SPAQ: Integrating digital healthcare to improve resilience

SOIK's SPAQ solution aims to address the specific problem of poor health service levels in fragile contexts, particularly the high maternal mortality rate in the Democratic Republic of Congo (DRC) where pregnant women are a hundred times more likely to die than in developed countries due to weak health systems. The major contributing factors to this problem are three missing integrations: new digital solutions are not integrated into routine processes of examination, data collectors are not integrated into the user group of collected data, and customer success is not integrated into key project objectives.

To solve this problem, SPAQ provides an integrated digital package of different devices, software, and consumables for daily use by small African health centers, with a smartphone app as the platform. SPAQ enables the digitalization of antenatal consultations (ANCs) to facilitate data collection, benefit the data collectors, and increase the quality of service. The solution is also designed to create both clinical and financial impacts, with a focus on improving patients' satisfaction by understanding their needs, increasing the number of customers, and generating income for the health centers.

The scale of the problem is significant, not just in the DRC but also in other fragile contexts around the world where health systems are weak or disrupted by conflicts, displacement, natural disasters, and pandemics. According to the World Health Organization, about 830 women die from pregnancy- or childbirth-related complications every day, with the vast majority (99%) of maternal deaths occurring in developing countries. In the DRC, the maternal mortality rate is 493, and many pregnant women do not have access to basic health services, including antenatal care, skilled birth attendance, and emergency obstetric care.

SPAQ's innovative solution addresses these challenges by integrating digital health technologies and business model innovations to improve resilience in health systems and ensure access to quality health services for underserved communities, including pregnant women, refugees, ethnic minorities, people with disabilities, and older adults. By providing an all-in-one digital package of devices and software, integrating data collectors into the user group of collected data, and creating both clinical and financial impacts, SPAQ has the potential to make a significant positive impact on maternal and child health outcomes in fragile contexts.

Our solution is called SPAQ, an integrated digital obstetrics healthcare service designed for small health centers in fragile contexts. SPAQ is an all-in-one package that includes a smartphone, software, medical devices, solar batteries, identification cards, and other consumables. The solution works by providing a smartphone app that guides health workers through the standard antenatal consultation (ANC) process, with innovative devices such as portable ultrasound and fetal monitors linked to the platform. This integration allows for comprehensive and accurate examinations without any omissions, with abnormality alerts and automatic displays to avoid missing signs of high-risk pregnancies.

SPAQ also enables the operator of data collection to benefit from the data. The health workers input the results of the examinations into the SPAQ app, with some indicators such as blood pressures automatically displayed with alerts to avoid missing signs of high-risk pregnancies. The data is registered in a cloud server and can be shared with experts in urban areas to help local health workers remotely.

Moreover, SPAQ is designed to create both clinical and financial impacts, assuring financial sustainability. The solution includes a function for pregnant women to answer questionnaires, which helps health centers to understand what patients want and increase the number of customers. By continuously collecting data on patient satisfaction, SPAQ and health centers can improve the quality of service focusing on patients' needs, which are sometimes different from clinical quality. During a 4-month trial in 7 health centers in Kenge, DRC, the centers saw 74% increases in ANCs and 42% in income, which can cover our subscription fees as well as creating clinical impacts such as 28 lives saved.

SPAQ also collaborates with community volunteers who are given smartphones with the app installed to go around the villages and conduct interviews with pregnant women. By doing so, even pregnant women living in remote areas with limited access to medical facilities can have their basic medical information incorporated into the system. Abnormal alerts notify the appropriate medical authorities via SMS, providing them with information about high-risk pregnancies and enabling them to take prompt action.

Overall, SPAQ's integrated digital healthcare service aims to improve the quality and accessibility of obstetric healthcare in fragile contexts, providing a comprehensive and sustainable solution for small health centers.

SPAQ targets small health centers in fragile contexts, specifically in underserved communities where pregnant women are at high risk due to poor quality of health services. In the Democratic Republic of Congo (DRC), for example, the maternal mortality rate is 493 per 100,000 live births, which is a hundred times higher than in developed countries like Japan. These women and their unborn children are often left without access to quality healthcare, as many small health centers lack the infrastructure, equipment, and trained staff to provide adequate antenatal care.

SPAQ is designed to directly and meaningfully improve the lives of pregnant women and health workers in these underserved communities. By providing an all-in-one package of digital obstetrics healthcare services, including a smartphone app, medical devices, and consumables, SPAQ aims to facilitate daily use and improve the quality of care. The app guides health workers through a comprehensive antenatal care process, which includes the use of innovative devices such as portable ultrasound and fetal monitors that are linked with the smartphone app platform. As a result, health workers can cover all standard indicators without any omissions and provide pregnant women with comprehensive care.

SPAQ also addresses the issue of data collection and use in underserved communities. The app integrates the process of digitalized antenatal care, enabling data collectors to benefit from the data collected. Health workers can input examination results into the app, and the app can automatically display alerts for abnormal indicators such as high blood pressure. All data is registered in a cloud server to be shared with experts in urban areas, who can provide remote assistance to local health workers. This allows for a more informed decision-making process and enables health workers to better identify high-risk pregnancies and provide appropriate care.

Finally, SPAQ addresses the financial sustainability of small health centers. By incorporating patient satisfaction questionnaires into the app, SPAQ enables health centers to understand patients’ needs and improve the quality of service. This has resulted in an increase in patient visits and income for health centers. As a result, health workers can receive better compensation and have a more stable work environment, which in turn can improve their motivation and job satisfaction.

In summary, SPAQ targets pregnant women and health workers in underserved communities in fragile contexts. By providing an integrated digital healthcare platform, SPAQ aims to improve the quality of care and access to care, enable informed decision-making, and address the financial sustainability of small health centers. Through these efforts, SPAQ can directly and meaningfully improve the lives of pregnant women and health workers in these communities.

Our team is well-positioned to deliver this solution as we have a deep understanding of the local communities and their needs. Our Team Lead, who is also the CEO, has lived in the Democratic Republic of the Congo for over 5 years and has worked closely with the local health workers and government officials. In addition, our team includes local staff who have experience working in the healthcare sector, providing us with valuable insight into the local context.

To ensure that we understand the needs of the communities we are serving, we have conducted extensive field research, including interviews with pregnant women, health workers, and government officials. We have also worked closely with local organizations such as the Obstetrics and Gynecology Association and the Midwifery Association to better understand the challenges and opportunities in the healthcare sector.

Furthermore, we have engaged the local communities throughout the design and implementation process of our solution. We have held community meetings and focus groups to gather feedback on our prototype and have incorporated this feedback into the final design. We have also worked closely with local health workers to ensure that our solution is easy to use and integrates seamlessly into their workflow.

Overall, our team's experience, expertise, and deep understanding of the local communities have enabled us to design and deliver a solution that is tailored to their needs and is sustainable in the long term. Our commitment to engaging and involving the communities in the design and implementation process has ensured that our solution is meaningful and impactful to those we are serving.

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We are applying to Solve because we believe that Solve's resources, network, and expertise can help us overcome several barriers that we are currently facing.

Firstly, we are seeking technical support to improve and scale our digital healthcare solution. Specifically, we are looking for partners who can help us with AI-powered data analytics and machine learning to improve the accuracy of our clinical decision-making support system. We also hope to find partners who can help us with the development and integration of additional features and functionalities, such as telemedicine and remote monitoring, to expand the scope of our solution.

Secondly, we are seeking financial support to expand our operations and impact. While we have been successful in generating revenue from our existing customer base, we require additional investment to scale our solution to more health centers in the DRC and other countries facing similar challenges. We hope to connect with impact investors, philanthropic foundations, and corporate social responsibility programs that align with our mission and vision.

Thirdly, we are seeking legal and regulatory support to navigate the complex landscape of healthcare policies and regulations in the countries where we operate. We hope to find partners who can provide us with legal advice on matters such as data privacy, medical device regulation, and intellectual property protection.

Lastly, we are seeking market insights and guidance to better understand the needs and preferences of our target customers and stakeholders. We hope to connect with partners who can provide us with market research and analysis, as well as mentorship and coaching on business development, marketing, and sales strategies.

Overall, we believe that Solve can provide us with invaluable connections, resources, and expertise to overcome the barriers we face and achieve our mission of improving maternal and child health in fragile contexts. We are not solely focused on raising funds, but rather on finding partners who share our values and can help us make a meaningful impact in the communities we serve.

Our solution is innovative in the way it addresses the unique challenges faced by fragile communities with limited access to healthcare services. We have designed SPAQ to be an all-in-one digital obstetrics healthcare package that is specifically tailored to the needs and constraints of these communities. By integrating various technologies and devices into a user-friendly smartphone app, we are able to provide high-quality and comprehensive maternal and child health services even in areas where medical resources are scarce.

One of the key innovations of SPAQ is its integration into the routine processes of local health workers, making it easier for them to adopt and utilize the digital tools in their day-to-day work. We have also included a feature for community volunteers to reach underserved populations and input basic health information into the system, which is then shared with healthcare professionals in the area. This is a significant improvement over traditional paper-based systems, which can be difficult to manage and often lead to information gaps and missed opportunities for early interventions.

Our solution has the potential to catalyze broader positive impacts by demonstrating the feasibility and benefits of integrating digital health solutions into fragile contexts. We believe that our approach can inspire other organizations and stakeholders to develop and implement similar solutions in other regions and countries facing similar challenges. By changing the market in this way, we hope to contribute to the global efforts to improve maternal and child health outcomes and reduce health inequities.

In the next year, our impact goals are to expand the reach of SPAQ to an additional 100 health facilities in the Democratic Republic of Congo and to conduct training programs for 200 health workers. This will result in an estimated 15,000 antenatal consultations with SPAQ and 50 lives saved. Additionally, we plan to conduct surveys of pregnant women and health workers to continue improving our solution based on their feedback.

In the next five years, our impact goals are to expand the reach of SPAQ to 10,000 health facilities across sub-Saharan Africa, which will result in an estimated 5 million antenatal consultations with SPAQ and 16,000 lives saved annually. To achieve this, we plan to collaborate with local and international organizations, governments, and investors to scale up our solution. We will also continue to conduct research and development to improve SPAQ based on the evolving needs of our target population.

Furthermore, we plan to leverage the success of SPAQ to catalyze broader positive impacts in the maternal and child health sector. By demonstrating the effectiveness of our integrated digital solution, we hope to encourage other organizations and governments to adopt similar approaches. We will also continue to collaborate with stakeholders in the health sector to advocate for increased investment in maternal and child health in fragile contexts.

Overall, our impact goals are ambitious, but we believe that they are achievable with the right partnerships and support. We are committed to working towards our vision of a world where every pregnant woman, regardless of where she lives, has access to quality maternal health care.

For measuring the progress of our impact goals, we have identified several key indicators that are closely aligned with the UN Sustainable Development Goals. These indicators are important to help us track our progress in achieving our impact goals and to ensure that we are delivering meaningful and measurable impact to the communities we serve. The specific indicators we are using to measure our progress are as follows:

1. Number of health facilities where SPAQ is installed and used: We are tracking the number of health facilities where SPAQ has been installed and is being used for antenatal consultations. This will help us understand the extent of our market penetration and the adoption of our solution in healthcare facilities.

2. Number of healthcare workers trained to use SPAQ: We are tracking the number of healthcare workers who have been trained to use SPAQ. This will help us ensure that the solution is being used correctly and that healthcare workers are able to take full advantage of its capabilities.

3. Number of digital antenatal consultations performed: We are tracking the number of antenatal consultations that are being performed using SPAQ. This will help us understand the impact of our solution on the number of antenatal consultations being performed and ensure that our solution is being used to its full potential.

4. Reduction in maternal and neonatal mortality rates: Our ultimate goal is to reduce maternal and neonatal mortality rates. We are tracking these rates in the communities where we are working to monitor the impact of our solution.

5. Antenatal consultation coverage: We are tracking the antenatal consultation coverage in the communities where we are working. This will help us understand the impact of our solution on increasing the number of antenatal consultations being performed and improving overall healthcare coverage.

6. Financial sustainability: We are tracking the financial sustainability of the healthcare facilities where SPAQ has been installed. This will help us understand the economic impact of our solution and ensure that healthcare facilities are able to continue providing quality care to their patients.

By regularly tracking these indicators, we can assess our progress toward our impact goals and adjust our strategy as needed to ensure that we are delivering the greatest possible impact to the communities we serve.

1. Access to quality maternal and child health services is a basic human right, and improving access to such services will contribute to a reduction in maternal and neonatal mortality rates.
2. Digital health technologies can address the shortage of qualified healthcare professionals, lack of infrastructure and resources, and geographical barriers that impede access to quality maternal and child health services in fragile contexts.
3. Digital health technologies can improve the quality and efficiency of healthcare services by facilitating the delivery of evidence-based care, reducing errors, and promoting patient-centered care.
4. Empowering healthcare workers with digital health tools can lead to better job satisfaction, retention, and performance, which can ultimately lead to improved health outcomes for patients.

SOIK's approach to achieving impact is based on the following logic framework:

1. Inputs: SOIK has developed a digital maternal and child health solution called SPAQ, which includes a mobile application, medical devices, and a cloud-based data management system.

2. Activities: SOIK conducts pilot projects to test the feasibility and effectiveness of SPAQ in small-scale medical facilities in Africa. During the pilot projects, SOIK provides training, technical support, and ongoing evaluation to healthcare workers to ensure they can effectively use SPAQ in their daily work.

3. Outputs: Through the pilot projects, SOIK installs SPAQ in medical facilities, trains healthcare workers to use SPAQ, and collects data on the use of SPAQ.

4. Outcomes: As a result of the pilot projects, SOIK expects to achieve the following outcomes in the short and long term:

• Improved quality of maternal and child health services: SPAQ provides evidence-based guidelines and tools for healthcare workers to conduct antenatal consultations, track fetal growth, and monitor maternal and fetal health status. By using SPAQ, healthcare workers can provide more accurate and timely care, which can lead to improved health outcomes for pregnant women and their newborns.

• Increased number of antenatal consultations: SPAQ allows healthcare workers to conduct digital antenatal consultations, which are less time-consuming and more efficient than traditional paper-based consultations. By increasing the number of antenatal consultations, healthcare workers can detect and manage pregnancy-related complications earlier, which can reduce the risk of maternal and neonatal mortality.

• Reduced maternal and neonatal mortality: By improving the quality of maternal and child health services and increasing the number of antenatal consultations, SOIK expects to contribute to a reduction in maternal and neonatal mortality rates in the communities it serves.

5. Impact: In the long term, SOIK expects its solution to contribute to the achievement of the Sustainable Development Goal 3, which aims to ensure healthy lives and promote well-being for all at all ages. By improving access to quality maternal and child health services in fragile contexts, SOIK hopes to contribute to a more equitable and just world.

SOIK's theory of change is informed by evidence from previous studies on the effectiveness of digital health interventions in improving maternal and child health outcomes in low-resource settings. SOIK also seeks to engage with its target population and other stakeholders to ensure that its solution is aligned with their needs and priorities.

SOIK's digital obstetrics solution, SPAQ, is powered by a combination of smartphone apps, web apps, and portable digital medical devices. The SPAQ smartphone app allows pregnant women and healthcare workers to authenticate themselves with a unique QR code or NFC-enabled card, even in offline environments. The app is designed to work with portable digital medical devices such as ultrasound machines and fetal monitors that can be powered by a power bank and used in remote or resource-constrained areas.

One of SPAQ's key features is an automatic alert system that detects anomalies in patient data and sends an SMS notification to a designated phone number. The system is designed to work even in areas with limited internet connectivity, making it an effective solution for fragile contexts where access to healthcare is limited.

Moreover, the data collected by SPAQ is stored in the cloud, allowing patients to access their medical records regardless of their physical location. This is particularly important for refugees and other mobile populations who may move frequently and need access to consistent healthcare.

Overall, SPAQ's innovative use of technology addresses many of the challenges facing healthcare in fragile contexts and has the potential to significantly improve maternal and neonatal health outcomes.

SOIK is committed to incorporating diversity, equity, and inclusivity into our work. Our leadership team is diverse, with members from different racial, cultural, and educational backgrounds. We believe that this diversity strengthens our team by bringing different perspectives, experiences, and skills to the table.

We recognize that there is always room for improvement, and we have set goals for becoming more diverse, equitable, and inclusive. We have taken several actions to achieve these goals, including:

1. Community Engagement: We engage with local communities to understand their needs and involve them in the design and development of our solutions. We work with local NGOs and community-based organizations to ensure that our solutions are culturally appropriate and address the unique needs of each community.
   

2. Inclusive Design: We incorporate principles of universal design and accessibility into our products to ensure that they can be used by people of all abilities, including those with visual or hearing impairments.

3. Internal Policies: We have implemented policies to promote diversity, equity, and inclusivity within our organization, such as a zero-tolerance policy for discrimination, harassment, or bias of any kind.

We believe that incorporating diversity, equity, and inclusivity into our work not only strengthens our team but also enables us to better serve the communities we work with. By actively seeking out and valuing diverse perspectives and experiences, we can develop solutions that are more effective, equitable, and sustainable for everyone.

Our business model is centered around providing value to health centers and governments/aid agencies through the use of our digital obstetrics solution, SPAQ. We provide health workers in health centers with a tool that not only improves the quality of healthcare services, but also collects and uses data to drive better decision-making.

Our main customers are health centers and governments/aid agencies. Health centers benefit from improved healthcare services, increased profitability, and better data management. Governments and aid agencies benefit from being able to easily manage projects and obtain quantitative results in real-time.

To reach our customers, we primarily work through donor agencies, ministries of health, and provincial health departments. We organize training and trials at medical facilities within each provincial health department, and our goal is to eventually have SPAQ added to their annual activity plan. Donor agencies and the Ministry of Health finance this plan, and we receive revenue from these sources.

After project implementation, we ensure financial sustainability through a subscription service. Target medical facilities subscribe to our service and make monthly payments, which includes internet connectivity, provision of ID cards, and supervision by provincial health departments.

Overall, our business model focuses on providing a valuable solution to our customers while also ensuring financial sustainability through a subscription service.

SOIK's revenue model is two-fold: (1) selling the SPAQ solution to health centers through the "to B model" and (2) providing advisory services to governments and aid agencies through the "to G model."

In the to B model, SOIK will sell the SPAQ hardware to health centers, along with providing training and support services for its use. After hardware procurement, health centers will pay a subscription fee to SOIK for the ongoing use of the SPAQ solution. SOIK will provide internet connectivity, ID cards, and supervision by provincial health departments.

In the to G model, SOIK will obtain funding through ODA and financial resources from the annual activity plans of the Ministry of Health and Provincial Health Departments. SOIK will also offer advisory services to governments and aid agencies for project management, data analysis, and impact evaluation.

As SOIK expands its market and establishes a certain scale of government procurement, it plans to raise funds through equity finance to further expand its operations and improve its solutions. Additionally, SOIK will explore the possibility of partnerships and collaborations with other organizations to leverage resources and achieve greater impact.

Here are some examples of how SOIK's plan to achieve financial sustainability has been successful so far:

• We have secured a grant of approximately 100 million JPY (about $910,000 USD) from the Japanese government, which has enabled us to develop and trial our solution in five provinces of the Democratic Republic of Congo and other countries.

• Two out of the seven target facilities in the Kwango pilot project have purchased the SPAQ product, while the other three paid for it through our rental and subscription model. This has helped us generate revenue and establish a sustainable business model.

• In January 2023, the Ministry of Health in DRC has ordered 130 SPAQ kits and other consumables from SOIK, which is about $577,000 USD. This indicates a strong interest in our solution and potential for future revenue generation.

While we have also received grants and support from other organizations, such as the Japanese International Cooperation Agency (JICA), we believe that a sustainable business model is crucial for the long-term success of our solution. To this end, we are continuing to explore various revenue streams, including product sales, rental and subscription models, and government procurement contracts. Our goal is to achieve financial sustainability while also maximizing our impact in improving maternal and child health outcomes in fragile contexts.