Mobile App to Ensure SRHR for Her

Reproductive healthcare of girls and women in Bangladesh are severely neglected among marginalized communities’ families who reside in slums, coastal areas, hills, chars etc. The situation is similar for women living in urban cities too. Restrictive cultural norms, no negotiation power in the family, no financial means or lack of exposure to SRHR (Sexual and Reproductive Health and Rights) knowledge and services attribute to such state.

 Adding to these vulnerabilities, when these girls and women visit a gynecologists in our country they often face offensive comments, disrespectful attitudes and receive unsolicited advice on their marital status, contraception, choice of pregnancy etc. instead of just getting a professional, bias-free consultation for which they are paying. Case in point, a recent outrage of a woman on receiving the worst Gynecological service on social media has prompted many women to share their own experiences as well. Even a newspaper daily picked up the news on it. Now, this is the situation for urban women and girls who are usually educated. But even then these harassing experiences prompt many women to just avoid going to doctors for SRH consultation or not speak about it to anyone. 

We held a small survey of 100 girls and women about their gynecological experience. 75% of the respondents replied, they were not satisfied with doctor’s unsolicited comment on their sexual practices or marriage status and they would not go back to this doctor, 3% said they only went there because they needed to solve an issue, 2% said doctor’s service was good and 20% said they don’t know why they need to go to Gyne doctor.

The demand for safe, pleasant, non-judgmental SRHR services are high among most females (15 to 64 years) not only in Bangladesh but also in South Asia and other regions. Right now, in Bangladesh, the potential market size is approx. 55 million where in South Asia 567 million and globally 3.9 billion. 

We are addressing some following issues with our solution.

• We are on-boarding only those Gynecological doctors that have outstanding reputation to maintain professional conduct at all times, avoid coercion and treat their patients with dignity, compassion and kindness. 

• We are providing on-demand SRH needs for rural and urban females through our App. If not by this app, the rural women often have less chance to get SRH consultation at their convenience because the hospitals are very far away from their home, many cannot manage long travel distance, even if they manage to do that there is no guarantee that the doctors will be available when they reach there or if there is any doctor for SRH service at all. 

• Our patrons would be safe from non-consensual care since after receiving any kind of SRH Consultation, they would be prompted to rate their experience with the doctor, our service etc.These will be stored anonymously.

• Many women and girls from rural areas lack medical literacy to clearly express their problems. We are addressing this challenge by hiring women managers / human assistants in the local hub who speak the target consumers' languages / dialect and are from that village or nearby area which will help create trust among the rural women. While talking in a casual manner women managers can gather patient history and provide the necessary information to the doctor for correct diagnosis.

• To minimize the shunning of SRH services, we are holding many awareness sessions with rural women, their communities and other important people.

• Our SRH Consultation fees would be affordable even with privately practicing doctors so that rural women and girls can enjoy SRH services and enjoy healthy life.    

• We are addressing the ignorance about lifesaving SRH knowledge & services among women and girls through our knowledge platform. In rural areas, our women managers are key to sharing the knowledge among girls and women.

A one-stop Mobile App that will allow the users to book Sexual and Reproductive Health Consultation services with doctors, order and get hassle-free delivery of  products such as condoms, contraceptive pills, pregnancy kits, medicines (after doctor’s verification), sanitary napkins etc. Girls and women who have smartphones can make a direct conversation with a Chatbot and enjoy the services. This app is also a SRHR knowledge repository with FAQs and articles for anyone, especially girls and women to educate themselves on SRHR topics in Bangla.

To reach the girls and women residing in rural areas who may not have smartphones or are not capable to order SRH services or products through Chatbot, we will set up Local Hubs in selected rural and hard-to-reach areas where they receive Human Assistance from trained women managers to order SRH Consultancy or products or information from our App. In this way, our platform will ensure every girl and woman from all corners of the country are exercising their Sexual and Reproductive Health and Rights.

Technology

Initially, our app would be made using the android operating system since most of our target audience use android. The chatbot would be created using Artificial Intelligence (AI) and Natural Language Processing (NLP). The app would also have features that connect users to our call center agents, payment gateway system, cloud database etc. 

App Activity Mapping /  Process

• SRH Consultation service >> talk with chatbot to find consultation service >> select option >>  write problem + symptoms >> set preferred date and time for consultation >> payment >> confirm consultation by call center agent / app confirm message >> get reminder by app notification / call center agent >> video call in app with doctor >> review consultation experience  

• Knowledge Platform >> talk with chatbot to redirect to FAQ / Articles to learn SRH topic / search in the repository to read up

• Product Order >> Take help from chatbot to search product / type to search product >> select product >> add information for unit and delivery information >> payment >> confirmation of order by call center agent / confirmation message from app >> track product >> receive product >> review product and service

Offers for app users

• Assign a point to users for using any Consultation service or for ordering any product. Accumulation upto a certain number of points can provide a free or discount offer in the next purchase. 

Our solution serves the SRH needs of the girls and women from urban cities as well as girls and women from rural villages, slums, coastal areas, hills, chars etc. They usually fall between the ages of 15 to 50 years old. 

Most urban women have smartphones and are using various apps in their day to day lives. A small percentage of females from rural areas have access to their own smartphones. They usually use their father’s or brother’s smartphone occasionally. Typically, they are the most familiar apps like facebook, youtube, tiktok.  

Although urban girls and women can reach SRH services at any time since per capita doctors numbers are higher in urban cities, but, they often receive judgmental opinions which deter many to not seek out their suspicion of diseases or persisting SRH problems because they don’t feel comfortable with the service provider, although, it is their reproductive rights to receive hassle free, pleasant SRH services. 

For girls and women living in rural areas, through our app, they will have greater access to doctors because now they don’t have to travel far or wait longer to check if a doctor is present on that day. They can book SRH consultation from any doctor residing anywhere in Bangladesh. This is very helpful as many rural areas have a meager number of healthcare professionals. Also our trained female assistants would help the girls and women to order products or doctors appointments who may have limited health literacy and with necessary privacy so that their cultural norms are respected. As a result, girls and women now would have a higher opportunity to lead healthier lives.

My team understands the Bangladeshi females SRH (Sexual and Reproductive Health) need very acutely as all of us are native Bengali females ourselves and have received oppressive Gyne services at multiple points in our lives. Also, we felt helpless while growing up because we were mostly unaware and didn’t have reliable sources to learn about SRH topics.

We have been working closely with the marginalized communities girls and women for the past 6 years to break period taboos from the society by arranging school and community sessions, rallies etc. at slums, remote villages, hill track areas etc. with Wreetu Comic Book, a complete  Puberty and Period guideline for adolescent girls in Bangla. We have been orienting the adolescent girls' families, parents, teachers, neighbors, community and their male peers in the sessions as well. These combined activities and efforts have helped us to normalize talking about period in the family spheres. Girls can now freely talk about their menstrual needs within the family and with their friends. They know how to  hygienically manage their periods to keep themselves safe from various infections and diseases. They know what to eat to maintain their strength etc. Also boys become more sympathetic towards their female peers and family members during period days. The teasing attitude about period among boys have reduced significantly in the schools and communities where we have conducted sessions and these schools became a part of our network which works to ensure ‘Reproductive Justice for all’.

In addition to conducting our Puberty and Menstrual Health Management sessions we found that many girls after they became aware about hygienic period management, they want to maintain it but many were unable to because the market available sanitary napkins costs between $1.74 to $2.09 which is very expensive for their families. To support them, we have launched a 1 year reusable Wreetu Reusable Sanitary Napkin which is eco-friendly, affordable, free from fungal and bacterial colonies tested by BCSIR (Bangladesh Council of Scientific and Industrial Research). This napkin has supported 500 Amphan affected girls and women from coastal areas of Bangladesh in 2020 and till now with our napkin 4000+ girls and women have been lifted from period poverty and are now able to enjoy autonomy in personal hygiene.

While doing these works we have encountered numerous gynecologists. Beside some small number of non-judgemental Gyne doctors most had very biased views. Our network of girls and women often ask us hundreds of questions regarding menstruation, menstrual irregularities, period cramp, white discharge  etc. So, we created a Safe Space (facebook group) for girls and women by on-boarding only those Gyne doctors from whom we have personally taken services from or have very positive reviews. Girls and women regularly ask questions in our group and our on-board Gyne Doctor team freely provides consultation or ask for face-2-face meetings with them in case of severe issues. During the initial months of Covid-19 the numbers of SRH Consultation seekers grew ten-fold and we offered ‘Emergency MHM Service’ for free to 50 girls and women. During this time, many girls, women and even men reached out to us to extend our MHM service to various SRH services including emergency contraceptive options, family planning, pregnancy, pregnancy complications, STI, RTI, consultation about insertable menstrual products etc. From our social responsibility to serve more girls and women during crisis period, we introduced paid tele-medicine ‘Emergency Gyne Service’. The logic behind introducing paid service was to respect the doctors time and also conduct a small acid test in the viability of the service.

We have served 4000 girls and women through our Tele-Gyne service. This was a big shift from behavior to visit a doctor to receive consultation to switching on video calls or phone calls to connect with the doctors. More and more people are now open to receiving SRH Consultancy from their phone as this is more convenient.

• Guidance on operation

• Technical and financial guidance to build app and test

• Guidance on how enter different South Asian country with similar social stigma towards SRH where languages are different

Our solution is focusing on creating an inclusive eco-system so that girls and women can receive SRH consultation and information at any time combining technology (App) and low-tech resources. In this case, using the large number of available but unused human resources (females). Our solution is largely by women and for women.

We are confident that our approach and solution would be very effective because we are looking to solve the unattended SRH needs of millions of girls and women, most of whom live in rural areas of Bangladesh. Although most of them are not tech-savvy, they can be trained easily to remedy the situation and using selected representatives we could reach more women who desperately need reproductive healthcare consultation and many times where doctors are in insufficient numbers. 

We believe in inclusivity and we have designed our services in such a way that ‘No one is left Behind’ because timely SRH Consultation and knowledge help people especially women to make educated life decisions and exercise ‘Reproductive Justice.’

Check-in with KPI, milestones

• Set incremental milestones

• Change measurement through feedback collection, FGD, interview with the target market, service providers, women managers etc.

We will need an Android operating system for the app. The chatbot would be created using Artificial Intelligence (AI) and Natural Language Processing (NLP). The app would also have features that connect users to our call center agents, payment gateway system, cloud database etc. In a nutshell, Internet of Things.