Masuno: A virtual help-desk for Covid-19 response.

Masuno: Improving decision-making during the pandemic through trustworthy information and free mental health support.

Liliana Parra - Founder and Team Lead

Juan Camilo Díaz - Operations Lead

Mariana Bolívar - Partnerships and Curator Lead

Supported by our extended network of volunteers.

During the Covid-19 pandemic, information overload or the so-called 'infodemic' has been recognized as a global problem impacting people’s health and well-being. 

 Not only we're overwhelmed by the bombarding of misinformation. Poor content and anxiety-provoking media reports are getting in the way of people finding information that is helpful to make decisions and cope with the pandemic.

 There are also substantial barriers to equitable access to quality information. Authoritative guidelines, support services and evidence-based resources are available but often fragmented, too technical and poorly indexed in web searches. This situation can have diminishing effects on mental well-being, by a.) Increasing vulnerability to misinformation, b.) Increasing feelings of confusion and hopelessness, c.) Hindering decision-making,  and d.) Obstructing the discovery of support services available. 

 In low and middle-income countries, such as Colombia, with pervasive education and mental health inequalities, this situation can be particularly acute. 

 Lessons and data gathered by the Masuno project shed light on important questions such as:  What can we learn from the current pandemic about increasing access to trustworthy information? How can we improve informational efforts in crisis contexts to make them more consistent with people's psychological and practical needs? particularly for those most affected by multi-dimensional inequalities.

Only three in every ten people who reported having mental health needs in Colombia accessed services. Six out of ten reported not seeking help because they considered it ‘not necessary to look for professional health’, ‘neglect’ or ‘not wanting to see a professional’. These attitudes are associated with the stigma and fear of first-time patients. Living in a remote area was also identified in research as a determinant for access to professional help (González et al. 2016).  

Access to private mental health services in Colombia is usually paid out-of-pocket, with psychology services unavailable in most health insurance plans. People can only access a psychologist through a previous consultation with a physician. Appointments are booked weeks in advance. 

Masuno closes the gap for millions of Colombians with little access to education or mental health support to navigate and cope with the complexity of the pandemic. These are often low-income populations, living in remote areas and facing many areas of vulnerability. The project has been most popular among the young, but thanks to the intuitive design of our solution, doesn’t exclude any age group. 20% of our knowledge centre users are over 55+ years.

s a public good, Masuno provides an accessible, comprehensive and user-centred knowledge hub and helpdesk with the potential to be integrated and enhance informational channels from public organisations (e.g. integration with web pages from local municipalities or service providers). 

 Masuno does not compete with other sources or media outlets to create content; it provides a platform to facilitate discovery and access to verified, actionable information for lay audiences. 

Masuno allows rapid identification of unmet needs and knowledge gaps, which can contribute to increase responsiveness and improve the provision of information and services. For instance, during the first year of the pandemic, based on help requests received and resources views, we identified Covid tests as the main area of interest/need. Despite all the news and content generated on this subject, people (particularly those without no payment capacity) struggled to know when to get a test, how, where, and what to do if they don’t manage to get one. In response, we centralized authoritative knowledge to answer these questions and consolidated a national directory of authorized Covid-test centres (with 195 views). Out of our 40 multi-dimensional sections, Covid-test was the most visited, with 38% of total views.

Our target population is Colombian people, nationally and abroad, with a particular focus on those affected by multidimensional poverty and inequality. For this purpose we work in two main areas:

1. Mental Health 

The provision of free, professional and virtual psychological emergency services, and consultants referral to primary or secondary care according to their needs, leads to the output of underserved populations receiving appropriate mental healthcare, integrated with the national health system. 

2. Informational services

Our main output in this area will be a knowledge base centralizing self-help resources and support services. Intermediate outcomes include: improved discoverability and access to trustworthy information and support services as a result of reduced fragmentation, and strengthened criteria to select and assess information.  

Given the evidence on the harms in the decision-making of information overload (Misra, Stokols, 2012), depression and anxiety (Bishop Gagne 2018), our main assumption is that the integration of mental health and informational services in a holistic approach to psychological and practical needs will be conducive to improved decisions to face the effects of the pandemic. This connects with our pursued impact of resilience to the pandemic in conditions of equality.

Our scalability strategy is anchored in multi-sectoral partnerships, capacity development and the numerous possibilities for agile adaptation and scalability offered by the Zendesk technology.

Consistent with our ethos of replacing fragmentation with coordination and harmonization, in the next year we will keep harnessing collaborations with organisations interested in learning from our experience to complement or improve their services (details on our pipeline of collaborations and knowledge-exchange plans are in the partnership section). This means that even if we don’t gain funding, our model still can continue to promote resilience to the pandemic in conditions of equality through our partners. 

One of the main advantages of our technology is that it offers great flexibility to escalate rapidly and cos-effectively. In the next three years, we plan to improve our filter and automation capacities, train our chatbot and work with policy-makers and service providers to integrate our functionalities and knowledge base into the web pages of local institutions. With the aim of improving their capacity to respond to the needs of their targeted populations. 

We can also work with local communities to strengthen their capacities to provide peer support and primary care services in mental health, also facilitated by our solution. 

Due to operational capacity constraints, our results to date have been measured at the output level. Outcome indicators are proposed below. 

To favour comparability, our mental health evaluation framework is tailored from DFID’s approach (DFID, 2020). Output indicators include: number of people receiving emergency psychological assistance, and the percentage of this reporting never having accessed professional mental health support. So far 112 people have accessed this service. While we haven’t yet collected data on the percentage accessing these for the first time, our psychologists affirm this has been the case for nearly all consultants. 

At the outcome level, we will use internationally standardized measurements (PHQ-2 and GAD-2 questionnaires) to collect data on depression and anxiety pre-post (timeframes to define).

Demographic, traffic and interaction indicators are used to assess discoverability and engagement with our content. To date, 85% of users have accessed our resources directly from organic search, suggesting these are easily discoverable. 

Further data analysis will be conducted to derive insights and learnings for improving informational efforts in crisis contexts, (e.g. effective formats, language, indexation techniques), and also allowing identification of gaps in information or services. 

The main barriers we have faced derive from our operational capacity constraints. We are a group of volunteers working remotely with the time we have available, which we need to reconcile with our own commitments and challenges. 

In order to bring Masuno to its full potential, we need financial support to maintain a dedicated team to cover the operational and strategic areas of our work. 

Legal barriers also arise, derived from the fact that we are not a legally established organization. Our mental health support service cannot meet all legal requirements to be considered a telemedicine service unless we have a proper legal entity. Finally, our ability to raise funds is also limited by this situation. 

We have informal partnerships with Zendesk and Centribal, our technology sponsors.

We apply to the Trinity Challenge because we're confident in our solution's potential for improving resilience to the pandemic in conditions of equality, as well as in our capacities to take Masuno from a successful pilot to a fully operational project. 

We want to reach not thousands but millions in our region and help not only a hundred but thousands of people who cannot afford a mental health session with a professional. 

We believe the world would be a better place if all could have equitable access to verified information and resources that can help us cope with the pandemic's effects. 

This challenge could be our best opportunity to take Masuno on a growth path and accelerate our results. Our mission is to help our communities address the pandemic's challenges and effects promptly and with the best user experience available in the market. We know that only through outstanding service will we serve our communities thoroughly, and that is why we're seeking more support, financial funding, and coaching to make this possible. If we fail in securing such funding, we will continue doing what we do anyway. But we sincerely hope for Masuno to reach its full potential.

We have demonstrated skills to generate fruitful inter-sectoral collaborations. We have developed 18 collaborative initiatives with partners across the public, private and civil sectors, which have been instrumental to increase our reach and impact. This includes the Organisation of American States, the Colombian Ministry of Foreign Affairs, Bureau Veritas, and Karisma Foundation. 

In the next year, we are prioritizing the dissemination and discussion of our learnings with actors who can potentially leverage the Masuno model, or that can use our data to develop research on the interplay between information consumption and mental health, informational efforts in a crisis context. 

Trinity Challenge partners could make essential contributions, including our operational model, technology, and impact approach. We would be delighted to receive coaching for:

• Developing a sustainability strategy, or ideally, a social impact business model that allows us to be independent of external funding while keeping our services free for users.

• Ethical and secure collection of data that protects our user’s privacy and agency. 

• Developing the largest most accessible directory of telemedicine services in Colombia and the region. (3-year target). 

We would also be keen to improve our capacity to utilize behavioural sciences to improve access to our tools and services.