Research and Product Design Lead.  She is an Ob/Gyn with expertise in family planning and abortion care. She holds a Masters in Public Health in Global Health from Harvard T.H. Chan School of Public Health. Roopan is Women's Health Advisor for Médecins Sans Frontières (MSF) and has worked as an emergency Ob/Gyn in a number of humanitarian crisis settings.  She was pivotal in including mifepristone on the core essential medicines list. In 2022, she was recognized as Canada’s Top 100 Most Powerful Women.

Genevieve Tam is the Co-Founder, Director of Projects, and Product and User Support Lead.  She is an Ob/Gyn with extensive experience in global women's health from education, project management, and program implementation. She holds a master's degree in Public Health from the London School of Hygiene and Tropical Medicine. She volunteers with the Canadian Network for International Surgery as an instructor and editor for their capacity-building training programs in low-resource settings. She was the Gynecology Team Leader for MSF in a maternal health project for Syrian refugees, migrant workers, and marginalized Lebanese in Lebanon.

Together they built a team of dedicated feminists and sexual reproductive health experts. The Aya Contigo Team consists of 18 Latinas based in Venezuela, Colombia, Argentina, Mexico, Nicaragua, and Spain.  Together they make up the Aya Care Team which provides virtual chat accompaniment and emotional support for users; the Aya Community Engagement Team which conducts outreach to expand Aya’s trusted referral network and community mobilizing to advocate for sexual and reproductive health and rights; Aya Social Media Strategist and Manager; the Design and Impact team which consists of our UX/UI designer and our impact strategist.  In addition, Vitala has a finance team that supports financial and accounting processes as well as business and sustainability planning, and a fundraising team including a grant writer and a storytelling strategist.

In Colombia, Vitala partners with Profamilia Association, a Colombian organization with over 30 years of experience promoting sexual and reproductive rights for the entire Colombian population. They will be a key partner in this work. Profamilia also participates regularly in humanitarian meetings in Colombia to address the influx of Venezuelan migrants. They have a particularly strong focus on Cucuta, a town on the border of Colombia and Venezuela through which many migrants and refugees pass. Profamilia runs a network of sexual and reproductive health clinics, many on this border, which will be a key part of the referral network for Aya Contigo. Additionally, Profamilia is well connected to other local organizations in the area, and we will leverage that network to adapt Aya Contigo to the needs of migrants.

4700 people have engaged with the platform with 600 chats to date to our virtual Aya Care Team . 

We are applying to MIT Solve to assist us in rapidly scaling to increase support for Venezuelans migrants and other vulnerable women and girls in Colombia based on our human-centered research. Solve’s partnership will assist us in continuing to empower our teams and build our community networks to demonstrate that digital solutions such as Aya Contigo are a benefit in contributing to and connecting the community-based feminist ecosystems to the formal healthcare system to build their local capacity to provide sexual and reproductive health services. 

The goal is to: 

1) Scale to all vulnerable Venezuelan migrants and other vulnerable people living in Colombia: including young people from ages 10 - 19, women and girls living in rural and indigenous communities and the millions of Venezuelan refugees/migrants in Latin America

2) Peer-to-Peer Support for youth: adapt a peer-to-peer forum currently being piloted in Venezuela for Venezuelans for young Venezuelan migrants in Colombia

3.) Sexual and gender-based violence (SGBV): expand and include an SGBV component to Aya, which would consist of information to raise awareness, support disclosure, to provide reliable resources about their rights to comprehensive care and appropriate referral pathways.

We have identified the following areas for in-kind / consultation support to better develop our product market strategy and expansion strategy: 

Senior Software Engineering: advice on new technologies, for example, AI and machine learning and assist us to integrate different technologies (Whatsapp Chatbot, live chat/counseling features, peer-to-peer network) onto one platform. 

Marketing Analysis: assist in guiding us on how best to position our products in the existing market, how to be less donor-dependent and build a social enterprise model. 

Online Advertising Strategy: assistance on how best to develop a communications strategy for the dissemination of Aya Contigo and help us better articulate to a diverse audience the synergy between our products and our process as Vitala Global. 

Business Development/Analysts: support in building a not-for-profit social business to be financially sustainable while maintaining our goals to prioritize impact first. 

Through Vitala’s work, we are becoming a platform that is bridging the gaps between the formal health system and community care models by embedding our tools within healthcare systems to create a continuum of support and services. We are utilizing, leveraging and retooling technology to provide access and support for pregnant individuals for self-managed care in humanitarian crisis countries. The apps and digital tools currently available provide one-dimensional care in the form of resources. We are the only platform that accompanies women through a safe medication abortion and family planning journey, providing evidence-based, reliable private digital resources to avoid unsafe abortions with one-on-one chat support through a virtual chat and SMS notifications in Venezuela, which we also aim to roll out in Colombia.

Aya Contigo is unique because it is one of the first examples of a digital self-care tool that has been co-created with women, girls and their community to address a stigmatized sexual and reproductive health issue in a complex humanitarian crisis. Using a human-centered design research methodology, building a robust theory of change, monitoring and evaluation plan and developing and implementing safeguarding and cybersecurity policies, Aya Contigo is demonstrating it is possible to develop quality digital solutions that can empower women and girls.

Aya is accessible as a web app to be used on a web browser or downloaded to a mobile phone or tablet through the Android Play Store.  Once downloaded, it can be used completely offline - this was an important design and development decision based on concerns from the users and stakeholders regarding the unreliable internet connectivity. 

Human-centered design research identified that women wanted the option of having reminders to support them through the abortion process (e.g. pill reminders, emotional support prompts). WhatsApp was found to be the most widely used form of communication, more so than methods such as SMS or email, therefore opt-in check-in reminders from Aya come through WhatsApp, which will then redirect users to the app for evidence-based and safe resources or referrals. 

Aya can change women’s access to sexual and reproductive health support in humanitarian crises as well as in rural and isolated settings. Through our beta rollout, it has successfully demonstrated a virtual accompaniment model as a safe, acceptable and feasible harm reduction tool in the safe abortion ecosystem to support women’s quality of care through a safe self-managed abortion with pills. It could reduce indirect costs and resources associated with traditional over-the-phone or in-person accompaniment models, empower women to manage their journey, and provide a scalable approach to increasing access to accurate information. Its interactive components use WhatsApp notifications to support the quality of care. 

Aya as a digital platform has been designed for scalable replication to be deployed to all vulnerable Venezuelans, including those living in rural and indigenous communities and the millions of Venezuelan refugees/migrants in Latin America and the Caribbean. 

Of note, the World Health Organization endorsed Aya Contigo as one of the top 5 innovative solutions for abortion care.

In the next 12 months, our impact goals will focus on strengthening existing activities to scale Aya Contigo within Venezuela and Colombia to adapt and co-create Aya Contigo to the Colombian context. We aim to:  

• Launch Aya Contigo in Colombia, specifically to Venezuelan migrants and refugees, as well as other vulnerable groups living in Colombia. This will be done through our partnership with Profamilia. 

• Expand emotional self-care section in-app and chat support 

• Refine movement building strategy amongst local partners with a core focus on those who work with migrant populations

• Conduct values-based and sexual and reproductive health workshops 

• Co-create with new content/features for app/chat including consideration of AI integration to the chat

• Establish a referral network of clinicians, psychologists, legal support for migrants

• Community engagement and movement-building workshops with an emphasis on exploring values around abortion and contraception

In 2 to 5 years, as we continue to scale in Venezuela and Colombia, we will aim to launch Aya Contigo in similar contexts. This includes those with restrictive laws and/or humanitarian crisis, as well as other countries where the influx of migrants and refugees is high. Stakeholder mapping of potential partners in Latin and Central America has begun with the intention to move in parallel as we work on scaling current efforts. We aim to partner with international and local organizations and by utilizing our human-centered design process and toolkits, support partners to adapt and implement Aya Contigo to their respective contexts. 

We will also develop a licensing fee model that will be pitched to larger humanitarian organizations such as Medecins Sans Frontieres or International Rescue Committee. We would facilitate the scaling and implementation of Aya Contigo in various countries they support. In addition, we will build a rapid response human-centered design toolkit that will allow us to quickly build and adapt Aya for acute crisis scenarios as it is during these moments of mass migration that women and girls are in need of support and referral to trusted sexual and reproductive health services.  

We also plan to work in less restrictive settings within Latin America to support existing teleabortion services. In partnership with Profamila, we will explore this. Aya Contigo is a useful resource specifically to Venezuelan migrants moving between countries while requiring assistance on information to self-manage their abortions and information on the SRH laws in the different countries they may enter. 

In addition, due to ongoing instability in access to sexual and reproductive healthcare in developed countries, there is also great interest in reverse engineering Aya for volatile geographies like the United States. We predict the launch of an iteration of our platform in a number of challenging states and potentially nationally within 5 years.  

We have developed a robust Monitoring and Evaluation Framework based on our Theory of Change. The framework divides our indicators across 5 objectives: Impact, Access, Effectiveness, Quality, Efficacy. We also have specific KPI metrics for the app using Google Analytics. The indicators to measure impact are gathered from quantitative surveys that include NPS scores, qualitative data gathered from interacting with users over the virtual chat support and web and mobile data analytics to explore usage patterns. We are exploring the implementation of a data analytic platform to develop dashboards that will allow us to better visualize and report on our indicators. Examples of the KPI's we track in Venezuela are: 

• # of Venezuelan women and girls who successfully self-manage their abortions using Aya Contigo ( this includes: self-assessing for eligibility, self-administering and self-assessing for completion)

• # of Venezuelan women and girls who access their contraceptive method of choice due to recommendations by Aya Contigo

• percentof users claim to be able to make their own informed decisions regarding MA after using our referral network and mobile application.

• # of Venezuelan women and girls who feel positively about their abortion experience and received the care they were seeking

• percent distribution of Venezuelan women and girls representing rural/remote areas who successfully self-manage their abortion using Aya Contigo

• # of users would recommend Aya Contigo to other people

• # and % of users who self-report feeling supported in their decision

• percent of users who felt prepared for what to do if they experienced warning signs or in the event of complications
• percent of users who felt reassured of their privacy and safety throughout their abortion process/procedure

• # of Aya Contigo users who successfully obtain medication abortion pills 

• # of Venezuela women/girls self-reporting improved knowledge and awareness of family planning (safe abortion care and contraception)

• # of trusted referral networks secured through MOUs signed and implemented

• percent increase in referrals to Aya Contigo after formal establishment of partnerships

• Stakeholders self-report a positive change in attitudes on self-managed MA after intervention, by source of agreements and commitments 

• # of users who keep using Aya Contigo 7, 14, and 30 days after 1st launch 

• # of advocacy interventions made (publications, blogs, social media, etc)

• # of local and international organizations implementing Aya Contigo as part of their programs

Similar KPIs are being designed for Colombia and other contexts with an emphasis on migrants/refugee populations.

Vitala Global has conducted primary research with Venezuelan people, SRH organizations and activists to understand the crisis, services, experiences and barriers that pregnant individuals are experiencing. Vitala Global’s interventions and this theory of change are rooted in human-centered research, global health organizations' recommendations and guidelines as well as the team's clinical and medical expertise to create the desired change.   

Impact Enabling conditions to experience reproductive autonomy: women and girls have a greater ability to exercise control over their reproductive lives as empowered agents in their needs and decisions.

Long-term outcome 

Effectiveness: Highly effective digital support system for self-managed medication abortion: Aya Contigo provides quality and accurate information and care digitally that enables the user to feel prepared and supported through their self-managed abortion and/or post-abortion contraception journey.

Short-term / Medium-term Outcomes

Quality: Improved ‘quality’ abortion care: Aya Contigo delivers a *women-centered, integrated approach to comprehensive abortion care where the merging of self-managed care, clinical care and community is centered in empathy, support, expertise, and safeguarding human rights.

Efficacy: Strengthened and empowered abortion community: Community of partner organizations, activists, feminists are committed to support women in their SMA journey and safe abortion advocacy 

Access: Improved self-managed abortion experience: Women are able to self manage a medication abortion through Aya Contigo and access a reliable referral network that supports their abortion and contraception needs (utilization, satisfaction, confidence).

Outputs: 

Quality:

• Aya Contigo team has the technical competence necessary for delivering quality abortion care from the point of screening to guiding in medication abortion and providing aftercare

• Strong comprehensive communications and referral systems are in place alongside technologies and staff for access to high-quality abortion care

Efficacy: 

• Increased capacity of local organizations to support women to access medication abortion via Aya platform

• Created a safe space to facilitate technical exchange/dialogue within the abortion community

Access:

• Increased knowledge of and access to Aya Contigo mobile platform

Context: Vitala conducted a human-centered research study in 2020, with over 1000 Venezuelan women, 12 grassroots organizations and sexual and reproductive health activists. It identified the need for reliable contextualized digital safe abortion and contraception information to help prevent unsafe abortions and unplanned pregnancies. There is growing acceptance of digital interventions with evidence suggesting that clients prefer the practicality and confidentiality of technology-enabled interventions and guided online support, as opposed to in-person services.  Evidence and guidelines from The WHO have proven that women can self-manage their own abortions with pills safely and meet their unmet contraceptive needs if they are provided with the right information and access to referral mechanisms as well as decentralizing and optimizing the use of healthcare resources. Many interventions in medical abortion care, particularly those in early pregnancy, can now be provided at the primary-care level and on an outpatient basis, which further increases access to care. Medical abortion care reduces the need for skilled surgical abortion providers and offers a non-invasive and highly acceptable option to pregnant individuals. Furthermore, self-assessment and self-management approaches can be empowering for individuals.

The tech that powers our solution is a progressive web app that can be used in web browsers and also can be downloaded as an offline app on any operating system, and can also be downloaded from the Google Play Store in Venezuela.  A progressive web app was the solution for us to be able to quickly iterate content and features in response to user feedback using an agile content management system (Contentful), without the user having to wait for updates to be published.  We have WhatsApp API integration (Twilio) for chat support and pill reminder notifications, and an embedded chat platform (Crisp) within the app for real-time accompaniment while using the app.  We are exploring automation, ethical artificial intelligence, smart filters, and peer-to-peer matching/community building are all areas we would like to explore to provide further support to Aya users. Anonymous and passive data collection on users' use of the app will assist us in geomapping and better understanding where the users are coming from and where we need to target our outreach. 

Equity consideration is at the forefront of our organization. Vitala Global is a female-led organization that works to ensure that those who are the most marginalized are given the opportunity to work with us and are represented in our digital solutions. We engage people representing the communities with whom we are implementing Aya to ensure lived experience in context to each location is represented. 

Examples of this: 

• 18 local Venezuelan staff 

• team leads for the community engagement team and care teams are Venezuelan migrants 

• software developers are queer-led female-led that focuses on training people who have been victims of gender-based violence

We foster equity through open dialogue, transparent processes, and a fair distribution of resources. Inclusion is an outcome of diversity and equity strategies created in this initiative through ongoing participation and cultivating full and meaningful engagement of stakeholders at every level.

Vitala Global scales and impacts in two ways: through its product and its process.

1. Product:

Value proposition: explained in detail in previous questions

Key customers: explained in detail in previous questions

Key activities: explained in detail in previous questions

Key revenue:

We will offer Aya for free for the most marginalized (refugees/ migrants/ underserved communities) and those living in challenging contexts. We are exploring B2B in partnership with large NGOs, iNGOS, private partners to license the app and use Aya Contigo on a wide scale for their beneficiaries. We are also exploring B2B2C models in contexts in LATAM that are less restrictive in partnership with pharmacies in Mexico and to explore B2C with an option for those willing to pay, knowing their contribution will support someone else that is underserved access an abortion

2. Process:

Value proposition: we integrate our public health knowledge and humanitarian experience into our research and design approach to enable human-centered innovations that are relevant and meaningful to individuals and communities that seek digital solutions for self-managed abortion and contraception care. This model not only enables Vitala to scale its human-centered design process in SRHR solutions across NGO partners that support similar causes as Vitala, it also subsidizes Aya user fees in Venezuela at 18-20% margin per project.  

Key customers: organizations (e.g. NGO partners) that support similar causes as Vitala 

Key activities: We consult organizations that are developing digital tools and solutions to SRHR issues using our expertise from developing Aya Contigo

Key revenue: consultancy fee

Key expenses: staff costs 

Goals:

• By 2024: operational sustainability; i.e. activities are accurately costed and funds cover all expenses; co-founders’ in-kind contribution ends then

• 2025 and beyond: financial sustainability i.e. effective and consistent cost management to continuously build up surpluses to reinvest back into the organization to deepen impact

Below are the financial strategies we have in the pipeline: 

Immediate to short-term (2023-2024) [already in place]

• Continue grant application (grant writer hired, seek consortium formation opportunities, establish network) 

• Consultancy revenue: First consultancy with Profamilia in Colombia using our human-centered research and design processes to increase beneficiary reach through a digital tool. 

• Adapt and monetize Aya Contigo to the United States market : in partnership with the Planned Parenthood Federation of America with intention to license Aya Contigo to them; focus on Latina/x and BIPOC communities in areas most affected by the overturning of Roe v. Wade  We will leverage a B2B model, through which we will generate revenue to reinvest in our work that targets the most underserved. 

• Develop and implement a ‘freemium’ business model: a basic product will be offered for free, and a premium product will be charged via a subscription model. Payers can include middle-to-high-income users themselves, healthcare providers, and/or partners, who can subsidize the cost for low or no-income users. Business channels will span D2C (direct to customer) and B2B2C (business-to-business-to-customer) models via partnerships with private or public providers.

Medium-term (2025-2026)

• Seek consultancy projects with INGOs with bigger budgets to increase margins 

• Establish partnership models to diffuse technology to local and international partners: create social franchises or consider licensing fees for Aya Contigo

Long term (2026 and beyond)

• National scale of Aya Contigo in the United States 

• Scale to less restrictive countries in Latin America with a revenue generation model, while maintaining a free model for migrants and other vulnerable populations 

• Establish partnerships with Canadian health insurance companies to provide mental health support for early pregnancy loss 

• Establish partnerships with large companies (e.g. Spotify) to include early pregnancy loss support as part of employee benefits

• Earn subscription fee from early pregnancy loss platform (digital platform currently being co-designed with North American women)

For the following priority country markets, and up until the end of 2024, Aya Contigo will enter and/or scale through the following prioritized business channels. Post 2024, distribution channels in these countries will be determined based on market research, partnership/business opportunities, and entry experience. 

Target user demographics 

(assumed that all are women & girls of reproductive age)

Business channels 

(in order of priority and with freemium model, unless otherwise indicated)

LATAM-Mexico

Urban and young middle-to-high income users in Mexico City first, then nation-wide. 

Migrants in key Mexican hubs

• D2C 

• B2B2C via pharmacies and private providers  

• B2B2C via partners (e.g., iNGOs like MSF, feminist accompaniment organizations)

LATAM-Venezuela

All women & girls of reproductive age.

• D2C (only free version) 

• B2B2C via partners (i.e. iNGOs like MSF)

United States 

Latina and BIPOC users, then the general population nation-wide.

• B2B2C via PPFA, private providers, other partners like Plan C, and employers 

• D2C

To date, Vitala Global has raised 1.2 million USD. Grand Challenges Canada (GCC) is one of our primary funders. They funded our initial OPTions grant that first provided the foundation for our work on Aya Contigo in Venezuela. We have since received additional GCC funding under the Transition to Scale Phase 1 category, which has enabled us to scale our work to Venezuelan youth. We are now preparing to apply to GCC Phase 2. We have also received funding from The Philanthropy Workshop, which is being matched by Pivotal Ventures and can go towards Phase 2 of GCC. 

In 2022, we were also awarded a grant from the Planned Parenthood Federation of America (PPFA), which enables us to launch Aya Contigo within the United States market. We are exploring business models for revenue generation that specifically target Latina/x and BIPOC communities through B2B channels.

We also have anonymous angel investors that have provided significant operational funding support to Vitala Global due to their interest in safe access to SRH. They have supported us with $206,000 CAD for one year with plans to continue their investments. 

As part of our sustainability plan, we are licensing our unique process that combines the intersection of human-centered design, sexual and reproductive health focus, digital platforms, and challenging contexts (humanitarian, restrictive abortion laws, marginalized groups).  By providing consultancy services with our expertise we will use the consultancy funds to cover the costs of maintaining and scaling Aya Contigo to other challenging contexts.  We are currently providing consultancy services to two organizations: 

1. Profamilia, a large non-profit SRH provider in Colombia, to co-create digital solutions to extend their teleabortion platform reach to marginalized populations

2. International Planned Parenthood Federation, to develop a digital health intervention statement to support their member associations increase reach of their existing services.