Cowva

Annually, more than 1.5 million people die from vaccine preventable diseases worldwide. With exception to clean water, vaccines remain the most cost effective method for disease prevention saving about 3 million lives every year. 

In Nigeria and most parts of Africa, access to vaccination service, service delivery constraints, lack of awareness, and poor vaccine literacy continue to hinder disease prevention efforts. These constraints are evident as they translate to poor vaccine coverage and immunization completion rates.

 The last National Immunization Coverage Survey in Nigeria showed that about 77% of children aged 12 to 23 months did not receive complete routine immunizations while 40% had not received any routine immunization at all. 

In terms of completion, most caregivers were unaware of the vaccination status of their children and this is in part influenced by the fact that only 29% of people have access to a child health card.

Cowva vaccination management system enables vaccination care providers to efficiently provide vaccination care and vaccine related information to their patients. Through automated appointment scheduling and reminders, vaccine recipients get timely SMS and email reminders of their vaccination appointments and in turn have a reduced fall out rate, ultimately translating to an increase in vaccine completion rate. The hassle of accessing vaccination records is also taken away as both patients and providers can easily verify records in a few clicks. Eliminating long hours spent on sorting through piles of physical records and outright loss or damage of paper cards. 

The process of documentation goes hand in hand with the vaccination delivery flow including standard operating procedures to ensure efficiency and high quality of care delivery. It guides the vaccinator through the process including providing relevant information and checkpoint questions to be shared with the vaccine recipient. At the completion of a new record, the system also provides advice information for the patient, specific to each vaccine. 

By supporting efficient vaccination services delivery and powering documentation, Cowva is poised to rapidly decrease new events of vaccine preventable diseases, improve surveillance and reporting efforts, increase vaccine coverage and completion rates; for the achievement of the Immunization Agenda 2030 (IA2030).

Cowva currently serves vaccination care providers and their clients accessing vaccination services through them. Our solution aims to aggregate data throughout the vaccination care ecosystem to support public health planning, reporting and preparedness. 

We are working to improve how health providers in Nigeria provide vaccines, vaccine information and education to their patients. Their processes are currently manual and this often makes documentation and reconciliation an uphill task. The platform also helps to take away the burden of important routine time consuming tasks like sending patient reminders and appointment scheduling, enabling them to focus on more productive core functions. For healthcare administrators, Cowva empowers them with reports and tools for monitoring and improving their practice. 

Our approach also ensures that data access is democratized. Therefore patients can easily access their records whenever they need them without having to contact their health care provider. 

The overall impact is the improvement of vaccination service delivery for clients, vaccination education, reduction in vaccine hesitancy and improvement of vaccination completion rates. 

Governments and funding agencies will benefit from the data that is being pooled from private sector players which has not been available in this part of the world. This will also provide a clear picture on areas of improvement and solution spaces that require further exploration and/or attention.

Through our work over the years in delivering vaccinations and working in close partnership with vaccine distributors and also training vaccination care providers, we have been able to develop a deep understanding of the overall ecosystem. 

We understand the problems faced by the providers, from access to products, delivery and also record keeping. For the patients, hesitancy and poor vaccine literacy often means decreased uptake and for those already accessing service, they often are unable to get a hold of indestructible records especially when they are required for verification purposes. 

We are constantly speaking to patients to understand their needs. Same goes with other relevant stakeholders like vaccinators, administrators of health facilities, vaccine managers, vaccine distributors etc. This constant communication keeps us in the loop and ahead of the curve as we are constantly thinking of ways to improve their experience with vaccination management.

The space of vaccination care is constantly evolving and so is public response as well as organizational and public health systems understanding of the solution space. As such we are constantly taking lessons from happenings, interaction with users, health facilities and direct vaccination care providers to improve the experience and offer more features and functionalities.

Due to novelty, the use case for Cowva has yet to be established on a large scale. Also because scale has to be reached in terms of access to health facilities, data insight for decision making is currently not robust enough. With increased uptake and adoption through marketing and government endorsement, the full potential of the solution can then be harnessed.

We are applying to solve problems because we require support with product marketing and business development. Alongside the grant funding provided, we also believe in the potential of the MIT Solve network to enable us to break into new markets through introductions and recommendations.

Delivery, documentation and management of vaccinations by care providers is currently heavily dependent on an error prone manual process. Cowva seeks to digitize this process for health care providers. Patients are also often lost to follow up leading to incomplete vaccinations and partial protection. For more significant public health gains and a drastic reduction in vaccine-preventable disease incidence, Cowva bridges the gap in efficient execution. 

It also enables patients to take charge of their vaccination records and informs them of what they need, when they need them. In turn, they are more receptive to vaccinations, more engaged, vaccine literate and champions against vaccine hesitancy. 

We are constantly engaging with vaccinators, health facilities and end users to understand their needs and this is a core of how we go around developing the solutions to the problems they identify.

To reduce mortality resulting from vaccine-preventable diseases globally

INDICATOR 3.b.1 Proportion of the target population covered by all vaccines included in their national programme

Proportion of the target population with access to 3 doses of diphtheria-tetanus-pertussis (DTP3) (%) SH_ACS_DTP3

Proportion of the target population with access to affordable medicines and vaccines on a sustainable basis, human papillomavirus (HPV) (%)  SH_ACS_HPV

Proportion of the target population with access to measles-containing-vaccine second-dose (MCV2) (%)  SH_ACS_MCV2

Proportion of the target population with access to pneumococcal conjugate 3rd dose (PCV3) (%) SH_ACS_PCV3

We believe that enabling vaccination service providers to fully engage vaccine recipients through an immersive vaccination delivery process will lead to net positive outcomes. 

Activities that ensure people get timely vaccination reminders via SMS, email and instant messaging, easy access to vaccine records,  secure documentation, and proper vaccine education and enlightenment.  

Short-term outputs measured as the number of reminders sent in the form of SMS, email, and instant messaging, number of clients vaccinations documented, and number of vaccine education activities conducted.  

Ultimately, leads to improved outcomes of increased vaccine literacy, uptake, completion rate and coverage.

This will have an overall impact of reducing mortality resulting from vaccine-preventable diseases.

Cowva operates on a high level web application framework. This enables us to optimize the workflow across the vaccination management cycle.

Our appointment schedulers and automated reminders are achieved by leveraging core APIs provided by SMS, e-mail and other instant messaging service providers.

Primary data is collected directly by vaccinators―community healthcare workers, nurses, physicians, and pharmacists. 

During data collection, next appointments and reminders for clients are automatically scheduled. As such they do not have to go through the trouble of reminding clients individually prior to their next vaccination visits. 

The amount of time they spend on this task as well as other reporting is significantly reduced and consequently their overall workload.

We have at our core a vision for diversity and inclusion. That is why the constitution of our board favors a higher female to male ratio. In addition, new members to the founding team will be done to ensure a firm gender balance is achieved. 

We strive for balance within the team and therefore ensure that every new addition is made based on fair judgment. We do not hold any biases based on age, gender, identity, race, tribe, religion, sexual orientation or other differences. We are invested in ensuring representation for all, prioritizing marginalized groups and those underrepresented within our structure. 

We will continue to ensure increased representation for underrepresented groups and believe in the beauty of diversity. 

Our offerings are also aimed at ensuring equitable access to high quality vaccination services regardless of location or financial status.

Cowva clients are small to medium health facilities licensed by the government to provide vaccination services. 

Our value proposition is a simple, secure, and efficient technology to manage immunization processes. This service is offered to both vaccination care providers and their clients who are provided with accurate vaccine information and timely access to their verifiable records.

Health care facilities using Cowva have their processes optimized for efficiency, increased client satisfaction due to automated follow ups and increased revenue. 

To generate revenue, we operate a subscription  business model.  To use our software, our clients, the vaccination care providers, are charged a monthly subscription fee ranging from $10 to $27. For records verification, their clients are also charged a fee per download of records which are held securely online. 

The organization offers a month of free trial, and subsequently discounts on yearly subscriptions to build relationships with clients and also reduce the barrier to entry. We also offer technical support and training to vaccinators to improve the experience of their clients served. 

We will partner with affiliates and vaccine distribution companies to get the solution to their client base. Our close relationship with these partners ensures we can reach new markets as well as continue to research and develop a more tailored solution to our clients. 

Cowva will continue to generate revenue from direct subscription sales to health facilities. 

As a cloud storage service and verification service provider for vaccinations, revenue is also be generated from vaccination record downloads by vaccine-recipients.

Cowva will secure grant funding to provide services to NGOs for free.

Cowva has been bootstrapped, and also been supported by grant funding received from International Youth Foundation (IYF). Since moving from the first stage of development, about 40% of revenue generated has been used to fund the cost of operating the system. As Cowva continues to scale, we envisage that margins will rapidly increase. 

To support early release of new iterations as well as offer the service at no cost to nonprofits and select government agencies, we also hope to raise more grant funding in the future.