Oky - Digital SRH education for girls by girls

Problem:

Sexual and Reproductive Health (SRH) information and education is crucial for equipping girls and young women with the knowledge, confidence and skills to make safe and healthy choices about their menstrual and reproductive health, sexuality, and relationships. Despite governments around the world recognizing the value of sexuality education and including its provision in laws and policies, implementation varies greatly. In Asia Pacific, less than 35% of young people report having received SRH information at school. Barriers to SRH education delivery can exist at the cultural, community, organizational, teacher and individual levels. Schools may not implement the curriculum - in Kenya and Tanzania only 51-75% of schools cover sexuality education despite it being mandatory. For teachers, inadequate training, support and resources can result in discomfort in delivering SRH education and inaccurate messaging. For example, in Vietnam sexuality education is optional and teachers report not being confident to deliver the curriculum. Social taboos, and the shame and stigma surrounding sexuality can prevent girls and young women from seeking out information or discussing these issues, even with family members. When guidance is provided, it may be fraught with myths, inaccuracies, unsafe practices, or perpetuate harmful gender norms. Many girls search online for SRHR information however it can be difficult to find trustworthy, quality information that is adolescent-friendly, in their language or relevant to their context.

This lack of SRHR information can have many negative impacts on girls' and young women's health, well being and opportunities in life. Inadequate information can hinder their ability to understand their body changes during puberty, menstruation, and make informed decisions about their sexual and reproductive health. They may be more vulnerable to being pressured or coerced into risky sexual behaviors. Such behaviors can lead to unintended pregnancies, sexually transmitted infections, gender-based violence (GBV) and other risks. Globally, there are an estimated 21 million adolescent pregnancies each year, among girls 15-19 years living in LMICs. Approximately 50% of these pregnancies are unintended. Pregnant girls face increased risk of mortality and morbidity from unsafe abortions and adolescent childbirth. An unplanned pregnancy can also disrupt girls' educational and career aspirations, and lead to child marriage. In Asia Pacific alone, an estimated 19 million girls 15-19 years are currently married or in union. These outcomes often compound social disadvantages for a girl and her family, restrict her role to the domestic and reproductive sphere, and prevent her from reaching her full potential.

Solution: 

Oky, is a digital, girl-centered innovation -  an open-source mobile SRH education and period tracker app co-created with and for girls in LMICs. Oky is an approved digital public good and tackles the taboo, stigma, misconceptions, harmful practices, and lack of quality information on SRH. Oky uses menstruation as an entry point for girl-friendly content on a range of topics, including family planning, fertility, pregnancy, sex, human rights, relationships, child marriage, mental health, violence and staying safe. This content has been developed in collaboration with global and local SRHR experts, including from UNFPA. The app also provides contact information for local SRH and GBV services, for accessing in-person support when needed. 

Oky illustrates innovative tech design to bridge the gender digital divide for girls and young women. Oky was built together with girls to meet their digital realities, regarding connectivity, devices, literacy, privacy concerns, and gatekeepers. As a result, Oky is gamified and fun, fully functional offline, easy to navigate, accessible for girls with disabilities, suitable for low-end devices that girls might have access to, accommodates phone sharing, does not collect personal identifiable information, has highest data protection and privacy, and is entirely free, without ads. By using Oky, adolescent girls and young women can learn about their bodies and SRH in positive and empowering ways, while improving their digital literacy.

Digital solutions can complement in-person education, reach more girls at a lower cost and deliver evidence-based, girl-friendly information and cycle tracking directly into their hands, in the way they want it. While there are many commercial period tracking SRH apps on the market, these mainly target adult women (for conception), are rarely educational, can be gender-stereotyping, and can compromise data. These apps are rarely adapted to local languages or contexts, do not function offline, or are not tailored to girls’ questions and lived experiences.

Oky meets the criteria for the 4HERPOWERCHALLENGE as it has been co-created with and for adolescent girls to address their key challenges to SRH. Oky also meets several challenge dimensions as it leverages digital infrastructure to enhance young peoples' access to SRH education, information and services and addresses root cause barriers such as stigma and taboos, to improve SRH outcomes for girls and young women. Oky also provides an opportunity, through co-creation, to strengthen the capacity and engagement of young people, especially girls, in the development and growth of a digital solution to address their SRH needs.

Oky’s primary target audience are adolescent girls aged 10-19 years, specifically those living in poverty in developing countries whose access to information is constrained by the social stigma surrounding SRH and digital inequality. As of October 2023, Oky has been localized and launched in 11 developing countries and has over half a million users, most of whom are adolescent girls.

Marginalized girls, such as girls with disabilities, refugee girls or those on the move, living in conservative, remote, or ethnic minority areas, are particularly impacted by the lack of relevant information. In response, Oky is designed specifically to be inclusive, accessible, and relevant, and ensures their participation in the design process. This includes approaches to meet the needs of girls who do not have smart phones and/or internet access, such as offline functionality and multiple-user login for phone sharing, Oky peer-to-peer education, and the development of low tech Oky versions, such as interactive voice response and SMS for simple phones, and radio programs for community listening.

Secondary audiences include young women, boys, parents and caregivers,
educators, health workers, religious leaders, and governments. Oky can help
adults overcome personal discomfort to talk about periods, puberty, SRH and
other sensitive topics. Oky also supports teachers and health providers to
deliver sexuality education and contacts for SRH and GBV services are
included in Oky to facilitate access to in-person support when
needed.

Oky’s impacts the lives of adolescent girls by empowering them to navigate adolescence with confidence and make informed decisions over their SRH. Oky builds users' knowledge about SRH, GBV, and healthy relationships and supports girls to develop positive attitudes towards their bodies and SRH. Oky also helps adult users overcome personal discomfort so they may better support adolescents’ SRH.

There is initial evidence from in-app surveys and pilot qualitative research, that Oky is delivering the outcomes envisaged:

82% of respondents in a Global Oky in-app survey (n=542 from 73 countries) reported learning new information from Oky, and 84% trusted Oky information. 

97% of respondents to an Oky Indonesia in-app survey (n=1002) reported having a better understanding of SRH after using Oky; and 92% agreed that Oky helped them distinguish myths from facts. This is supported by results from a qualitative study in Indonesia, where both adolescents and adults (including young women, teachers and counselors) reported Oky increased their knowledge. Participants indicated Oky helped them gain a deeper understanding of how to support themselves or others. Adolescents noted being happy they were able to access sensitive content without embarrassment.

96% of respondents in a small Oky Philippines survey (n=76) reported better SRH knowledge; 91% indicated they had learned new information from Oky; 92% reported trusting Oky and 54% said they had shared the Oky app or content with a peer.   

Over a third of respondents from the Oky Global and Indonesia surveys reported better awareness of services in their areas and how to access them. And 61% of Oky Indonesia and 83% of Oky Philippines respondents indicated more positive perceptions of themselves and increased self-confidence.

Girl-centred design is key for Oky - everything about Oky is for girls, by girls. Unicef has a focus on gender equality and adolescent girls empowerment, with significant internal expertise and experience in engaging adolescent girls. It has significant strengths and core competencies which uniquely position it to lead further scale up and new deployments of Oky:

-Diverse expertise across multiple sectors, specifically gender, WASH including MHM, sexual reproductive health, and child protection

-Established systems to ensure accountability and transparency, including governance models for working with government and CSOs

-Existing offices and teams in all target countries with strong understanding of children’s rights and established networks including with relevant government ministries

In addition, UNICEF can draw on the lessons learned and approaches which have already demonstrated its capacity to successfully scale innovations including the following:

• The Learning Passport: an online, mobile, and offline tech platform providing high quality, flexible learning for out of school children. It is also deployed in schools to build a more digitally literate generation. Since 2020 Learning Passport has scaled to reach 2.4 million learners in 26 countries
• U-Report: UNICEF’s digital engagement platform for adolescents and young people, collecting opinions via polls and communicating key information via numerous messaging, social media and SMS channels. Since its launch in 2011 it has expanded to 90 countries and 23 million users
• Oxygen plants-in-a-box: the fastest product innovation in UNICEF's history, delivered to 27 countries in 2022 to increase their oxygen production capacity in response to the COVID-19 pandemic

To date Oky is already being implemented in 14 countries around the world, with local organizations who become Oky franchise partners* driving the localization and implementation process together with girls. They receive Unicef Oky Core Team support, technical advice and quality assurance. Oky local franchise partners join Oky based on their interest and criteria, including they have ongoing programming with and for girls and women; deep-rooted presence in-country; alignment with Oky’s vision and principles; openness to working with others; and an appetite for digital technology for social impact. 

Localization takes a collaborative approach building ecosystem support from Government, communities, and CSO stakeholders engaging representatives from key government ministries (Education, Health, Youth, Women and Children), and CSOs/NGOs/UN agencies with expertise in SRHR (including UNFPA) to vet and validate Oky content. This co-creation process harnesses the expertise and experience of communities and their leaders to ensure Oky implementation meets girls' SRH and digital needs, is culturally appropriate, and leverages existing programmes. This collaborative, localized approach to deployment has resulted in government agencies and religious organizations endorsing Oky and promoting it for use in schools, even in conservative settings such Indonesia and the Bangsamoro Autonomous Region of Muslim Mindanao (Philippines). *Current Oky franchisees include PKBI (Indonesia), LVCT Health (Kenya), Tai (Tanzania), NFCC (Nepal), Plan (Philippines), Girl NGO (Ukraine), OpenLine (Kyrgyzstan), WASH NGO (Mongolia), SaCoDe (Burundi), LoveLife (South Africa), SPLASH (India), and Save the Children (Papua New Guinea).

Currently Oky has more than 500,000 online users worldwide (+ offline users) including more than:

95,000 for Global Oky (73 countries)

292,000 in Indonesia

42,000 in the Philippines

22,000 in Mongolia

22,000 in Kyrgyzstan

7,800 in West Bengal India

7,750 in Eastern and Southern Africa.

Most users are adolescent girls aged 10-19 years.

Oky is a digital, girl-centered innovation - an open-source mobile SRH education and period tracker app co-created with and for girls in developing countries. The app is an approved digital public good and illustrates innovative tech design that tackles the taboo, stigma, misconceptions, harmful practices and lack of quality information on reproductive health. Oky content is also open source (under the Creative Commons License), available online and can be used by other organizations and individuals, whether in face-to-face programs or digital platforms. For example, Oky content has already been used in the PSI Big Sista chatbot (Nigeria) and Girl Effect Big Sis chatbots (South Afric and Tanzania). The open source code (without Oky branding) is also available on GitHub for any developer or innovator to use in developing their own app.

Oky’s innovative social franchising model is the key to scaling Oky across countries. This first of its kind social franchising of a digital solution to a trusted local actor at no cost, empowers and capacitates local partners to drive and own localization, deployment, maintenance, management, promotion and scaling of Oky in their market, with Unicef and ecosystem support. Through the social franchise model, local actors become part of and benefit from the Oky franchisee network and global Oky ecosystem. Members of the Oky community benefit from peer production - sharing tools, approaches, or code builds, reducing the need for reinvention and avoiding replication of efforts. Any improvements made by one franchisee (UI/UX, features, content etc.) are available to all. If a franchisee cannot invest in iterations, the localized Oky version can still evolve by integrating enhancements from others, i.e., pulling through new GitHub sub-modules.

Sparking more digital innovation to close the gender digital divide is also part of Oky's vision. The Oky journey has been filled with challenges and learnings. The Oky Core Team capture these insights so they can be shared to help other innovators, designers and implementers of digital products and services build more inclusive digital solutions. Publications to date include a series of evidence briefs: What we know about the gender digital divide for girls, Using big data for insights into the gender digital divide for girls, Accessible and inclusive digital solutions for girls with disabilities, and Can peer-to-peer approaches help unconnected girls benefit from digital approaches (in print). In addition, the team have created a GenderTech toolkit with best practices: including 'How to build digital solutions for girls digital realities', 'How to co-create digital solutions with girls', 'How to include girls in digital product user testing', and 'How to conduct remote user consultations with girls'.

Oky’s vision over the next five years is to evolve further as a gender-transformative digital commons, with collaborative governance, led by girls and local actors, built out through peer and user co-production, leveraging both frontier technologies and low tech solutions to benefit as many users as possible and break the taboo of SRH once and for all.

By achieving this vision Oky will progress Sustainable Development Goals 3,4 and 5 (Good Health and Well-being, Quality Education and Gender Equality).

Oky Impact goals:

1) Girls’ empowerment. Girls everywhere, of all abilities, have support, confidence, and agency over their bodies and make informed decisions. 

2) Social norm change. Everyone benefits from Oky as a ‘pocket SRH encyclopedia’ which helps eliminate taboos and harmful gender norms.

Oky will achieve these impacts by improving:

(1) Knowledge: Users gain knowledge about  SRH, GBV, healthy relationships, and can distinguish myths from facts. (Indicators: % of users report learning new information from Oky; % report Oky helps them understand more about SRH; % report Oky helps  them distinguish myths from facts; % trust Oky information; % report a  better awareness of services in their area and how to access them).

(2) Perceptions: Users have more positive attitudes towards their bodies and SRH. (% report more positive perceptions of themselves and increased self-confidence)

(3) Community attitudes: Adult users overcome personal discomfort to discuss periods and support adolescents’ health. (teachers and parents report improved confidence in discussing SRH and supporting adolescents). 

(4) Ecosystem support: Oky is included in and promoted through partner networks and government programmes and platforms. (# of partners promoting Oky; # of programmes and platforms include Oky).

With 4HERCHALLENGE support, Oky will reach a primary target audience of 2+ million girls by 2028 through (i) localization and launch of Oky in new markets, (ii) support for effective marketing and promotion to the target audience and leveraging national ecosystems in current and new countries.  

*More than 18 countries have expressed interest in deploying Oky: Brazil, Bulgaria, Bangladesh, Botswana, Colombia, Egypt, Ecuador, Ghana, Jordan, Madagascar, Morocco, Mozambique, Nigeria, Pakistan, Peru, Thailand, Uganda and Vietnam.     

The ultimate goal of Oky is to break the taboos surrounding SRH and empower adolescent girls to make informed decisions and overcome restrictive gender norms. The Oky Theory of Change requires the outcomes described above (knowledge, perceptions, community attitudes, ecosystem support) to achieve this impact. To achieve these outcomes the following outputs will be required:

Girls (10-19yrs): participate in user-centred design (#); users register Oky accounts (%); users with disabilities register Oky accounts (%); users are active/engaged (%); time spent accessing different Oky features (#).

Communities: partners participate in Oky localization/national ecosystem (#); government agencies and stakeholders endorse and disseminate Oky (#);  Oky included in partner promotional channels/activities (#); adults/service providers (teachers/health workers) use Oky to provide SRH education (# schools/health services); adults view Oky on social media channels (#).

Franchisees: localized versions live (#); Oky downloads (#); app crashes (#), new Oky content items (#); attendance franchisee learning events and South-South cooperation (#); social media click-through rates (#).

Oky core team: publications for Oky partners and the wider community (#); learning events hosted and South-South cooperation facilitated (#). 

Initial evidence from in-app surveys and qualitative research indicates these outputs are achieving the desired outcomes (see previous). More in-depth impact evaluation research is planned for 2024.

Oky is an internal startup within UNICEF, hosted by the Digital Centre of Excellence for scaling as a digital public good (DPG), led and guided by the Gender & Technology Senior Advisor with the Oky core team. Franchise and ecosystem partners are also supported by Unicef country and regional offices, leveraging UNICEF’s brand, capacity and partnerships.

Two staff and several part-time technical consultants are working on Oky.

Oky development with girls began in 2018, with the first launches in Indonesia and Mongolia in mid-2020. 12 more countries were onboarded in 2021-22 and 11 local Oky versions are already live (+global Oky app in 4 languages).

The Oky Core Team has members from eight different nationalities and 80% are female. Oky regional support and coordination is provided for in five regions including East Asia and Pacific, Eastern and Southern Africa, Europe and Central Asia, Latin America and the Caribbean, Middle East and North Africa.

Diversity, and the inclusion of marginalized girls, has been core to Oky implementation. Localization processes  include girls with diverse demographics including girls from urban, per-urban and rural settings; in- and out-of-school; different religions and ethnicities; diverse socioeconomic backgrounds and girls with disabilities. For example, Oky Philippines localization included consultations with girls of Mangyan, Teduray, Tausug, Yakan, Sama, Badjao, Maguindanaon and Maranao ethnicities, Muslim and Christian religions, and girls with a variety of disabilities. Oky deployment includes localization of content to local languages - Oky is currently available in 17 languages, with more adaptations under way e.g., in South Africa, Oky will be localized in four languages. 

Franchisees and Oky ecosystem partners come from all sectors of society. This leverages creativity and diversity in the scaling and build out of Oky.

Considerable work has been done to ensure Oky reaches girls who do not own smartphones and/or lack access to internet connectivity. Low tech solutions for simple phones are under development (IVR and SMS) as well as radio programmes. In addition, peer-to-peer approaches have been developed and successfully piloted in Indonesia, to enable girls without phones to benefit from Oky content and build digital skills, with activities including adapting popular games (Oky Ludo; Snakes and Ladders) and encyclopedia cards.

There has been considerable focus on making Oky accessible for girls with disabilities, ensuring Oky meets the Web Content Accessibility Guidelines. Guidance and toolkits have been developed for the inclusion of girls with disabilities in Oky activities, including localization, launch, and post-launch promotion. Digital inclusion support is provided to franchise partners from the Oky Disability Specialist and local Organizations of People with Disabilities (OPDs) partner with Oky. Also, a tablet version of the app has been developed to enable landscape mode as well as portrait viewing which will support users with visual impairments and those using a tablet attached to their wheelchair (it will also be useful for classroom and peer-to-peer activities). There is early evidence that girls with disabilities are using Oky.  46% of Oky Philippines in-app survey respondents reported having a disability.
SRH content for girls with disabilities has been co-created, tested and included in Oky. 

Learnings from working with girls with disabilities have led to the development of an evidence brief and GenderTech tool (in print) supporting inclusion of and accessibility for girls with disabilities in digital solutions. In addition, a digital skills module for girls with disabilities has been developed and is currently being tested, with tools and instructions for OPD partners to train children with disabilities on how to find, activate, and use pre-installed accessibility features on their device (phone or tablet), so they can use Oky and other digital services and content of interest.

Oky is an internal UNICEF start-up that uses an innovative business model for scaling. Through a social franchise model, UNICEF is the franchisor and contributing partner (with a small UNICEF Oky Core Team serving as technical advisors and for QA) for franchise partners who lead and own Oky in their respective country. Franchise partners sign a franchise license agreement (FLA) that was developed by UNICEF Legal department. The FLA lays out the roles and responsibilities, Oky principles, and other important stipulations. The franchise is for social impact, free of royalties and fees. 

The social franchise approach fosters localization, local ownership and capacity building. As Oky scales across countries and regions, it is iterated and adapted to the context by franchise partners, together with girls and collaborators, including UNFPA. The app is localized (language, content, design, features) and supplemented with multi-platform products (low or frontier tech) where relevant. This unique social franchise model leverages diversity, creativity, and different expertise. It allows multiple simultaneous deployments around the world and facilitates faster and cost-efficient product build-out. Franchisees benefit from peer-production and consumer contributions. The social franchise model also catalyzes shared learning, digital collaboration, and ecosystem development This includes South-South technical collaboration, with franchisee twinning and mentoring.

Development of national Oky ecosystems facilitates promotion and dissemination of Oky in a country. Collaborating with key stakeholders, both Government and CSOs, in Oky localization provides an opportunity for them to vet and validate Oky content, create alignments with their own programmes, and integrate the app into their activities. This has been particularly successful in the Philippines where Oky has been endorsed by the Ministry of Education and is to be mainstreamed into CSE and Wash in Schools. And in Indonesia, Oky has been integrated into the national digital teacher training platform and UKS school health program.

Oky has a multi-pronged pathway for scaling which includes open source, social franchising, single tenancy, commons-based peer and user co-production, and ecosystem support. This approach will enable Oky to sustainably exist and evolve in deployment countries, benefiting as many users as possible, at low cost.  

As an overarching premise, Oky scaling builds on ecosystem support and multi-stakeholder collaborations, aligning with SDG Target 17.16 to enhance the global partnership for sustainable development. As a recognized digital public good, Oky’s open-source code and content, its gender-transformative nature, and careful design vis-a-vis girls’ digital connectivity, attracts partners and (pro-bono) collaborators from all industries for build out, enhancements, and dissemination. 

Oky’s innovative social franchising model is the key to this endeavor. This first of its kind social franchising of a digital solution to a trusted local actor at no cost, empowers and capacitates local partners to drive and own localisation, deployment, maintenance, management, promotion and scaling of Oky in their market, with UNICEF and ecosystem support. Through the social franchise model, local actors become part of and benefit from the Oky peer network.

To sustain Oky in a market, annual hosting & maintenance costs of a local Oky app are minimal (around $15-20K p.a.) compared to traditional development programmes or proprietary solutions. Franchise partners can raise funds for their local versions via crowdfunding, sponsorships, or donors, or leverage innovative finance. However, they cannot commercialize their Oky app (fees, paywalls, ads) given end-users are adolescent girls in LMICs without (or limited) purchasing or financial decision-making power. 

For Oky dissemination and promotion in a market, UNICEF supports franchisees to partner with the private sector, including mobile network operators; build alliances with service providers and organizations working in the Education, Health, WASH, Women’s Rights, and Youth Empowerment sectors; and collaborate with governments to integrate Oky in their programmes. Oky mainstreaming in schools, supported (or mandated) by Ministries of Education at national level, such as for example in the Philippines, reaches high numbers of users without resource requirements for the Oky franchise partner.

Oky has demonstrated proof of scaling through the first deployment cohort. MIT Solve investment will play a crucial role in strengthening the social franchise model, boost peer and user co-production, and galvanize partnerships/ecosystem support for promotion and dissemination, including bringing its content to girls via partner platforms and programmes.

With sufficient investment and support, Oky can be expected to benefit more than 10 million girls over the next 10 years.