Kènèya Blon

In low-income settings, there are still many barriers which prevent mothers from seeking and accessing quality maternal and neonatal health information and care. If they struggle to make decisions about healthcare for themselves and their children, mothers encounter delays that cause complications and worse health outcomes. Our voice-based solution makes basic maternal and neonatal health information, such as how to breastfeed or prevent malaria, available to mothers with limited literacy skills when they need it. It is a phone-based application that also reminds them of vaccination schedules and allows them to ask questions and receive answers from doctors, without having to leave home. By putting an on-demand resource directly in the hands of mothers, we can equip them with the knowledge to make health decisions quickly and efficiently, wherever and whenever they need it.

Millions of mothers in Mali do not have access to the health information and care they need, which contributes to some of the highest maternal and child mortality rates in the world. A primary challenge that mothers face is that much maternal and neonatal health information is not delivered in a way that meets their needs and lives. In Mali, 66% of women have no education and the literacy rate for women is just 28% (DHS-IV, 2018). In the peri-urban communities we serve, we find that up to 97% of women did not have the chance to go to school or to build literacy skills. The health information they do receive is usually only available to mothers when delivered by the health workforce, either from visits by community health workers or expensive trips to health centers. When those resources are not available, mothers must rely on memory when problems arise at home, or seek information from the resources within reach. But we can help women better utilize one of the resources they already have. Every mother we surveyed had a cell phone, but only 1% had ever used it to access health information.

Kènèya Blon is a smartphone application that delivers health information and allows women to ask health questions using a voice-based technology created by Lenali, a social media platform developed in Mali. Designed for mothers without literacy skills, the health content is available through audio recordings in their language, Bambara, and they can interact with the application, such as asking a physician a question, using the voice-based interface. They can navigate through and use the application completely by voice. The application is designed to be used in contexts with limited infrastructure and connectivity, where content can be uploaded and downloaded when a connection is available. Once downloaded to their phones, mothers can listen to the recorded messages whenever they need access to information on a certain health topic.

Kènèya Blon was developed in collaboration with 400 mothers living in Sabalibougou, a peri-urban community in Bamako, Mali as a project to bridge the digital gender divide and understand the social norms which govern women’s use of technology. In the communities we serve, mothers do not have the opportunity to earn incomes of their own and they are expected to stay home, taking care of their homes and families. This puts mothers in an untenable situation - they are responsible for their family’s health, but do not have the ability to access care and services when they are needed. Instead, they must rely on what their husbands provide them, which requires negotiating for scarce family resources. The women we serve struggle to access health information and care, to make the best use of those scarce resources, so together we designed a technology that would help them at those moments, like when her baby has a bad cough, but she doesn’t know if she should make the long, costly trip to the health center in the morning. Or when she knows that she is due for a prenatal checkup, but doesn’t remember when her appointment is scheduled.

The mothers we serve in peri-urban communities have very limited access to maternal and neonatal care. Together, we developed Kènèya Blon so they would have a reliable resource they trust to improve their health. Women report that the platform saves them time and resources by having access to clear information, adapted to their needs, without having to go to their health center. By removing barriers to information, mothers can make better decisions; by connecting them to doctors at their health center, they strengthen their relationship with and trust in the health system.

We developed this solution in communities where we already work with health centers to improve healthcare quality and already deploy health workers, health savings groups, and health promotion activities. These interventions don’t reach every family, and are not always available, not only in the communities we serve, but around the world. Other technologies that use a cell phone still require literacy and numeracy skills – mothers must be able to read an SMS message, or use a numbers on a keypad to access an IVR message. Most of the mothers we serve are excluded from these solutions. However, with a completely voice-based solution, technology finally becomes accessible to them.  In communities and countries that still primarily rely on spoken communication, a technology that can be used completely vocally and in local languages creates a simpler, more understandable, and more inclusive platform.

The voice-based technology we use was developed by Lenali , a start-up based in Bamako and named by Quartz Africa as a Top 30 Innovator. They aim to create an alternative, voice-based social media network because they believe that the low use of social media in Mali (>20%) and across sub-Saharan Africa is not simply a problem of access to telecommunication infrastructures and their costs, but a lack of understanding and relevance of existing services for those who do not read and write easily. The innovation they used to connect users via a social media network, we intend to use to increase access to quality maternal and neonatal care.

Kènèya Blon was constructed using a voice-based technology created by Lenali to facilitate information exchange among those who struggle to access traditional technology.  We used Lenali’s technology to create an Android mobile application that is designed to be used primarily offline, so that mothers can access health information whenever they need it. Once downloaded, all content is stored locally on their phones. If they have a question to post on the platform to be answered by a doctor, they can record it at any time and post it using a data or internet connection immediately or when they have access. Taking into account the local availability of phones and technology, Kènèya Blon is designed to work with 99% of Android smartphones in circulation, compatible with Android Jelly Bean 4.1 and later versions. 

The technology we use was created in order to build a voice-based social media network called Lenali, which CNN dubbed “Mali’s homegrown Facebook.” In that application, the technology currently has over 75,000 users. More information can be found here: (https://www.africanews.com/2019/08/14/lenali-the-malian-app-empowering-illiterate-small-business-owners//)

Kènèya Blon was developed and tested during an 18-month pilot project and is currently used by 251 women, all of whom have demonstrated increased knowledge of maternal and neonatal health subjects and have reported increase ability to participate in decision-making in their households.

Our intended impact with Kènèya Blon is to help more mothers access maternal and neonatal healthcare and improve MNCH health outcomes. For the women we serve who did not have the chance to build literacy skills, the primary barriers they encounter is a lack of information and the resources to use that information to help their families. Kènèya Blon overcomes the barrier to information and allows mothers to use information to make an informed decision. Mothers can then seek care when needed by either accessing funds from their health savings group or by being able to share information with their husbands on why additional care and expenses are required. All 251 women currently using Kènèya Blon report both an increase in access to information, and an improved ability to use that information to improve their or their family’s health.

After the initial development and pilot project, there are currently 251 women using Kènèya Blon. With average family sizes being 5.8 people, we estimate the technology is serving a total of 1459 people. We work with over 5200 women in our savings groups across peri-urban Bamako, and aim to make Kènèya Blon available to all of them within one year, for a total impact on 30,160 people. Within five years, we hope to make Kènèya Blon available to the women served by our partner health centers, about 25,000 women, for a total 145,000 people.

We believe the potential for scale and reaching women and girls is very high. We want to use technology as a tool to extend the reach of proven and effective interventions and the voice-based technology and interface we use is uniquely adapted to do that. We have successfully tested Kènèya Blon with hundreds of women and have several ideas on how to improve it based on their feedback. In the next year, we would like to work with our partner community health centers and potential new parters to develop and implement the suggestions we have received. Long-term, community health centers will be key partners because Kènèya Blon can help them engage more fully with the communities and families they serve. We also have plans for expanding resources and services for women through the platform, such as health financing services.

As use of technology grows, we believe use of smartphones will continue to grow in Mali, and Kènèya Blon is uniquely positioned to keep up with that growth. As a voice-based platform that relies on the preferred language of the user, it offers flexibility and accessibility to all - meaning it can work anywhere, in any country, using any language.

The project during which we developed and tested Keneya Blon included an examination of the social norms that govern women’s use of technology. At the beginning of that project, we conducted an extensive baseline study that examined the cultural barriers that might prevent women from using Kènèya Blon and addressed them during the initial project. 

A primary barrier is the availability of smartphones for the women we serve. While cell phones are common, smartphones and the ability to access the infrastructure to support them are not yet as widespread, though access is expanding rapidly. 

We would like to find a strong partner with an interest in both health and technology to help us expand the reach of Kènèya Blon in the long term. We have identified an ideal partner and are in the process of exploring collaboration with them.

We have 4 full-time staff who work on Kènèya Blon amid other responsibilities, and we have 53 part-time staff who help us deploy Kènèya Blon in the communities we serve.

We developed Kènèya Blon by listening to the needs of women we serve in peri-urban communities and working with them to create a resource that would be valuable to them, and improve their lives. This is the approach we have taken to address maternal and child health needs for over 13 years, during which time we have developed a deep knowledge of, and respect for, the problems we are trying to solve together, and potential solutions.

Our primary stakeholders are the women in low-resource communities we serve, with whom we developed Kènèya Blon. We are working to strengthen the role of community health centers in the technology, to increase engagement between providers in the local health system and the patients they serve. The role of our initial partner Lenali, whose technology was used to build Kènèya Blon, is largely concluded now that we have a functioning application.

We are a community health organization, and our expertise is in helping the communities we serve identify solutions that can increase equity through access to quality healthcare. Technology is a tool that can help us, but we do not have all the experience and knowledge needed to help it thrive and reach as many mothers as possible. We believe in extending our impact and reach through partnership. We value local partnerships in Mali, and will keep our focus there, but we know that both we and our partners would benefit from learning from others. Kènèya Blon will be the strongest and best platform if we can take the input and feedback of the women we serve and work with experts to provide them with the technology they have asked for.

Our aim with Kènèya Blon is not to generate revenue. It is to create a resource for mothers who are losing their lives without access to quality information and care. Our focus is building the best technology we can and making sure it gets into the hands of as many mothers in Mali as possible. 

We're open to learning from anyone who can help us make Kènèya Blon the best it can be, and help us reach more mothers. We will always welcome help with designing stronger monitoring systems, or with impact evaluation.

Our organization is dedicated to improving the lives of mothers and children in Mali. Women are at the heart of our strategies because they are the heart of improving the health and wellbeing of their families and communities. Kènèya Blon represents a tool that could not only help us support women more effectively, it could transform the way we serve women living in low-resource settings with additional health and financial services. Women literally use their voice to access Kènèya Blon; we want to help them use their voices to unlock their full potential.

We believe that one area we can strengthen within Kènèya Blon is the ability of the health workforce to use it to reach and support pregnant women and newborns. Especially during the time of COVID-19, Kènèya Blon can allow health professionals to stay in touch with, and continue providing care to, mothers and newborns remotely. Telemedicine is not feasible in the communities we serve, but the voice-based connections and images that are a part of  are.

The purpose of Kènèya Blon is to put more resources in the hands of women and in this case, it was designed by them, too. We think the voice-based technology we use could be a platform for a wide variety of health and financial services for women who have been excluded from technology-based interventions due to a lack of literacy skills. We would use this funding to expand the functions available in Kènèya Blon while also collecting as much data as possible on its use and other potential applications to expand more inclusive services to women.