Kiran: Gamified VR for SRHR

The project specifically tries to overcome the taboo and lack of awareness surrounding the Sexual and Reproductive Health and Rights (SRHR) in adolescent girls in remote rural and tribal areas. The challenge or scale of problem consequent of the taboo nature of these topics are well understood - In India, it's estimated that only 35% of women use sanitary pads, highlighting the lack of access to proper menstrual hygiene products; in South Asia, one out of three girls knew nothing about menstruation before experiencing it; UNICEF reports that 10.23% of teenage girls in the age group of 12-18 drop out of school after they start menstruating due to the lack of facilities and awareness.  Many studies in India have also found that  a large number of youth have poor or limited knowledge around sexual and reproductive health 

To address this lack of information, the typical approach by local community organizations is to conduct awareness campaigns and group sessions with a central woman trainer. Multimedia content is also used by video projection to the entire group. However the personal nature of the SRHR topic is such that learners shy away from asking questions that might be relevant to specific issues suffered by them. Myths and cultural beliefs contribute to the stigma surrounding this topic, making it difficult for girls to discuss their experiences openly and seek proper guidance. For example, a woman might be facing domestic sexual violence but might not own up to it or ask questions around it, lest others find out and she is socially ostracized. 

Confidentiality and anonymity is key in SRHR conversation but the requirement is of a scalable solution which works for large groups. The need is for a solution that ensures a private space for an individual but yet can work with a group. 

We have upgraded the standard trainer-led awareness session into a gamified personal experience using a VR-based program designed to provide an immersive and interactive learning experience about SRHR. 

Using a smartphone and low cost VR headsets or dIY cardboard cutouts, we create a VR experience. In the app, offline content is pre-loaded which presents the learner with choices. Learners make those choices through simple left or right movement (which is captured by the smartphone’s motion sensors) and this opens more informative content personalized to the learners choices. 

Since nobody is watching the choices being made, the learner moves beyond the presence of a group and makes choices more freely seeking more information on matters that personally after her. This behavioral aspect has been successfully verified through our pilot studies with test groups. It is also backed by research on this topic (https://www.researchgate.net/publication/349437253_Creating_Awareness_About_Health_and_Hygiene_During_Menstrual_Cycle_Among_Indian_Adolescent_Girls_Using_Virtual_Reality)

Gamification of the otherwise taboo topic drives up engagement from the learners and normalizes discussion around it. The relatable story based VR experience with different situations enables the adolescents and young adults to experience different real life situations and relate to how it impacts the physical, mental health as well as the course of someone’s life.

We believe that simple technology solutions have the highest reach. For example, even with a kit of 40 entry level smartphones and 40 low cost headsets, we are able to make the typical present-day awareness program more private, immersive, personalized and trackable, thereby making its outcomes significantly more effective. Further, our content is re-adaptable, that is, even when our learners start having access to smartphones themselves (as mobile penetration improves), they can independently browse through the content (beyond group workshop sessions).

We work with adolescent girls, young adults, and young women in the age range of 14-30. Our learners come from remote rural and tribal areas and often have low levels of literacy. Currently, our efforts are concentrated in the rural regions of Indian states such as Rajasthan, Odisha, Assam, Manipur, Karnataka, and more. Once translated into other languages, our solution has the potential to be effective across the Global South.

Our learners have frequently been disempowered due to historical oppression. They have experienced severe violations of their personal rights and often encounter significant challenges in terms of education, healthcare, and hygiene.

They frequently lack accurate and comprehensive information about their own bodies and the biological processes related to menstruation. As a result of the absence of awareness and guidance, they do not practice proper hygiene during their periods, leading to health issues. The stigma surrounding menstruation causes girls to miss school during their periods, resulting in gaps in their education. Social and cultural taboos related to menstruation contribute to a culture of silence and shame, which hinders open discussions about the topic. Additionally, there is a lack of awareness about sexual health and associated rights, leading to unhygienic practices and the violation of personal rights.

Our solution operates at five levels: 

Firstly, it brings information to the learner in a simplified comprehensible visually immersive manner. It responds to one's personalized information needs. This significantly improves knowledge levels and is proven in our pilot studies. 

Secondly, to the trainer, it flags any individual who needs special attention. The app usage data, without disclosing much personal information, indicates to the trainer learners who might be suffering critical illnesses or a victim of domestic violence, harassment or assault. 

Thirdly, through an immersive shared experience (yet, private at an individual level) it normalizes the conversation around taboo topics of SRHR. This in the long term, leads to a mindset change. 

Our master trainers are live examples of the transformative journeys such knowledge and mindset shift can catalyze. The app is enhancing this process, making it more personalized, private, effective and scalable. 

Our core implementation team primarily consists of powerful young women who come from grassroots communities themselves and have suffered themselves. An example of our trainer is Asha, a woman from a Rajasthan village,  who confidently presented her journey in overcoming taboo on menstruation related topics, by speaking about it on national television (https://www.youtube.com/watch?v=CCva3Vcacwc&t=2s). Our other master trainers have a similar background and they shape our pedagogy, review our content, app interface and workshop design. We have achieved the capability and agency of these trainers through years of deep engagement with the community.  

Our key team lead, Dr. Monalisa Padhee, although not from a marginalized community, acknowledges that the taboo on menstrual health topics is pervasive across India - urban or rural. She has also closely faced misinformation and Battling this issue has been her personal passion demonstrated by her academic journey doctoral degree in reproductive physiology. She has been working directly with the grassroots team for 8 years now and is a supporter of bottom up participatory approach of solution design. 

We are also supported by the close community connections of Bindi International (aka Barefoot College International), the game design and technical support of ImpactOnus (an Indian impact consulting entity focused on grassroots innovation) and the contributions of Team4Tech volunteers.

We have built a first level prototype application (a minimum viable product) which allows us to test if learners can successfully use, engage and if their learning outcomes are enhanced.

We have conducted tests with 40 adolescent learners in rural Rajasthan and the learning outcomes are significantly higher. 

These make our solution more a prototype than a concept.

Our innovation leverages the aspect of anonymity in a digital space and the private space offered by VR to address SRHR. In that sense, it is an innovative use of existing technology for social impact. 

We also strictly believe that high impact technology for marginalized communities cannot be high investment. As such, we have kept all requirements for implementation of our solution simple, offline and doable using a smartphone and cardboard (for VR headset).

In the first year, we intend to make a robust version of the application with a smoother design and with more enriched content. We also intend to conduct pilot and gather learner behavior data of at least 5,000 users across India in 5 main languages. 

In next five years, we intend to have usage data of more than 10 million beneficiaries through 50+ organizational partners. We are envisioning to remove lack of knowledge around SRHR completely from this beneficiary set. With time, we intend to integrate added modules that aid the beneficiaries beyond knowledge in SRHR care. 

5

1 Team Lead and knowledge expert: Monalisa Padhee

3 Master Trainers: Asha, Kismat, Dheeraj

1 Technology & Design consultant: Shuvajit Payne (ImpactOnus Consulting)

Our curriculum has been developed over 5 years. 

We had first tested VR usage by our grassroots learners in 2018.

The content and the technology is being developed and finetuned this year.

Our core team includes representation of multiple genders and sexualities and we have a strong zero discrimination policy with a focus on mutual respect. 

Our solution, by design, focuses on rights of the marginalized communities. It further focuses on promoting conversation on SRHR and extends it to gender conversation, talking about equality of gender identities. 

Our plan is to build a ground-tested application and a training package at pilot level and generate sufficient data to demonstrate the potential of the tool. This phase is expected to be supported by innovation grants. 

Once the application data proves its effectiveness, we intend to reach out to like minded organizations (CSOs) which are engaging in SRHR awareness and adopt a B2B subscription basis usage model. This is more cost effective for the paying organization too since it saves significantly on grassroots training effort without compromising on learning outcomes. In the longer run, we intend to advocate to become the government recommended application for awareness on sensitive topics. 

In our model, the initial protype and pilot cost is expected to be covered by innovation grants. 

Post this phase, our major cost is in support, hosting and upgrade and this is likely to be covered through payments by organizations who subscribe to use the application. Further innovation work shall be through sustained fundraising in the form of donations and grants. We also intend to leverage support of volunteers (like from our partner TeamforTech) in design and tech development.