Okkanti: Building Community Care Infrastructures

In the United States there is a public initiative for the inclusion of culturally congruent community based doula (CBD) services to address the persistent challenge of addressing high rates of mortality and morbidity and to fill gaps tied with care shortages. Doulas are already trusted information sources in their community, harnessing this trust to create more equitable healthcare networks has been shown to decrease the rates of preterm labor, low birth weight babies, cesarean rates, and to improve maternal mental health and rates of lactation.  

It's challenging to identify the number of doulas in the workforce. The Maternal Health Learning and Innovation Center cites that 9k doulas are registered in the US, but the majority of the doula workforce neither uses the NPI registration system or completes or maintains Certification. 

The doula model is an innovation that continues to evolve, and holds the potential to address persistent challenges and gaps in our care systems.  ICU Doulas and End of Life Doulas, Sanhujoriwons, in South Korea, are examples of care model innovations that result in reduced on health systems. The Gay Men's Health Crisis workers represent the power of marginalized communities to build their own networks for health advocates, educators, and direct care, much as Chicago Women's Health Center trained reproductive health workers to fill the niche needs of the lesbian community. 

A desire for autonomy, from how to organize, when to work, and how to be compensated, is a key theme for the workforce. From our own stakeholder interviews, non-traditional paths of training have also been consistent among the workers. 

As doulas are integrated into care models, there has been increasing attention to the obstacles they face.  To solve for the challenges, this understanding of the organizational structures that they are creating and how they want to work is key. 

Isolation, lack of support getting started as a doula, business model sustainability, lack of backup and collaboration structures, the need for better pay, and benefits, along with the imbalance of unbillable time operating their practices and resulting burnout,  are reported themes.

 Medicaid reimbursement demands a new level of technical knowledge, operational processes, billing tools, and documentation, all experienced as significant barriers and stressors, and the need to build referral channels that bring best fit clients, including a mix of private pay opportunities to bring in topline revenue, proves challenging.

Our own listening surveys and that conducted by doula researcher Amy Gilleland at a gathering in Wisconsin of 40 providers in the state, brought up similar themes.

• Desire to collaborate

• Need for mentorship post training

• Desire to avoid the ‘business side’ but also desire to maintain autonomy

• Work  gaps, travel distance, less than ideal fit

• Trauma exposures, perinatal loss, client communication, burnout, isolation
  

• Feeling devalued (BIPOC providers predominantly but not exclusively)

• Okkanti is solving for these needs and challenges so that the workforce can continue to maintain their impact serving the diverse needs of their communities, in both stable and fragile contexts.  

Okkanti is solving the challenges doulas, midwives,  community health workers and carepreneurs experience starting, growing and sustaining these impactful models of care. 

Our technology solutions include the Okkanti Care Finder, an intelligent all-in-one matching, scheduling and practice management tech platform as well as a mentorship-based support system in the Care Collective.  

Okkanti provides solutions that simplify and remove bias from social prescribing; improve access for pregnant and parenting people to maternal health supports;  and provide innovative structures for worker sustainability and autonomy. 

By building a ready-to-mobilize engaged member community of health workers, together with our technology partners, Okkanti makes it possible for previously fragmented, often marginalized, but skilled, knowledgeable and vetted providers to be dispatched to serve communities with niche needs, and in the context of emergencies and care shortages. 

 Learn more about How Okkanti helps doctors to refer, families to find their best fit, and doulas and care workers to start and grow successful practices. 

Doulas are part of an ecosystem of care innovators.  1 in 5 doula organizations provide additional services, and among these workers, there are lactation consultants, midwives, reproductive health educators, physical therapists, and many other ‘carepreneurs’ who are not only solving their communities’ health gaps but often creating jobs. Supporting these vital care workers will improve their wellbeing and lead to measurable improvements in outcomes for birthing people and babies.

While there is current funding, and Medicaid coverage for these services, these workers are entrepreneurs or starting their own collectives or community doula organizations, and they will continue to be utilizing non-traditional employment to continue their work in their communities. 

The release of a budgeting tool from Rutgers and Health Connect One, points out that community funded, not-for-profit models will require innovative strategies and fee for service offerings to fill the shortfall in Medicaid funding.  Even the most funded groups anticipate the need to accept for-fee top line revenue to make their work sustainable. 

Okkanti aims to empower, serve and accelerate the growth of these carepreneurs through these activities: 

A membership-based community to address gaps in training, mentorship with an ecosystem of diverse trainers.

Technology Solutions and integrations that are affordable and adaptable to the ways that these workers work, such as The Okkanti Care Finder , an all-in-one scheduling, booking and practice management solution adaptable for the formation of collectives or alternative structures

Opportunities through referral channels developed by Okkanti

I'm building this solution out of 26 years operating one of the earliest and at one point, largest doula organizations in North America.  I've trained, mentored and supported hundreds of doulas, lactation consultants, and midwives, and founded WisdomWay Institute, where I've worked with maternal health workers and other care professionals to practice mindfulness in caregiving, trauma-informed, relationship-centered and anti-bias caregiving frameworks.  I developed some of the first Certification requirements for postpartum professionals in the 90s, when I was on the Board of the National Association of Postpartum Care Services and developed my own First Year Specialist /Postpartum Doula Certification curriculum.  This has afforded me countless opportunities to understand the challenges faced by health professionals both in and outside of maternal health, as well as those experienced by the more than 10k pregnant and parenting people I've cared for, and the doulas, midwives and other community health workers with many intersectional identities.  

 Alysan Anderson and our team has spent the last year simply having conversations with the community members we want to build this solution with.   We hosted a brunch with early influencers and stakeholders in the doula community, have scheduled two additional formal design and listening workshops, and completed a 100 person listening survey from conversations with our clients about their experiences.  

One of our first milestones was to launch the Care Collective this January, 6 months after we established Okkanti as a B-corp, with 12 early adopters, who were invited specifically to co-create this solution with us and we'll continue to host live and online conversations. 

As we do our outreach to community organizations and individuals, we aim to deepen our understanding of the solutions that best solve their challenges and pain points while we invite collaboration.  As a B-corp technology company, we want to fuel the work of our many NFP colleagues. 

We have 40 individual users in our Care Collective,  and are currently launching a pilot with 35 additional members.  We have formalized partnerships with these training partners: Midwest Maternal Child Institute, WisdomWay Institute, and Sarah Munoz, Spanish Speaking for Doulas founder. 

Our pilot organization currently serves an average of 500 careseekers a year and will bring their activity onto the platform.   

We have two additional pilot organizations in planning sessions with us. 

I've been building my solution and gaining incredible mentorship and guidance over the last year. 

This year's challenge allowed us to further our strategic vision for a global application, as we work on phase one growth in the Midwest of the United States. I recognize that it would be invaluable to have connections and support to address compliance especially in international markets, and to help us and our technology partner, Impact Partners Network, to work on government /NGO agreements and otherwise to bring out solution into the emergency preparedness space.  Health System decision-makers and key stakeholders are needed connections.  I would love to find in the Solver community a potential collaborator/co-founder, or board member, but along the way know Okkanti would be greatly supported by the impact-focused team of experts in your communities.  

Setting us up to measure impacts would also be a valuable contribution to the success of our company's efforts. 

Okkanti is the only company looking to solve the maternal health challenge by designing solutions around the ways that workers in this space want to serve their communities. Our solution is designed to empower workers while catalyzing measurable improvements in rates of cesarean and pre-term births.

We're the only solution that leverages both independent contractors and care organizations, both for-profit, and not-for-profit, and builds a marketplace where revenues from consumer services can offset shortfalls and gaps inherent in community funded programs.  We solve for worker sustainability, and a next generation care 'gig worker' while building a network that reduces health disparities and can, with Impact Partner Network, mobilize quickly to stabilize their communities to build health equity, and in times of emergencies, climate crisis, displacement, and other disasters. 

We're the only organization envisioning a diverse collaboration among trainers and training organizations to solve for an industry looking for standardized training measures  

Our solutions solve for these key stakeholders: 

• The currently fragmented care workers

• The health systems that need a better, unbiased way to make referrals

• The pregnant and parenting people who can find vetted, qualified care for their niche needs that they can afford/that takes their insurance

• Local and regional governments and health systems facing worker shortages who can turn to a qualified, vetted worker pool through our integrated partnerships and communication channels

Finally, Okkanti is specifically adaptable to accommodate more worker ownership and while working with agencies and organizations, sees a roadmap for disrupting the agency model so that workers can be paid more sustainably. 

Our intended outcome is to provide over the next 5 years, matches that provide care to 12k careseekers, resulting in 1k fewer primary cesarean births, 220 fewer preterm births, and that achieve an increase from population baseline in breastfeeding initiations, and exclusive breastfeeding at 3 months. 

We can gather data from care booked on our platform, but this is just one way that we enable referrals to become matches in the Okkanti Care Finder and increase the capacity of our members to serve their communities.  Our commitment to impact includes our listing of organizations that may not yet be paying members. We’ll use site analytics to determine how many referrals are originating from our site, and will work with our paying and free members to provide us with data tracking that we cannot ourselves build into the technology. We have incentives built into our model to encourage behaviors and utilization of the tools in the platform, such as offering bonus payments that effectively reduce the rate of commission for reaching certain thresholds, and access to scholarships or cancellation coverage for our members who are engaging not just in the platform for booking but for other compliance behaviors - among which data collection will be one.

 Impact Partners Network will support us in tracking the dispatching Okkanti members in emergencies

With our current pilot we are tracking:

Core KPIS: 

SEO/Website visitors/bounce rate/conversion

#leads

# and % of conversions to match stage

# and % of conversions from match (meeting with provider) to booking

# days/time to book

Average sale per user

Audience /followers

# Member signups

# Members onboarded: # Members  using features on Care Finder

ROI for mentor/client experience contact sessions

as well as

FTE hours spent on scheduling, booking and coordinating care before and after the full implementation of the Okkanti Care Finder 

The impact of mentoring frameworks on a number of doula related outcomes (achieving certification, retention/conversion rates, client NPS, worker wellbeing/burnout preventing

The use of the Care Collective platforms and learning tools.  Our early findings show growth of signups to our social platform but limited engagement with posts and content. We’ll be comparing live, in-person events of various types, in addition to continuing to build online community through best practices in Community Management.  Our KPIS include audience signups, activity/engagement, and 'needs met' tracking of peer and mentor encounters.  

The effectiveness of the Okkanti Care Finder, we’ll keep data on # of and types of appointments, satisfaction with opportunities and schedule, data on time and costs. 

To evaluate the effectiveness of our outreach campaigns, we’ll track the adoption of Okkanti as a referral source, and we’ll track the timing of referrals. We will be identifying ways to measure the adoption of Okkanti as a referral to patients by trimester of pregnancy, asking, "Does this platform make early, consistent and unbiased referrals"

And additionally, for long-term outcomes, we're evaluating and will work with technology partners to collect data related to: 

• Severe maternal morbidity (SMM) and Mortality
• Neonatal Mortality Rate
• International Health Regulations (IHR) capacity and health emergency preparedness
• Education attainment (Certification, and Continuing Education) for CHW
• Earnings per worker/increase over prior year

Okkanti was founded on the idea that greater support, collaboration, and accessibility for Doula care would measurably improve outcomes for birthing people and babies. To begin designing the soltuion, our first activities involved creating channels for collaboration and co-creation with our community. 

As a 2-sided marketplace, we established care consumer priorities, completing a 100 person listening report that identified the needs and pain points that careseekers have in readying for birth and parenting, the fears and concerns they have, their existing support networks, and their questions and experiences finding and seeking support services, such as doulas. 

To prioritize needs of the doula, and community health workers, we've gathered insights from the hundreds of providers that have been trained, mentored and supported within our organization and we performed 3 formal listening group sessions, 3 individual in-depth listening to the customer sessions, and we've launched the Care Collective, an online proprietary social platform for doulas to find and exchange support and learning.   

Finally, to validate the impact of mentorship, and to develop alternative structures of non-hierarchical scaling, we developed and are testing a leadership innovation,  gathering data on the impact of those leadership activities and mentorship on the doula’s ability to secure more opportuntities, retain clients,  and to prevent burnout. 

Our intended outcome is to provide over the next 5 years, matches that provide care to 12k careseekers, resulting in 1k fewer primary cesarean births, 220 fewer preterm births, and that achieve an increase from population baseline in breastfeeding initiations, and exclusive breastfeeding at 3 months.  We aim to lessen the severity and duration of PPMAD.

The short term outcomes we aim to achieve are to build a network of 10% MOM growth of new paying members and a total available workforce of 2500 members in 5 years; to build 100 referral channels that consider Okkanti a key source of community referrals to CHW and doulas, and together with other multichannel campaigns, grow leads of careseekers by 10% MOM;  maintain a 50% conversion rate that allows us to provide a total of 18k care matches in 5 years. 

Okkanti Care Finder, in it's MVP, is a web-based application that is custom coded to perform key functions as a marketplace unique to this workforce and how they function.  It includes intelligent matching, ai care coordination and automations, chat features,  geolocation, integrated scheduling, appointment tracking, communication/video integration, 3 step verification and other HIPAA compliant strategies. 

Okkanti's Care Collective, in it's MVP is hosted by disciple media, but can be built out with LMS features and updated to a smartphone app as well as a web based platform. 

Our partnerships with Impact Partners Network furthers our capability to mobilize the member workforce in emergencies and both stable and fragile contexts and other partners, such as Unite Us, allow us to extend our Care Coordination and referral networks.  Financial partners and payer innovations, such as Be Her Village, can extend our features. 

Okkanti's technology is trademarked, patent # 97059718.

Okkanti is a digital platform that is improving access for all pregnant and parenting people to resources, tools, and culturally-aligned providers that empower, inform, and support.  

Our core beliefs and driving values:  

• Nothing without compassion

• Doulas and maternal health supports are key to building generational health

• Representation matters

• Belonging is a practice

• We can be unstoppable in building reproductive health equity when we are stronger together. 

How we work: 

Our community is built on our values of Belonging, Awareness, Accountability and Compassion, and we believe that it’s by having each other’s BAAC that we can do good work in the world while learning and growing as ever evolving people and leaders.  

Our mission: 

Okkanti is an infrastructure and ecosystem organized to ensure that all people have the reproductive health supports they need to thrive. 

• We build access. 

• We build safe, respectful and compassionate care solutions. 

• We build solutions for those that hold the key to building generational health. 

By supporting those that serve our communities, we envision a future free from health disparities, and a deepening value and appreciation for care work in all its forms.

Our Commitment to Diversity, Equity, Inclusion and Belonging:

Our companies are committed to celebrating and serving our diverse communities and to addressing health inequities and worker sustainability by building solutions and structures that allow everyone to thrive. 

We recognize the harms caused by systems of domination and oppression, and exist to reduce suffering, to further a more compassionate and equitable world and to allow every person to have wellbeing as their birthright.  We will tend to the garden we can reach, while sharing tools that bring collective strength to the movement of reproductive justice. 

We believe that in all ways, we are stronger together as we work to improve the health of people and our planet, and are committed to expanding the diversity and perspectives of multiple stakeholders that inform our activities, our business model, our culture, and our solutions.

Our leadership team currently includes: 

LGBTQ female cis-gender white,  founder and primary shareholder

Seeking a Black or underrepresented co-founder

Our development team is international, 50% female, Ukraine, India, and US based.

Minor shareholders and Advisory Board Members include a Haitian-American female physician, a Black male physician, also an Immigrant to the US, and one white male executive 

Our team, including an intern, have participated in a 3 month process of working with a social justice and DEI expert/communications lead who supported conversations on centering the voices of those we serve. 

2 members of our team participated in the Inner MBA, a mindfulness -based leadership program with DEI integration.  We continue to build mentorship networks and will focus on adding diversity to our team after we're funded and able to add new positions. 

Careseekers purchase care services, and schedule book and transact securely with providers. Commissions are deducted as a cost-sharing charge for care booked on the platform (18% on average), and contractors or organizations paid out on a weekly basis. Additional revenue from learning activities both for careseekers and members ranges from $39-2500. 

Members pay an ARR and Organizations pay an ARR and fee per member listed and in turn: 

- access a library of industry resources, mentors, and scholarships with diverse trainers

-build a searchable profile with niche expertise, intersectional identities, and a consumer focused understanding of their training and qualifications

- access best -fit opportunities on the platform, securing private pay, backup, sliding scale, and insurance-billed opportunities closer to home while leveraging their expert niche and cultural identities

- use the integrated calendar features, scheduling, booking and practice management tool, and access built in communication tools and client care templates

- receive full billing services, including insurance billing and pre-approvals

- earn a myriad of benefits including cancellation coverage, cash advances, scholarships  

- apply for leadership training and an incubation program to move from a solopreneur to entrepreneur, building a collective, for-profit, or not-for-profit organization with the mentorship, technical support and access to platform features designed for growth 

Members are incentivized to be contributors in the Care Collective, engaging as peer support to others and earning scholarships and other rewards for being co-creators in the solutions that Okkanti is building. 

One of the early member benefits we’ve been testing is the Care Collective, an online social platform where carepreneurs can exchange skills, knowledge and resources. Still in testing, we’ve had enthusiastic adoption from mentors, trainers, and training organizations, such as Midwest Maternal Child Institute, one of the few nationally accredited midwifery schools and certifying body for maternal health workers. WisdomWay Institute and a Spanish-Speaking for Doulas* organization are building their student organizations on the platform. 

We’ve discovered that while our Care Collective was designed to address the need that was expressed to communicate outside of big tech social platforms, users are most engaged with offline community-building activities and less likely to be regular contributors to the online Community.   We’re working with these early insights to create grassroots strategies to build belonging alongside our online community that we’ve created. 

Our model includes an aggregated Marketplace, with Membership and Entreprenuerial support. 

Our membership based model includes an ARR and an 18% commission for care booked on the platform, plus sponsored learning and other events.  The lifetime revenue value from all sources per member is  $21,962 with a CAC of $100 for the member, and $100 for each acquired careseeker.  An average booking is based on $2800 per careseeker 

Our model includes a 2% pledge that will go towards supporting workers with emergency loans, scholarships and other needs, and a 10% employee equity pool.

Our pilot program beginning this year will allow us to test our MVP while building up revenue from members and bookings.   

Our current need for $1.2 m in financing is built into our cash forecasting model as a revenue-based loan, with repayment to investors starting in year 3, completed by year 5 with a 3 x return.

We have bootstrapped and been supported by A4CB, a community-based lender, to build our MVP and to achieve our early milestones. 

We are beginning our fundraise, looking for blended non-dilutive funding, such as grants, and investor capital. Our initial offering is a revenue based loan.