Knowan

Problem: Sexual and reproductive health (SRH) data are not being leveraged effectively to advance health and development outcomes.   Current data governance systems are not effective in enabling the generation, sharing, and use of data in a safe, ethical, and secure way while also delivering value equitably. 

In low- and middle-income countries (LMICs), over 100 million unintended pregnancies occur every year (49% of all pregnancies in those countries), 35 million abortions are conducted in unsafe conditions, 299,000 women and girls die from causes related to pregnancy and childbirth, and 133 million do not receive the treatment they need for certain STIs.  Globally, over 220 million women and girls lack access to the contraceptives they want and need.  There are a number of complex reasons why women and girls are impacted in these ways.  However, one key theme is consistent across all these challenges – data.  The problem is, data is fragmented, inaccessible or siloed, unreliable, untrusted, or non-existent. 

The challenge in LMICs is, both in the private and public sector, data is not being leveraged to enhance service delivery and products, adequately grow businesses, or improve health outcomes in this space.

·      Data is currently siloed.  Governments and donors do not have access to adequate data - especially in developing countries.

·      Much of the big data with the most potential in SRH to be used for public good is collected from the private sector.

·      Low level of data literacy affects the demand for data or incentives and interest in using data. Low levels of data literacy make it difficult to create insights, optimize processes, or enable better decision making from data.

·      Individuals are not adequately, transparently, or equitably compensated for the data they provide to or through enterprises.

·      There is a lack of trust that governments and big data companies will ethically, securely, and efficiently use the data.

FP2030, an alliance of governments, foundations, multilateral agencies, civil society and private sector partners that supports the right of women and girls to decide-freely and for themselves- if/when to have children, notes that “an emphasis on high-quality data for family planning was a hallmark of the FP2020 initiative and will continue to play a central role in FP2030.”  In fact, data is one the 5 key focus areas: policy, data, financing, gender norms, and system responsiveness.

At Knowan, we want to maximize the potential of data by building an ecosystem that consists of two main components:

(1)    A trusted, decentralized data-sharing platform, powered by an existing open-source data exchange protocol, that enables the sharing of data and data-based services with a focus on the sexual and reproductive health sector.   For sensitive data, data providers would have the option to specify what part of the data sets others can access and which not. And, it allows researchers to run AI algorithms on a data set without ever gaining direct access to the data. This protects the privacy of all the individuals contributing to the data set while at the same time giving valuable insights that might lead to the creation of better AI-powered services or treatments for diseases/STIs; and

(2)      Because the data and the platform itself will not ‘lift people out of poverty’ – Knowan must focus on the users of the data to generate insights that can turn into action to improve data outcomes.  We are doing this through a unique structure – called a DAO (decentralized autonomous organization) with governance, treasury, strategy, voting, and growth led by the community. Through this organization, we can leverage the global community of SRH experts, technologists, data scientists, community workers, advocacy organizations, health providers, donors, AI experts, and individuals - really anyone in the ecosystem – to organically learn, earn, and innovate together to work towards solving this challenge.

At Knowan, we are focused on equalizing access to data - building a platform that enables the sharing of data or data services that could be leveraged in the context of the numerous and varied challenges faced within the SRH space.  Specifically, we are focused on how data and data services can support High Impact Practices (HIPs) – a set of evidence-based family planning practices vetted by global experts against specific criteria and documented in an easy-to-use format (www.fp2030.org/hips).  In fact, Data is one of the 5 key focus areas of FP2030.  Knowan also seeks to accelerate the use of AI-enabling tools and use cases that have been identified as high potential for impact on global health: particularly population health, individual health, health systems, and pharma & medtech (see, Artificial Intelligence in Global Health – Defining a Collective Path Forward (https://www.usaid.gov/cii/ai-in-global-health), a Report by USAID, Rockefeller Foundation, in close coordination with the Gates Foundation) with a focus on sexual and reproductive health data.  The report specifically included a recommendation to identify or create an open data platform for sharing datasets relevant to AI in global health, add datasets to the platform, encourage innovators to collect and share data where possible, and encourage the scaling of sustainable data collection systems (see Report, page 22).

As a social enterprise, we would leverage any revenue generated from data produced from digital health products focusing on sexual wellbeing and health in developed economies (e.g., U.S., Europe, Asia) – and reinvest the funds to support the infrastructure, human capacity building, and additional projects that propel equitable access to high-level data capabilities and tools, and improve sexual and reproductive health outcomes for women and girls in marginalized communities around the world.

According to a 2021 World Bank Group Flagship Report, “Data for Better Lives”, “[t]he innovations resulting from the creative use of data could prove to be one of the most life-changing events of this era for everyone.”  Guided by the work of the World Bank, Knowan is seeking to use data more effectively to improve development outcomes, with a focus on addressing the lack of access to quality SRH commodities and services that are needed by so many poor women and girls around the world. 

Knowan seeks to lay the infrastructure and frameworks for more effective and coordinated  disseminating, exchanging, and sharing data by governments, international organizations, donors/foundations, civil society, research entities, the private sector, and individuals.  By doing this, Knowan seeks to enhance accountability, improve policy making and service delivery, and increase business opportunities.  We will enhance accountability by enabling the use of data to improve policies with data-driven decision making and more effectively advocate for increased funding with supportive evidence.  We will improve policy and service delivery for women and girls by enabling the leveraging of data to ensure more transparency, supply chain improvements, quality use of social media for education, and improved cost savings through efficiencies. And, we will increase business and economic opportunities – enabling more data for fem-tech startups, improving products, ensuring cost savings, and increasing the production process.  And we will rely on our growing community to create and champion those additional solutions that only those with lived experiences and a unique understanding of the issues can champion.

Finally, by creating a space in web3 and data science that is focused on solving issues affecting women and girls, and emphasizing participation by those with lived experience in solving the issues, we will support them in their journeys in the web3 and/or data science.  This will provide the additional benefit of educating and encouraging more participation by women and girls in the web3 and data science fields.     

When our Founder, Kendra, was 23, she was denied access to the emergency contraceptives that she was seeking, not because of a medical or legal prohibition, but due to the personal beliefs of the doctor at the time.  As a result, Kendra has continued to be involved in volunteer activities to promote access to needed SRH services and commodities over the last 20 years.  Further, having spent over 15 years in foreign assistance, including as an executive within a U.S. Government foreign assistance agency, she understands the importance of engaging communities with respect to implementing large, complex solutions at a global scale.  However, her experience also gave rise to a realization that new systems and structures required for community participation and leadership in solving these problems is desperately needed to move the needle forward.  

As such, with community involvement at the forefront of our solution, the original team that catalyzed Knowan has a specific and stated intent to implement a solution that is not only meaningfully guided by the communities’ input, ideas, and agendas – but, perhaps more importantly and impactfully - lead and governed by those very communities themselves.  Control of Knowan will eventually be lead and governed by a DAO structure – a relatively new organizational structure, leveraging blockchain, that squarely places emphasis on having the governance, treasury, strategy, and solutions all lead and guided by those within the community – in a decentralized and democratic way.  As part of a recent grant received by OceanDAO for further engagement and outreach, Knowan is actively growing its community to include a diverse range of stakeholders who are all instrumental in propelling the success of the organization, and will eventually comprise stakeholders within the governance and voting mechanism within the DAO to ensure their voices are not only helping to design the solutions, but their visions and lived-experiences are at the heart of growing the organization, leading its strategy, and managing its resources.

At Knowan, we understand the complexity working with both blockchain and data. Accordingly, we are seeking partners to help advance our solution within the following areas: 

• Tokenomics, Token Engineering, and Governance: We are working to create a DAO that has the ability to ensure equitable participation and involvement by all members of the community.  However, with DAOs in their early stages, numerous DAOs are struggling with how to ensure fair participation, where power is not centralized with a small number of ‘whales’ who may have significant voting power.  We are currently working to involve additional stakeholders through engagement and outreach efforts to ensure a diverse set of stakeholders, from differing geographic regions, differing sectors (femtech, to advocacy, to donors, to R&D).  Recognizing that the token engineering and voting mechanism are pivotal structural and technical components that can have significant impact on the mission and direction of the organization, Knowan is seeking additional guidance in this area of governance -  including, but not limited to specific research and guidance relating to voting (e.g., best way to structure a voting mechanism [quadratic voting, voting delegation, risks/vulnerabilities, etc.])
• Building Trust: Trust is at the center of the our platform, including ensuring privacy, security of the platform and data & regulatory compliance.    With important data protection regulations to consider, Knowan is continuing to seek guidance relating to important data privacy and ethics considerations – ranging form GDPR, to HIPAA, as well as partners who can facilitate the technical capabilities to help ensure compliance in these contexts as well.  Further, the security of the platform itself is another field in which we would be open to support from partners who understand the specific security implications of building on Ethereum.  Finally, with trust at the forefront of our ecosystem – we are seeking to incorporate concepts that can enhance overarching trust in the data sets and system – for example, the use of data trusts.  We would be open to any partnerships that would elevate our ability to enhance trust within our system in any way. 
• Infrastructure: While utilizing Ocean which is an open-source protocol, Knowan is always open to partners who have knowledge building on Ethereum, and interested in supporting our efforts in any way to ensure our MVP is a secure product that, from the beginning, can be the benchmark to begin a trusted, decentralized, data sharing journey. 

Knowan is incorporating digital solutions within the ecosystem in unique and innovative ways.

First, the platform will utilize an existing open-source data exchange protocol, Ocean Protocol, which powers the secure sharing of data and is deployed on Ethereum.  Ocean was selected as one of the World Economic Forum’s (WEF) Technology Pioneers.  As outlined in a 15 June 2021 press release, Ocean was selected for its contributions to blockchain, the digital economy, and technology governance.  WEF acknowledged that they are building promising, ground-breaking technology that is inclusive and helps to give people more control over their data.  Ocean lets people buy and share data while keeping full control at all times.  It is an open-source data exchange protocol aiming to solve the centralization problem while making data available to the community to enable the development of better services and products.  It uses ERC-20 datatokens to gate access to data sets.  And, now that Compute-to-Data has been released on Ocean market, AI researchers can now access data, without exposing the data or allowing it to be copied.  Finally, Ocean can give full control and sovereignty to data owners – thus enabling a more equitable and transparent view to ensure equitable compensation related to data as well as innovative new ways to incentivize those to share data that can be useful to improve SRH outcomes.  These capabilities open up completely new possibilities, including potentially new asset classes, new ways for women/girls in developing economies to be compensated for providing data using digital currencies and other web3 enabled mechanisms (thus also supporting areas like financial inclusion).  Ocean protocol has been used in numerous sectors, including healthcare, and the auto industry.  There is a significant demand for quality data sets to train AI while maintaining privacy, and we want to make sure that women and girls are well positioned for the possibilities that the world of web3 will be able to help solve. 

The DAO governance structure will also utilize innovative tech solutions at the forefront of DAO governance and web3.  A Decentralized Autonomous Organization is basically, an autonomously governed, internet-based community.   By utilizing an organizational structure that decentralizes power, emphasizes transparency, and strives for autonomy, the DAO structure is designed to give all members the ability to participate in decision-making in a more fair, transparent, and meaningful way.  Further, as a social and community construct, the DAO will manage the financial capital of the ecosystem and data sharing platform, while emphasizing the social capital importance.  Finally, as an organic ecosystem, human capacity building and technology transfer/education transfer will become organic, thus enabling more economic opportunities and learning experiences through a structured community construct. 

We are seeking to have long-term and lasting impact, with a focus on SDG3, SDG5, and SDG 17.  Specifically, Knowan seeks to impact Target 3.7 by helping to "ensure universal access to sexual and reproductive health-care services, including family planning, information and education, and integration of reproductive health into national strategies and programmes."  We also seek to impact Target 5.6 to "ensure universal access to sexual and reproductive health and reproductive rights..."  And finally, to impact Targets 17.16, 17.18 and 17.19 by strengthening implementation and revitalizing the global partnership for sustainable development - specifically, mobilizing and sharing knowledge, expertise, technology, and financial resources to support achievement of the SDGs, encouraging "effective public, public-private and civil society partnerships, and enhancing "capacity-building support to developing countries...to increase significantly the availability of high-quality, timely and reliable data..."  

By enabling greater transparency and accountability, as a result of improved knowledge and data-driven advocacy, we seek to empower civil society and individuals to improve advocacy efforts, change attitudes using data, and more effectively advocate for change.  Further, Knowan seeks to improve policy-making, service delivery, and overarching health outcomes by generating more and better data on individuals and services that lead to data-informed decisions relating to effectiveness of systems, supply chains, and government programs.  And, Knowan seeks to unleash better AI/ML capabilities to improve the effectiveness of these same systems.  Finally, by enabling better partnerships with an innovative financing and governance model, Knowan seeks to increase private-sector business opportunities, emphasizing opportunities for marginalized regions or populations, promoting productivity and growth, and disrupting market power and traditional foreign assistance mechanisms - to enable the ecosystem to flourish, remain financially sustainable, and ensure community-driven leadership and solutions. 

Knowan is actively working to create a set of metrics and indicators that can be used to measure the impact of the ecosystem.  While our detailed evaluation strategy and impact assessment plan is still in a formative stage, we would be looking to measure impact and determine the effectiveness of planned output and outcomes from our actions.  We will focus our indicators on a range of areas, including digital health indicators and indicators relating to sexual and reproductive health outcomes.  For example, in digital health indicator, we would envision indicators similar to: % of users who demonstrate proficiency in use of the platform, % of users who rate the platform as “easy to use”, in addition to other specific indicators for both producers and consumers of data.  Regarding sexual and reproductive health indicators, we would anticipate indicators relating to mCPR [contraceptive prevalence rate, modern methods], uptake of modern contraception), among others. 

With the emphasis of a DAO on community – emphasizing co-creation, participation, and transparency, Knowan will work to leverage the community to create the evaluation and impact strategy.  Knowan’s core contributors would encourage the use of established work to guide the discussions (e.g., WHO Monitoring and Evaluation Digital Health Interventions, Reproductive, maternal, newborn, child and adolescent health (RMNCAH) Indicators, among others.

1. If we provide a trusted platform for sharing data and data services... 

by creating a more effective and secure way to share data and data services and creating trust in the data... 

it will create greater transparency over programs impacting the sexual and reproductive health of women/girls and enable better data-informed decisionmaking... 

Ieading to greater accountability and increased business opportunities....

and ultimately better sexual and reproductive health outcomes for women and girls via a financially sustainable ecosystem.

2. If we cultivate a trusted community focused on sharing data and data services... 

by creating an ecosystem democratically run by those within the community, focused on ensuring representation of those from marginalized communities, and a space for organic transfer of knowledge between women in web3 and data science... 

it will embolden women and girls with more knowledge and improve human capacity building... 

Ieading to greater diversity and inclusion of women, and those from developing countries or small island nations, in web3, data science, and other STEM fields...

and ultimately improve economic opportunities for women in these fields and ensure more equitable access to the digital economy.

Both the data-sharing platform and DAO are dependent on leveraging blockchain technology as the core technology necessary for our solution to function.

Within the DAO structure, Knowan is focused on ensuring diversity, equity, and inclusion are at the forefront.  Accordingly, when creating the governance construct, drafting bylaws or other governance documents, the diversity of the community, and voting power and governance power that will be leveraged within the DAO, will seek to eliminate disparities and barriers to participation as much as possible.  Emphasis in the structure will be placed on ensuring that the community will forever maintain a focus on diversity and inclusion within both the voting commmunity, as well as within the leadership and stewards contributing to the community and forum discussions.  As a community-led and governed organization, the community will be the ultimate determinant of who and how to ensure that all groups are welcomed, respected, supported, and valued, and appropriate mechanisms for community governance and inclusion will be specifically written and enforced by community members. 

At Knowan, we are using a multi-sided business model - specifically a variant similar to a customer segment cross-subsidization model.  

Basically, we take a commission on each data transaction that occurs on our platform.  In many developed economies, digital health products focusing on sexual wellbeing and health – from ovulation and reproductive trackers to contraceptive microchips, to AI-based sexual reproductive health chatbots, to other products related to intimacy and dating – are gaining traction.  In fact, the global sexual wellness market size is expected to reach $125.1 billion by 2026 – with North America leading this surge.  While the total global market for femtech products and services (generally defined as products, services, and software based on new technologies focusing on women’s health) is forecasted to be over $60 billion by 2027.  The problem is, the volume of data collected by many of the apps and products, as well as the private nature of the information, make privacy considerations a real concern. 

Knowan seeks to fill this need for a trusted marketplace with a platform (or, data marketplace), including compute-to-data (“C2D”) capabilities, that helps developers of health apps keep their promises to users and handle sensitive health information responsibly.   Compute-to-data “resolves the tradeoff between the benefits of using private data, and the risks of exposing it.  It let’s data stay on-premise, yet allows 3rd parties to run specific compute jobs on it to get useful compute results like averaging or building an AI model.”https://oceanprotocol.com/technology/compute-to-data#:~:text=Compute%2Dto%2Ddata%20resolves%20the,or%20building%20an%20AI%20model.

As a social enterprise, any revenue generated from data produced from digital health products focusing on sexual wellbeing and health in developed economies (e.g., U.S., Europe, Asia) – would be reinvested to support the infrastructure, human capacity building, and additional projects that propel equitable access to high-level data capabilities and tools, and improve sexual and reproductive health outcomes for women and girls in marginalized communities around the world.  

Initially, Knowan is leveraging donations and grants to complete the MVP, build the community, and better position itself for commercial success and impact.  However, the long-term financial sustainability of Knowan will depend on the involvement and investment by the community, in addition to a sustainable funding stream of data and data services produced and consumed on the marketplace/platform - of which Knowan will take a commission of each data transaction. 

Knowan has received a grant from OceanDAO for engagement and outreach, and upon successful completion of our grant deliverables - including more engagement with potential users and stakeholders - we would seek additional funding for our next phase.  In addition, Knowan will target several grant program within the web3 ecosystem, as well as more traditional foreign assistance and donor funding during the pre-revenue stage. Knowan is also considering the utility of an initial DEX offering (IDO) or other crowdfunding technique unique to blockchain.