Engagement milestone, Award-winning initiatives and Digital Health innovations unveiled.
Updates from Nivi's feature in the news, askNivi Journeys and the askNivi product.
Summary of this edition :
Nivi in the News : Nivi joins Google’s Cloud Accelerator program.
Nivi in the News : We’ve partnered with TATA 1mg, the leading ePharmacy in India to advance healthcare accessibility for askNivi users
Nivi in the News : Nivi’s research in partnership University of Lagos was published in Data in Brief
askNivi’s Health Journeys : Find out how we are advancing child health by engaging parents and caregivers in Nigeria
Product corner : Screening for better health - Nivi’s Digital screening and counseling features
Founder’s Note
Dear Readers,
I hope this note finds you well.
It’s been a fantastic start to 2024 for us at Nivi as we achieved a significant milestone of engaging over 900,000 users in India through askNivi. Most of the time, there is the daily, weekly, quarterly grind, but at reflective moments, reaching a milestone, recognising effort, there’s a sense of satisfaction and gratitude too. Serving more than 900,000 users in India means that we’ve facilitated more than 3.6 million health related conversations, helping Indians to make informed health choices and take action on their health.
In another exhilarating development in Kenya, our partner Ark Venture Studios was honoured with the “Best Vulnerable Customer Initiative” award at the Insurance CX Awards 2024! Winning this award is a moment of great pride for all of us. This award is a testament to the relentless hard work, unwavering dedication, and innovative spirit that our teams have poured into developing impactful solutions. A cornerstone of our collective efforts, particularly evident through our work with Femina Plus, has been to showcase the transformative power of equitable access to healthcare and preventative healthcare for all.
This journey would not have been possible without the trust, collaboration, and shared vision of our partners. Their belief in our mission to make healthcare equitable and accessible has been crucial to this success. I want to extend my deepest thanks to each of our partners for your unwavering support and commitment. Together, we have created a platform where users can trust the information and services they receive, empowering them to take charge of their health.
The dedication and hard work of the Nivi team has been the backbone of our achievements. I am honoured to lead such a passionate group of individuals who are committed to delivering a digital health platform that helps our customers understand and proactively connect with their target populations. As we celebrate these achievements, let us also renew our commitment to transforming healthcare delivery and making a positive impact on the lives of many more.
Thank you, partners, team, and users, for being a vital part of our journey. Here’s to achieving many more milestones together!
Warmest regards,
Sidd Goyal (Co-founder and CEO, Nivi)
Nivi in the News
Nivi has been selected as a recipient of the Google for Startups Cloud Program's Flagship tier. This tier is reserved for the most promising and innovative startups that use Google Cloud and Firebase services to scale their businesses and impact. As a GFS Flagship startup, Nivi, Inc. will receive up to $350,000 in credits for Google Cloud and Firebase usage over two years, as well as access to technical resources, training, workshops, mentorship and networking opportunities with the Google Cloud community.
Nivi has partnered with TATA 1mg in India to empower askNivi users with seamless access to a wide range of healthcare products and services. This collaboration aims to bridge the gap between personalised health content and accessible healthcare solutions and will enable existing and new askNivi users to conveniently purchase medicines, wellness and healthcare essential products and services online.
Nivi, in collaboration with the University of Lagos and supported by USAID and DAI Global under the Digital Frontiers Equitable AI initiative, announced the publication of a new research paper in the peer reviewed journal Data in Brief. Co-authored by Nivi's CTO and University of Lagos academics, the study presents unique insights from deploying multi-lingual AI to assess gender-equitable healthcare utilisation in northern Nigeria.
Advancing child health by engaging parents and caregivers in Nigeria
Nigeria and the burden of under 5 morbidity & mortality.
Although trends have been improving, in 2020, 1 in 13 children died before age five in sub-Saharan Africa. In Nigeria, the under five mortality rate is 132 per 1000 live births meaning that 1 in 8 Nigerian children never reach the age of 5. Malaria, pneumonia and diarrhoea are the leading causes of death among children, especially in rural and underserved populations. Addressing the childhood morbidities and mortality in Nigeria would go a long way to solving the challenge globally as Nigeria accounts for almost 15% of under-5 deaths globally.
The primary driver of death in low- and middle-income countries is late detection of childhood illnesses. Unpacking the factors in late detection highlights a host of individual, community, and health system level issues. At its core, however, empowering parents and caregivers to take action would go a long way to ensure earlier detection and treatment. That’s why we’ve now launched dedicated Diarrhoea and Nutrition Journeys in Nigeria!
askNivi Diarrhoea and Nutrition Journeys
The diarrhoea and nutrition journeys were designed in line with the Integrated Community Case Management (ICCM) of childhood illnesses for the Integrate 2.0 project led by SFH Nigeria. These journeys provide information and guidance to parents and caregivers of children under 5 about the causes, symptoms, danger signs of diarrhoea and malnutrition as well as treatment options. askNivi also provides referral services to providers for treatment and follow up based on Nivi’s 4A’s model of Awareness, Activation, Action and Adherence to help askNivi users achieve their health aspirations.
The journey on askNivi contains ‘learn more’ and ‘screening test’ pathways for users to explore information and to self- screen to determine their condition.
The target patient population are parents and caregivers of children under 5 years of age. ICCM guidelines are intended, or targeted, for parents, guardians and medical professionals looking after children below 5 years of age, to reduce the burden of morbidity and mortality because of these conditions.
Journey insights
Since the launch, late in August 2023, more than 7100 users have engaged with the nutrition journey, and 1600+ users have interacted with the diarrhoea journey (Awareness). 25% of the users, across both Nutrition and Diarrhoea journeys sought a referral from askNivi (Activation), and were referred to nearby chemists (PPMVs) and healthcare facilities. 6% of those referred from our nutrition journey reported visiting the facility while ~10% of the users from the diarrhoea journey reported visiting a recommended facility (Action). askNivi also follows up with those users who have received a referral, but haven’t reported a redemption (Adherence). It also follows-up with those who have reported a redemption to learn about their experience visiting the health facility (Adherence).
Nivi has recently also taken the pneumonia health journey live on askNivi Nigeria, which is designed in line with the Integrated Community Case Management (ICCM) of childhood illnesses project by SFH Nigeria. The Pneumonia journey also features two pathways for users to choose what their interest is. The first pathway is the ‘Learn more’ where users get to explore different topics on pneumonia such as causes, symptoms, treatment, and complications. They also get to be referred to facilities around their locality for proper examination and treatment. The second pathway is the ‘Screening test’ pathway where users opt to take a test, answering questions to determine if they may have symptoms of pneumonia, danger signs, and also get referred to facilities within their locality for proper examination and treatment.
Expected outcomes from the pneumonia journey are increased awareness amongst parents and caregivers using the askNivi chatbot, empowered decision making and improvement in health seeking behavior with resultant clinic visits for care and treatment.
Screening for better health - Nivi’s Digital screening and counseling features
For most individuals, health-related decision making can be complex and iterative, taking into consideration personal, interpersonal and context-specific factors. Contraceptive decision making for example, concerns about side effects, confidence in one's ability to adhere to daily or monthly use, efficacy of methods, partner support, and HIV vulnerability make it difficult for an individual to make an informed choice, also highlighted by Warren et al., 2022. When it comes to making health related choices, decision support tools are highly effective in promoting joint-decision making and improved health outcomes for askNivi users.
We launched the screening feature on askNivi to enable assessment of an individual's health risks and to recommend treatment options while adhering to clinical guidelines. The screening feature on askNivi asks users a series of questions to then determine an outcome of interest for the user. It also empowers users to get the information most relevant to their current context and situation thus enabling them to take direct action towards improving their health. askNivi currently offers screening conversations to the users on the following health concerns:
determine 3 appropriate contraceptive methods
determine HIV risk status
determine pregnancy status
determine quality of FP counseling post-visit (MII+)
Continuing on the example of Family Planning, we’ll cover the ‘determine 3 appropriate contraceptive methods’ to dive deeper into how the screening feature works.
BCS Algorithm to inform choice amongst FP consumers
In 2015, the Population Council released a revised guide called the Balanced Counseling Strategy Plus. A toolkit originally intended for Family Planning Service Providers working in high HIV/STI prevalence areas, it is one of the most comprehensive resources developed to improve the quality of FP services offerings worldwide. The toolkit has been updated over time, incorporating the latest WHO Medical Eligibility Criteria and new counseling cards addressing various aspects like adolescent counseling, male services, post-abortion care, and women’s support and safety. The Balanced Counseling Strategy Plus (BCS+) toolkit significantly improved the quality of the family planning service and enabled providers to address clients’ needs effectively during the same consultation thereby reducing missed opportunities when providing care for services individually.
Using this toolkit as the framework, Nivi developed the contraceptive (CC) screening feature on our WhatsApp health chatbot, askNivi to give decision-making support to askNivi users by offering high-quality virtual counseling.
We ask users questions around their current pregnancy status, marital/relationship status, current and past use of contraceptives, kids, family planning goal to then recommend appropriate contraceptive methods for the user. Each question sent to the user is based on the user’s response to the previous stage and askNivi only sends the question relevant for the user based on collective responses till each stage. For example, a user who reports not having kids is not asked about breastfeeding status and a user who reports having kids is asked more questions to better understand their context. The ability to conditional branch users to relevant journeys also allows Nivi to segment them into various cohorts based on the specific insight and engage them to develop consumer insights.
Journey Insights
98000+ users in India, Kenya and Nigeria have interacted with the contraceptive screening/decision support journey on askNivi and more than 70% of users sought a referral from askNivi after interacting with the content and getting askNivi’s recommendation.
As users progressed in the screening journey, they responded to questions about current and past use of contraceptives.
27% of the users reported using a method currently but were looking to switch to meet a need. 22% of the users said they had used a method in the past and discontinued, wanting to begin using a FP method again.
Upon referring a user to a health facility, askNivi collects information on their readiness to act on the referral, i.e. to visit the Nivi partner health facility.
Of users that sought and received an askNivi referral, when asked about the readiness to take action, 25% said they had high readiness whereas ~17% users responded with low readiness and the remaining weren’t ready to act.
For the users with low readiness or those that aren’t ready to act, askNivi follows up to understand barriers they face. It is essential to identify the factors that prevent individuals from accessing medical services, adhering to treatments, or engaging in preventative health behaviours. By recognising these obstacles, we work with our partners to develop targeted interventions to improve outcomes, enhance the quality of care, and ensure equity in health service delivery. This approach helps in tailoring healthcare solutions to meet diverse consumer needs, reduce disparities, and promote a more effective and health consumer centred healthcare system.
Further in the healthcare journey for the users, looking at redemption amongst the users who were recommended contraceptive methods, close to 6% of the referred users self reported visiting the facility and method uptake.
Amongst all those that reported a redemption, ~57% of the users had high readiness and ~26% had low readiness to act when asked earlier. The remaining were users who did not feel ready earlier but reported visiting the facility later.
askNivi’s content is developed using the states of change model to assess a person's readiness to change and can inform future interventions for other health concerns too. Nivi demonstrated in the past that it is possible to accurately predict future healthcare-seeking behavior based on information learned during the initial encounter.
The benefit of the Screening feature on askNivi for our partners & customers is to apply evidence-based health guidelines at a personalised level for their target population. It’s revolutionary because it enables askNivi to create conditional branching based on interpretation of complex and multiple user inputs and then share the most relevant information back to the user to drive action and behavior change by reducing inertia in decision making.
Similar knowledge based decision systems can be applied to a wide variety of health concerns like diabetes, hypertension, TB, Women’s health etc. and can be effectively used by health promoters, healthcare providers, insurers & manufacturers. If you are running patient support/awareness initiatives and would like to explore using a digital decision support or screening system for your target population, fill this form to contact us.
Well, that’s it for this edition. Hope you found value reading about updates, insights and news from Nivi. If you did, please use the share button below to share it within your network.
We partner with Health Promoters, Healthcare providers and Pharmaceutical companies/Manufacturers to integrate askNivi in their health interventions and to produce insights about health consumers and their behaviours.
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