PENSA *660#

PENSA provides a way to get MOH-approved health information to the under-privileged living in remote areas and with limited access to health centers, and even collects data from the users to help drive policy. It works on low-tech phones, is free of charge, and does not require Internet.

Executive Nerd, Valter Cumbi, has extensive experience building sophisticated systems and had the fortune to setup Mozambique’s first mobile TV, hybrid Internet bundle packages, and more. 

Mozambique, like many Low & Medium Income Countries (LMIC), has a large percentage of the population living in rural areas. 68 percent of our 29 million citizens live in these areas with limited access to basic health services and health workforce (with 0.055 physicians and 0.401 nurses and midwives per every 1000 people, relative to the WHO’s minimum recommended ratio of 2.3 per 1000 healthcare workers). This situation is not unique to Mozambique, as over 3.4 billion people live in rural areas. 

Exacerbating this problem is poverty which often prevents the underprivileged from owning smartphones, and allows them limited access to Internet. Again this is not unique to Mozambique as nearly 0.7 billion people world-wide live in extreme poverty.

This under-privileged and marginalized demographic, is often not reached by conventional public health communication methods, leaving them even more vulnerable to public health issues.

PENSA *660# primary client is the under-privileged living in remote areas. We provide them with free of charge, available on all operators 24/7, and works on any cell phone (including low tech phones), and functions even in areas with no data network (i.e. no Internet).

Since our launch in Mozambique in November 2017, we have reached 3 million users and 43 million visualizations on the platform, and average 100,000 visits per day. In a recent satisfaction survey our platform was listed as the main source of health information for the users, followed by health care professionals. Furthermore, 87% of our users informed that the information we provide helps them live healthier lives.

We similarly serve the National Health System, by providing them with a channel to instantaneously message all the platform users on important health issues, draw insights from surveys and usage data, and avail pertinent information.

Our solution allows the marginalized to live healthier lives (SDG #3), by providing critical information that they others would not have access to. This was outlined in the user survey we provide, but recently the University of Chicago also analyzed some of our anonymized data, and showed that during the Idai cyclones that devastated Mozambique, there was an increase in access to the platform from these areas. This shows the importance it serves in helping the citizens in their time of need.

As per our user satisfaction survey, the target population has limited resources at their disposal, making it difficult for them to get health information. While some posses radios, and fewer TV's, these devices are not constantly providing health information for them to learn. Also, many of the underprivileged live in remote areas that are far from the nearest health facility. In other words, they this demographic as almost no access to health information.

The demographic does, however, possess low-tech cellphones. For this reason, we designed a health solution that can be accessed from those low-tech phones, allowing them (finally) a source and direct link to Ministry of Health provided information.

As per the user survey we performed, our platform is tied for 1st or 2nd source of health information for our users, along with health professionals. And given that our solution is available 24/7, it's clearly being of use.

Our mHealth solution has already reached and helped millions of people with pertinent and timely information. However, we want to build on this by:

• Delivering services to the end-user such as vaccination registration, automated questions and answering, health facility evaluation/feedback. The delivery mechanisms could also evolve to include local languages and voice-based interaction for the illiterate.
• From the National Health System perspective, we have already gained their interest and attention with the flexibility and speed with which we deliver surveys on public health matters and supply relevant information. We want to build on this by refining the feedback loop to encourage more reliance on data to drive their policy. This includes improvements to technology, insight gathering with the assistance of AI, and finally training of the Public Health Leaders to best make use of this data.
• Finally, we need to introduce revenue streams to allow for the system to survive without external support. In the process, we will also add more advanced machine learning to help make more sense of user preferences.

In years 1 and 2 we will focus on all items above, as they are related. Year 3 we plan on expanding into other countries.

For information and service delivery, we are measuring impact by engagement. This includes statistics such as users that spontaneously access the platform daily, frequency of platform accesses by users, and areas of the platform they visit. We also periodically take surveys to get direct feedback from the end-user

Data-driven decisions/policy is currently measured through informal interactions with the National Health System and with the frequency with which they put goals for our platforms data in their 1-5 year plan (which is increasing). We aim to formalize this interaction and introduce objective KPI’s that trace directly to our solutions data/insights, and if/how it’s used in decision-making.

Revenue streams will be measured by relevance to the end-user, Return on Investment (for each revenue-generating features), and overall Income vs Expenditure.

One of our main barriers is financial: we need sufficient funds to support the team as we work to add/deliver meaningful features and functionalities to the solution. We need to be able to guarantee the salaries of the existing staff, pay for the infrastructure/equipment, and ideally enough to recruit more staff members (particularly in the areas we have gaps like business development, AI / big data / data science, and data-driven health management/policy).

Similar to above, is addressing the gaps in knowledge/experience. While above we mentioned recruitment, technical support and education (in some cases), could be sufficient to bridge the gap. Our knowledge is so far mainly in software development and marketing/communication, which doesn’t include things like a Question and Answer section linked to AI.

We also face a cultural barrier around computer literacy and the use of data to drive decisions. While our data is gaining ever more acceptance at the communications level, getting the decision-makers to access, trust, and use it, requires guidance, support, and convincing.

Finally we need to improve our legal standing, to best protect what we’ve worked hard to build. This is mainly around Intellectual Property and Terms and Conditions.

Ministry of Health (Mozambique)

We believe that the Trinity Challenge can help us overcome every barrier we presented:

• Financial – either through a direct grant, or guidance/technical support in improving our revenue generation, Trinity Challenge could address this barrier (Google, Facebook and Tencent are experts here). Furthermore, Trinity could help put us in touch with potential clients (such as Reckitt)
• Knowledge gap/experience – here Trinity Challenge could again support financially (to recruit), but even if this was done we would still need guidance/technical support in how to properly setup our AI capabilities, particularly to deliver automated Question and Answers, as well as provide surveillance and inference from the types/frequency of questions asked. This type of support could come from Patrick J McGovern or the academic institutions.
• Helping to change the culture around data use would most likely require the guidance and support of the academic institutions and/or the Bill and Melinda Gates Foundation to help create a plan that coaches the decision-makers through this process.
• Legal support would require the expertise of those dealing with similar issues world-wide, like Legal & General Group.

The Trinity Challenge has many organizations that could provide tremendous support to our solution:

• Google, Facebook, and Tencent – could help us optimize our product development, as well as the technology and software development practices we employ;
• Bill and Melinda Gates Foundation – have a pulse on the worlds most pressing development and inequality issues. They could help us stay in tune with the present and future needs of the under-privileged, to ensure our solution evolves accordingly.
• Patrick J McGovern Foundation – are ideally aligned with our desire to unlock the power and insights of the data we collect, to strengthen the impact we deliver. As experts, they could lead us in the right direction.
• The London School of Economics, as well as the Imperial College – would be ideal to ensure that the data we collect and analyze are in accordance with industry best practices, and in-line with high academic standards. We could even benefit from hands-on courses.
• Reckitt – could serve as an ideal client as we are exploring generating revenue, by selling health products through our platform.
• Legal and General Group – could help us with things like Intellectual Property and Terms and Conditions.