Agnes

2-way multichannel telehealth platform providing free, clinician-approved health information to people with low-tech phones and limited access to health services

Abisola Olaitan Oladapo, CEO

Nigeria ranks as 161 (out of 189) on the Human Development Index (HDI) and is considered a developing country (UNDP, 2020). Of the 200 million citizens, 48% live in the rural areas (UN, Population Division 2019) with limited access to basic services. As for health in particular, we have an inadequate health workforce, with 0.4 physicians and 0.148 nurses and midwives per 1000 people, relative to the minimum recommended ratio of 2.3 of all healthcare workers (WHO, 2019). 

As a result, the vast majority are ill-informed and unprepared to adequately deal with their health issues, and they often become apathetic and seek medical advice only when the situation is dire or too late. While many attempts are made to improve the populations' health, they generally focus on unscalable and costly methods: TV campaigns, face-to-face community outreach awareness, emails, smartphone apps, etc. 

These methods do not reach the most vulnerable demographic for whom internet access and TV is expensive. During a pandemic, face-to-face outreach risks pathogen exposure

Our solution serves Nigerian women, particularly the under-privileged in the urban poor and rural areas who use low-tech phones. 

We are feeding the platform with relevant health information and have received positive feedback. While we do have a toll-free line (answered by midwives) to answer questions, we call the women to ensure we are constantly meeting the users expectations and providing the content they need.

As for the state, they have grown to rely heavily on our platform. Our toll-free line (0800 MICH PLUS) is front and center of their posters and campaigns. At the request of the state we have sent out SMS awareness campaigns on vaccinations, health supplements, etc. Most importantly, we also provided usage data/reports to help guide their decisions and policies.

Nigeria has one of the highest maternal and neonatal mortality rates in Africa. Some of the contributing factors are distant health facilities and inadequate health workforce. Worsening this problem is that many citizens have limited access to data networks, although most have a cellphone.

To cater to the needs of this under-served demographic, we developed an telehealth platform that they can access without any barriers of entry. It works on any cellphone (even the most basic without Internet) through automated calls and SMS. It is free of charge on all national operators. 

The multi-directional platform delivers pertinent clinician-approved health information, collects & answers users questions and provides data and reports on the back-end for the Ministry of Health (MOH) and partners.

Impact evaluation of the women using Agnes showed that the pregnant women had higher maternal survival rates that women not using Agnes. This is an indication of how the platform is positively altering and affecting the health behaviour and outcomes of the population. 

With this report and increased usage of the platform, we would like to perform further studies to show how positively we are affecting the lives of the underprivileged.

Over the next one year, we would grow our impact to reach 1 million women by partnering with the Federal Ministry of Health and other entities committed to furthering the public good then scale to reach at least 4 million families in the next three years.

We collate data on our progress weekly.

Two key indicators of our progress and our performance so far on both metrics is below: 

1. Number of health modules delivered via voice: 35,000

2. Number of SMS delivered: 65,000

The main barrier we face are resources and guidance.

First, we would like to explore avenues for revenue generation beyond public partnerships.

The second is legal guidance to navigate how to establish a longterm contract with the Ministry of Health in a manner that facilitates revenue generation, as well as with the mobile network operators. 

Third we would like to increase the functionalities and features of the platform in alignment with the needs of the users and the revenue generation.

We ideally would like to receive non-equity based grants to address the barriers above. In the absence of such grants we are willing to pursue equity-based support and partnerships.

Lagos State is our (contractual) partner in the Agnes Project.

Mumspring Global Limited (Nigeria) is the company that built the Agnes software and continues to update the Agnes software on behalf of Mumspring International (UK).

Mumspring Foundation is an independent foundation that procures our services to serve its beneficiaries.

The Trinity Challenge partners will be able to support us by helping us explore and establish avenue for revenue generation beyond public partnerships. This is key to sustainable growth.

Additionally, we need legal guidance on navigating and establishing longterm partnerships with public entities in Africa in a manner that is independent of political influence. 

We need partners to help us strengthen our business model, impact metrics and legal protections.

Partners we believe can support with this include:

1. Mckinsey will help us strengthen our revenue model.

2. IHME can support with helping us refine our metrics and evaluation strategy.

3. Aviva can help us navigate working with insurance companies as partners.

We are also open to other partnerships with corporate bodies, nonprofits and educational institutions that can deepen our impact.