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AI enabled APP that provides Sexual and Reproductive Health Services during COVID-19

The AI enabled APP  is to be used by trained Community Health Workers, who will screen women during the pandemic for COVID-19. They  will also provide sexual health information to women of reproductive age (15-49) years, about Family Planning  and a wide range of choices.The will give advice, on how to access FP, HIV services, Antenatal Care services. The  AI enabled APP to be used even after the pandemic.The AI enabled APP interface will have USSD/SMS/Internet link based on the convenience of the end users.The diversity is meant to enable serving users in the rural and urban areas. The interface will have Sexual and Reproductive Health education tips  in the form of videos and texts. In addition, mental health support. The AI Sexual and Reproductive Health Chatbot to be programmed and understand which questions it should answer.They will be Doctors forum in which unanswered questions from AI will be referred to.The basic data for the target group, women of reproductive age(15-49) years, to be obtained from the Tanzania Demographic and Health Survey and Tanzania Bureau of Statistics.The features and functions of AI enabled APP will be achieved through the validation process, by working in partnership with different actors: the health care system providers, clients, researchers and regulators.Along with, they will be a formative and summative evaluation process.Sustainability, will be achieved through active participation and collaboration of different  stakeholders and successfully partnerships.Apparently, we will be working on the blank business model framework to achieve the business model.

Points to consider: 1) Training of the target group on how to access and use the APP. 2) Age of consent for girls and women below 18 years.

According to the Population Distribution by Age and Sex Report (TZ) 2012 ; Women of reproductive age population(15-49) is 10, 905,117 in Tanzania mainland and 339,007 in Zanzibar.( See the attachment)The target group comes from diverse background: urban, and rural settings, from streets, drop out from schools, students, employed, self employed and unemployed.Ranging from single, married, unmarried and cohabiting.

Problems that has led to me to come up with the above idea are;

1)Lack or inaccurate sexual health information to the target group.

2)Increase in adolescent childbearing among 15 years old.

3)Unmet need for contraception, for the target group.

4) Limited access to Sexual and Reproductive Health Services due to stigma, cultural factors and health care providers bias.

 

State your goals

 

1. Providing sexual health information to the women of reproductive age (15-49) years.

2.To provide information on Family Planning and a wide range of choices so that the women(15-49) years can make informed decision.

3.To facilitate accessing Family Planning supplies, HIV services, Antenatal Care services despite the restrictive measures during COVID-19, even after the pandemic.

4.To have two way communication with Doctors on the forum for professional help.

What problems (particularly in value chain competitiveness and global disruption) are your community’s stakeholders facing due to the Covid-19 pandemic?

Resources have been diverted from the Sexual and Reproductive Health Services in order to respond to the pandemic COVID-19.This has put women and girls at risk, because of shortage  that  has limited them, the ability to secure sexual and reproductive health services and other health promotion services.Some have faced shortages in their essential medicines.

What minimum viable solution(s) are you proposing to address the challenge(s) in your community?

 Gaps still exist within programs that target both knowledge and behavior change in the sexual activities of adolescents.(1)Currently, far to few young people are receiving adequate preparation which leaves them vulnerable to coercion, abuse, exploitation, unintended pregnancy and sexually transmitted infections including HIV.(2)Young people have special and reproductive health needs because of their relatively high risk  of being exposed to inaccurate or incomplete information, which leads them to acquiring HIV and other sexually transmitted infections, pregnancies and maternal complications.( Rani and Lule 2004) In 2000, 29% of the population in developing countries was of adolescent age, in the least developed countries accounted for 32% of the population.(3)The unmet need for contraceptives among adolescents, however, is more than twice that of married women.(4) Married adolescents often do not want a pregnancy, but have low contraceptive rates: in fact, recent data have shown that current use of contraceptives is often lower among sexually active, married adolescents.(5) Unmet need for both married and unmarried adolescents is therefore extremely high.(6) Despite the wide range of available contraceptive products, many unplanned pregnancies continue to occur each year. Many of the undesired pregnancies could be avoided if the unmet need for contraception estimated to 25% in Sub Saharan Africa was met. (7)  Like many countries in Sub Saharan Africa, Tanzania's  once successful family planning program has slowed markedly, with the rate of contraceptive prevalence well below levels needed  to reach current demand and country goals.(8)  In Tanzania, 34.4% of married women in 2010 reported use of any method of contraception, while modern methods reached a prevalence of 27.4% .(9) Of concern, however, is the increase in adolescent childbearing among 15 years old girls, which rose from 3.7% in 2004 to 5.2% in 2010, a pregnancy rate among children that is  too high.(10) About 70,000 adolescents in developing countries die annually of causes related to pregnancy and childbirth(UNICEF,2008).Complications of pregnancy and childbirth are a leading cause of death for older adolescents.(WHO,2012) Research suggests that current contraceptive use prevents approximately 272,000 maternal mortalities per year, and if current family planning needs were met, another 104,000 lives would not be lost (11), many of which would be adolescent ''lives'' saved .With the ongoing COVID-19 pandemic, health services and commodities have been overlooked, women continue to require family planning , menstrual health supplies and maternal care.Staff and resources are allocated towards critical care services, away from maternal services.It is a worrying time for pregnant women in need of routine health services.Using our AI enabled APP, we will be able to reach even , the hard to reach women from diverse background.Reducing the unintended pregnancies will help break the poverty cycle but also return the investment in further education, political stability and higher access to labor market in the future.(Bearing et al, 2007)

References: 1)Glasier A et al, Sexual and reproductive: a matter of life and death, Lancet, 2006, 368(9547);1595-1607

2)The UNAIDS, 2008 Global Report on the AIDS Epidemic.

3)IAWG on the Role of Community Involvement in ASRH Community Pathways to Improve Adolescent Sexual and Reproductive Health A Conceptual Framework and Suggested Outcome Indicators : December 2007.

4) Population Council, Family Health International, Ethical Approaches to A Gathering information from Children and Adolescents in International Settings, 2005.

5)Blanc A K, Tsui AO, Croft T N, Trevitt J L, Patterns and trends in adolescents'' contraceptive use and discontinuation in developing countries and comparison with adult women.Int Perspect sec Reprodu Health 2009:35(2);63-71

6) Chandra -Mouli V, Mc Carraher DR, Phillips S J, Williamson NE, Hainsworth G.Contraception for adolescents in low and middle income countries; needs, barriers and access. Reprod Health 2014 11 (1) ; 1

7) Sedgh G, Hussain R, Bankole A, Singh S. Women with unmet need for contraception in Developing countries and their reasons for not using a method.New York Guttmacher. Institute, 2007.

8)FHI 360 PROGRESS in Tanzania: National Family Planning Costed Implementation Program.(Retrieved 2 Sept 2014).

9) Health in Tanzania .Wikipedia , the free encyclopedia.abcdefghi(USAID(2010) Demographic and Health Survey-Retrieved 2 Sept 2014.

10) Ministry of Health and Social Welfare, National Adolescent Reproductive Health Strategy 2010-2015.

11) Ahmed S, Li Q, Liu L, Tsui A O. Maternal deaths averted by contraceptive use: an analysis of 172 countries, Lancet 2012;380(9837):111-25

 

Share your story (your narrative)

Being a Medical Doctor for a number of years, practicing in the Sub-Saharan Africa( Tanzania, Lesotho, South Africa) and Trinidad, on several occasions, in the emergency room, I came across young girls and women, presenting with heavy vaginal bleeding in critical condition, some of them, end up dying, others, may survive with complications. Only to find out, they are "aborting". Most of them, do not disclose what really had happened. I addressed the emergency situation, when, the patient is stable and well in less than a week discharge her/them. Because of the work overload and shortage of staff in the region, there is no time for educating them on sexual health. What can be offered or adviced to them, is to go via the Family Planning clinic.Most of them, do not go to the FP clinic, then, it becomes a "vicious cycle".There is no proper follow up system.With  the COVID-19 pandemic, the health systems in many countries are forced to allocate staff and resources towards critical care services and away from other areas of care e.g maternal services.It becomes a worrying time for women who are pregnant and in need of routine health services.My desire has been to reach these young women, using technology, so that,they can receive sexual health information and also have easy access to the Family Planning, HIV Services etc.

Please provide any additional relevant information that you would like to share.

who.int/reproductive health/publications/emergencies/COVID-19-SRH/en

Tanzania Population, Reproductive Health and Development 348-Tz-RAPID

Your Final Proposal for challenge

yes

edited on Jul 16, 2020 by EUNICE KAJALA
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Silvia Dusa May 30, 2020

Dear Eunice,

Thank you for submitting your application to the ITU's ''Women in technology Challenge"!

Can you please expend more on what is your connection with the idea? Why are you motivated to solve this issues?

Also, can you give more explanation on how you can make the idea sustainable? What is the business model behind? What are your main stakeholders?

Thank you and good luck!

Silvia

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EUNICE KAJALA Jun 3, 2020

Dear Silvia,

Thanks for your vote. I am a Medical Doctor, Innovator, with special interest in designing products, services and devices that support clients on health related issues.What has motivated me, is to work on the solution to the challenge of adolescent pregnancy and childbirth complications that lead to death, About 70,000 adolescents in developing countries die annually of causes related to pregnancy and childbirth (UNICEF 2008).
Apparently, my main stakeholders are colleagues from the ICT College, University of Dar es salaam.
Sustainability will be through the active participation and collaboration of different stakeholders and successfully partnerships.
At this stage, it is a blank business model framework while working for the business model.

Fahmida Hossain Jun 19, 2020

You have described your project very nicely. Undoubtedly, this service will bring benefits to women. My only concern is, how can a women get your service in areas where they have no mobile phone or internet connection? I think you should add some solutions to think of women in rural areas. Because women in rural areas are more deprived of this type of service than in urban areas.

EUNICE KAJALA Jun 23, 2020

Hi Fahmida,
Thanks for your contribution.Our interface will have USSD/sms/Internet
link, based on the convenience of the end users ( women).The diversity is meant to enable serving users ( women) in the rural and urban areas.

Fahmida Hossain Jul 24, 2020

Sounds great !!!

Sunday Bawa Jun 25, 2020

Sounds more like an SRH chatbot which is also able to provide referral services if it's a case it cannot advice on, also able to offer video call examination by a standby SRH care provider in real-time likely under a subscription basis. Nice idea

Sergio Pengel Jun 29, 2020

Eunese, I like the problem your solving here. Its needed.

First, it sound like this idea has been in your heart or development prior to covid as covid has the add on.

It sound that your solving a bigger issue which is providing resources to woman in need or rural areas, using AI to make better and faster decisions for doctors like you to the public. AI is has be trained, is woman your focus? woman with children? in you case, How does AI help without validated "rural" data?

EUNICE KAJALA Jul 2, 2020

Hi Sergio,

Thanks for your question. Our target group are the women in the reproductive age (15-49) years, the basic data on on their distribution will be obtained from the Tanzania Demographic and Health Survey and Tanzania Bureau of Statistics. The AI enabled APP is to be used as the Virtual Health Assistant by the Community Health Workers.The Community Health Workers with the use of an APP will provide Sexual Health Information, covering Family Planning and choices, HIV information, testing, supplies and referrals. etc Responding to your question " How does A help without validated rural data? There are five guiding principles for responsible use of AI in health care.Two of them are relevant to your question : 1) Fairness : AI enabled solutions should be developed and validated using data that is representative of the target group for the intended use while avoiding bias and discrimination.
2) Transparency: AI-enabled solutions require disclosure on which functions and features are AI enabled through validation process and the responsibility for ultimate decision taking. Fairness principle can be achieved sampling using statistical methods with the basic data from the Tanzania Demographic and Health Survey and the Tanzania Bureau of Statistics.The second principle, the transparency, can be achieved by working in partnership with different actors, the health care system providers, payers,patients or clients, researchers and regulators.There is also a monitoring process, formative and summative evaluation.

Sergio Pengel Jul 21, 2020

Sounds like a clear and transparent plan. I like it, leaves you with execution and adoption within Tanzania focus group. If it works,how do you scale? if it does not, what/is there a plan B?

EUNICE KAJALA Jul 21, 2020

Hi Sergio,
We will be piloting within Tanzania, starting with one region, Dar es salaam, then scaling it to other regions, up to the island of Zanzibar. We would like to scale it up to the Sub Saharan region, Malawi, Zambia, Mozambique, Lesotho etc. At the moment, The piloting, will give us a direction on plan B. Do you have any suggestion? Any place for Caribbean?

Achia Khaleda Jul 2, 2020

I like your project concept, But I am afraid about mobile internet. Who will be your end user and how they access the app. As you focused on COVID 19 situation, I think you can add mental health support also because it's very important for women.

EUNICE KAJALA Jul 3, 2020

Thanks Achia,

Our end users are Community Health Workers.who will be communicating via the AI enabled APP to the women of reproductive age(15-49) years. The mobile interface will have USSD/SMS/internet to enable serving users in the rural and urban areas. Thanks for your advice, we will add mental health support too.

Achia Khaleda Jul 24, 2020

thank you dear :)

RACHEL MIAMI Jul 7, 2020

This will help women especially at this season of pandemic ,you will have to prepare a good business model to ensure sustainability of your business even after the pandemic and concerning the mobile internet app you will have to educate women in the rural on how they can access and use your app so that they can benefit too

EUNICE KAJALA Jul 21, 2020

Hi Rachel,
Thanks, point taken.

Swapneel Khandagale Jul 8, 2020

I suggest a Doctors' forum be implemented in the app so that women can ask their questions directly to doctors instead of an AI. Also the AI should be able to understand which questions it should answer and which to forward to the Doctors' forum.
For women in rural areas, a call center service or missed call service can be implemented where the AI handles several calls using Session Initiation Protocol or call centres are used for receiving the questions.

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EUNICE KAJALA Jul 9, 2020

Thanks Swapneel, point taken.

Nivashini Rave Rattey Jul 9, 2020

The idea has been progressed to the next milestone.

Nivashini Rave Rattey Jul 9, 2020

Status label added: Community feedback received

Nivashini Rave Rattey Jul 10, 2020

Status label added: Expert feedback received

Nivashini Rave Rattey Jul 10, 2020

Status label removed: Expert feedback received

Victoria Masso Jul 21, 2020

Status label added: Mentor feedback received

Shawn Melville Jul 23, 2020

Dear Eunice,
I commend your effort as a doctor for recognizing the need for remote sexual and reproductive health services and for taking action to address the challenge of educating young girls. I think your idea is an excellent use case for an AI chatbot since it can give young girls tailored answers to their questions; however, I am of the opinion that you need to revise the structure of your proposal so that is easier for your audience to read and understand. Think about the order in which you want to present your idea so that it flows logically from one point to the next. I believe your solution has great potential but you have to communicate it well. Here are 4 key questions/areas to address in your proposal:
1. Do you have a 'Minimum Viable Product' or prototype and if yes, have you tested it?
2. How do you intend to reach your target market and what challenges you are likely to encounter?
3. What is your business model? In other words, how will you generate revenue and manage expenses?
4. How are you going to know that your solution is making difference?

EUNICE KAJALA Jul 24, 2020

Hi Shawn,
Thanks for your comment.Points taken. Responding to your questions:1) Apparently, I don't have a MVP or prototype.It is still on idea phase. 2a) I am intending to reach my target market by working in collaboration with staff at various Sexual and Reproductive Health clinics. We will be organizing session/workshops at those clinics, invite the target audience with their male counterparts and provide them with the information about our service. I will also use online links to those clinics, linking with our website and provide the information on the website.2b) The challenges are i) Young girls including boys already know everything about sex and sexuality through the internet and social media and it is difficult for them to distinguish between accurate and inaccurate information.ii) Ethical implications related to providing sexuality education digitally.iii) The dual use nature of technologies makes regulation difficult. The use of technology can be beneficial on one side, if used another way, can have detrimental effects.3) Our business model is through revenue-sharing model. I would like to partner with the AI development start up, which has experience in Proof of Concept(POC) and data science.We will build a POC, if it works , will share the benefits. 4) I will know if our solution is making difference by measuring its' impact using the Social Return on Investment.(SROI) methodology.

Shawn Melville Jul 25, 2020

Hi Eunice,
You can develop a prototype using free tools like InVision Studio, Photopea and Microsoft Bot Framework.
-https://www.invisionapp.com/studio/learn
-https://www.photopea.com/
-https://dev.botframework.com/
-https://www.youtube.com/watch?v=P-kKw2HGP3o&t=7s

I hope you find these links helpful. Please edit your proposal to include the responses you just shared and remember to be clear and concise with your writing.

Nivashini Rave Rattey Jul 24, 2020

Status label added: Expert feedback received

EUNICE KAJALA Jul 25, 2020

Hi Nivashini,
I need to edit as per expert feedback mentioned above, will you please open the editing for me.

Nivashini Rave Rattey Jul 25, 2020

no. this time, you start fill up your final submission form based on your expert feedback.

EUNICE KAJALA Jul 25, 2020

Nivashini,

Provide me with the link for the final submission form.

Nivashini Rave Rattey Jul 25, 2020

all documents are in the challenge site. press more. pls check properly. watch the video of webinar 2 and explore all sites in this platform. you will find all details

Htet Zan Linn Jul 29, 2020

@Eunice, Great Initiative. One of the most popular section for the teleconsultation app I am working on in Myanmar is women health issues. Does your application allow anonymity. What we faced sometime is because of being a conservative society women are more comfortable is they know the conversation is anonymous.

Carolyn Keenan Jul 29, 2020



Hi Eunice
Thank you very much for sharing your idea.
You use story telling very well to create a powerful narrative. It is hard to argue with the need for your app to support women in Tanzania with a range of sexual and reproductive health issues they are facing. The statistics on the number of adolescent deaths due to pregnancy and childbirth complications is shocking. There must be many thousands of others that suffer from debilitating long-term health issues as a result as well.
Along with some of the other commentators I would suggest your application could be strengthened by some more clarity around the tech/MVP/prototype. Perhaps you could look to partner with a tech developer interested in social impact.
The other area that needs addressing as others have said is the business case to enable you to secure funding in the first instance and sustainability thereafter. Through your statistics and resources if you can prove that funding the app will save money spent in treating the young girls and women and enables them to be productive and add to the economy then government funding could be sourced. A pilot of the tech could lead to it being used in other developing countries and could become a revenue stream.
There has been some very sound advice given to you in the comments section and it appears that your idea is continuing to develop. I wish you every success in this project because it is a terrible shame that what little money that was being spent on women’s sexual and reproductive health is suffering because of Covid-19.
Good luck
Carolyn

EUNICE KAJALA Jul 31, 2020

Hi Carolyn,

Thanks for your input.I am looking forward to partner with AI developer, experience in Proof of Concept(POC), do you know any?

Nivashini Rave Rattey Jul 31, 2020

You may now start filling up the final submission form and reach out to any mentors if you're stuck. Best wishes!

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EUNICE KAJALA Jul 31, 2020

Hi Nivashini,

Noted, with thanks

Calister Simba Aug 12, 2020

Hi Eunice,

This is a great idea but i have few concerns that you might need to take into consideration

1. As you have informed that you will be using AI enabled app and as you also know Tanzanian rural situations, most people don't have access digital tools such smartphones, laptops , ipads and also don't have knowledge on operating them. How will you be going to handle such situation whilst providing them with your solution?

2. One of my most concern in health apps is privacy of users' health information as well as data protection. How can you ensure this in app considering there are a lot of cyber attacks that aims at information leakage?

3. From my understanding, sexual and reproductive topic in Tanzania is a bit challenging especially in rural areas due to traditional view and ideologies, How are you going to approach this issue in order to successfully implement this project?

EUNICE KAJALA Aug 13, 2020

Hi Calister,

Good questions. Responding to question 1) The AI enabled APP has an interface that has USSD/SMS/Internet link based on the convenience of the end user.The diversity is meant to enable serving users in the rural and urban areas. Prior to the introduction of the APP, they will be training workshops and again training is a continuous process, there are community health workers and staff at various Sexual and Reproductive Health Centres, who will continuously train the target audience. Question 2) Concerning the privacy of the user's health information as well as data protection, we are considering SSL incorporation.
Question 3) It is very true Sexual and Reproductive topic is challenging issue due to cultural beliefs : To approach the issue, we will take a participatory approach from the idea to the implementation phase.Two members of the target audience, two members of the community and community health workers will be involved throughout the process. The two members of the community are strong, well accepted members within the community, whatever, they say, it is accepted.

Calister Simba Aug 14, 2020

Hi Eunice, Thank you for your responses..1)What I was trying to mean is that, taking an example of Tanzania, most girls doesn't own smart phones (out of 10 people you will find only 2 people own it) and I believe this is an app which requires a smart phone/laptops/ipads and access to internet either to download or use it, and I believe this is needed more in rural areas that in towns, how are you going to sort this issue?

2)Great response, but from my understanding SSL also has cybersecurity issues, take an example of websites, most websites use ssl but cyber attackers can still have access to them or even steal information, considering you are dealing with health information, one things that attract modern days cyber attackers, you need to consider all ways to keep these girls' information

3) That is a great way of sorting this issue, please i advise you to use observatory and interviewing participatory to get a good cooperation from the villages.

I'm rooting for this project so keep pushing forward.

EUNICE KAJALA Aug 14, 2020

Thanks for your response. Your contribution on protecting user's private health information is welcomed. On the issue of rural, we will introduce the USSD concept. Any additions, kindly advice.

EUNICE KAJALA Aug 15, 2020

Hi Calister,

May I have your email address please..

Calister Simba Aug 18, 2020

Hi Eunice, my email address is calistersimba0805@gmail.com

EUNICE KAJALA Aug 18, 2020

Hi Calister,
Thanks.

Calister Simba Aug 31, 2020

You are welcome

Muyunda Kaonga Aug 30, 2020

Hello Eunice, this is a brilliant idea we need more passionate people like you, awesome job. Throughout the COVID-19 pandemic, the World Health Organization (WHO) Director General’s has emphasized that “All countries must strike a fine balance between protecting health, minimizing economic and social disruption, and respecting human rights”. And this is definitely what you are doing in balancing that strike. All the best

Nivashini Rave Rattey Aug 31, 2020

Status label added: Submission completed

Nivashini Rave Rattey Aug 31, 2020

Well done overall!

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