The Marketplace Model and Nivi: Taking on Health Disparities by Leaps and Bounds
A look under the hood at all things Nivi
Marketplace 101
The definition of “marketplace” is “the arena of competitive or commercial dealings; the world of trade.” Today, the word might bring many different visuals to mind; but the concept itself is as old as civilization. From the Roman Forum in ancient Rome to the Agora in Greece and Khan el-Khalili in Egypt, marketplaces have always been a locus of transaction—where buyers and sellers can gather for the sole purpose of engaging in trade.
Though the form has changed, the internet has preserved the function of marketplaces while making them exponentially more efficient and accessible. It’s how Amazon grew from an online bookseller in the late 90s to the corporate mega-giant it is today. Virtual marketplaces, like physical ones, are attractive to both buyers and sellers; they offer a single location where buyers can go to find a wide variety of goods or services, and an assembly point where sellers can reach a high volume of customers with little effort and lesser expense. The marketplace itself, however, makes some sort of exchange with the buyers or sellers—Uber charges their drivers a fee for rides, for example; Amazon takes a percentage of sales from their sellers.
Despite the colossal growth in number and value of these virtual marketplaces over the past few decades, they have yet to penetrate one area: Health. There exist few to no marketplaces for healthcare seekers and providers, let alone scalable ones. Rather, individuals must place great effort into finding accessible, affordable health services and products—let alone explore a variety of available options. Likewise, providers possess few pathways into reaching and serving more patients.
Not only is that disconnect a detriment to society writ large, it is also a huge motivation for Nivi. Nivi’s health chatbot, askNivi, is a digital tool that connects healthcare seekers and providers, en masse. It seeks to tackle the disconnect from two directions: (1) by providing consumers a single location where they can find a wide variety of products and services along with the health information needed to make an informed decision, and (2) by providing healthcare providers (and supply chains) a stage where their offerings can reach a wider audience much more efficiently. In this way, askNivi is an equitable, empowering example of the virtual marketplace model—proven by its predecessors in other markets as both scalable as well as profitable.
Over the coming months we’ll talk more about different ways in which Nivi is solving different problems in the healthcare system through the marketplace concept—stay tuned for exciting updates. If you want to see how Nivi can help you, contact us today.
Driving Sales to Partners in Kenya
Traditionally, individuals obtain healthcare products and services through standard brick and mortar pharmacies, clinics, and hospitals. Often, however, doing so is a costly endeavor—robbing time from necessary roles like employment or caretaking to travel to that location. This inconvenience is perhaps the most impactful reason why the Amazon concept has translated so successfully to healthcare. The formation of online spaces where individuals can find and obtain products and services that directly benefit their physical and mental well-being has changed the public health field forever—making the act of getting care less expensive and more convenient.
With this model in mind, Nivi created its automated chatbot service, askNivi; aiming to expand the reach and impact of the companies, health facilities, and ecommerce providers it works with. As a free, confidential service, it readily and easily forms a reciprocal bond with consumers; growing awareness about important public health issues and all the options and providers available for them, while simultaneously building and maintaining trust.
One recent portrayal of this relationship is Nivi’s drive of sales to its partners in Kenya. For 45 days, Nivi experimented with planting specific information and prompts within its chatbot, askNivi, in an effort to promote Kasha—an e-commerce company selling women’s health, personal care, and beauty products in East Africa. Not only did askNivi inform users about what Kasha is and what it provides, it also began facilitating online orders via phone—encouraging engagement via a 5% discount by consenting to callbacks from Kasha to place their orders. Uncovered in this experiment was an informative, but favorable, paradox.
As expected, the purchasing power of users in Kenya lies primarily in mobile money and cash. However, users outside of Kenya’s most populated city, Nairobi, were, on average, mostly unaware of big ecommerce retailers like Kasha and myDawa (another of Nivi’s Kenyan partners)—despite such large retailers typically offering more choice to consumers than local shops and pharmacies! In short, it’s a glaring gap in the delivery and consumption of healthcare products; a gap as important as it is profitable. When, historically, individuals spend time, money, and energy to obtain basic healthcare, digital offerings are not only profitable, but vital to our public health. It’s a sign that askNivi’s position in Kenya is advantageous to suppliers and consumers, alike—and one poised for growth.
MSD’s HPV Survey in Kenya
HPV remains a serious challenge in low- and middle-income countries—especially those in sub-Saharan Africa—where 90% of cervical cancer deaths take place. Those of us in the global health space are well aware that cervical cancer is almost entirely preventable via (1) mass HPV vaccination in children and young people, and (2) regular screenings for women 21 and older—which is why Nivi has consistently sought to engage in HPV and cervical cancer awareness-building and connect its users to vaccination and screening resources. And this August, Nivi stepped it up by approaching the problem from a new angle, entirely: data on motivation.
In partnership with MSD Sustainable Access Solutions Group within MSD’s global market access team, Nivi released an HPV mini-survey in Kenya in August that assesses several thematic areas:
What do Kenyans know about HPV?
What do Kenyans know about cervical cancer?
How motivated are Kenyans to get themselves or their children vaccinated against HPV?
How motivated are Kenyans to get themselves or their partners screened for HPV and cervical cancer?
To accomplish this, the survey quizzes users on their existing knowledge of HPV, the HPV vaccine, and cervical cancer (especially the causative relationship between HPV and cervical cancer) while building on that knowledge in the process—ending with an assessment of their readiness to pursue relevant health services and connecting them to those services, should they wish it. It’s a triad approach; one that creates awareness of a health issue, introduces the right interventions for said issue, and gathers information that can help inform other organizations’ approach to the very same.
Data is an incredibly valuable resource to actors in the public health space—often making or breaking entire initiatives. But the tools to gather that data are limited, and many rely heavily on boots-on-the-ground, in-person operations. askNivi, in contrast, does not. As a digital health intervention, askNivi is a widely available and easily accessible tool for evaluating a wide array of health knowledge, as well as individuals’ readiness to take action. Moreover: it’s engaging! With around a 90% completion rate, askNivi quizzes are an expedient, efficient, and convenient way to segment a population of users by knowledge level for any given health issue.
The presumption that increased health knowledge translates to increased health action is a reasonable one; yet shockingly, that is not what we learned from this HPV survey in Kenya. Counterintuitively, the survey informed us that—while overall knowledge of HPV and its connection to cervical cancer was low—knowledge level had no impact at all on whether or not users choose to act on an HPV intervention.
Intention to schedule appointment not limited to high knowledge users
We also found that, while lack of resources was perceived as the greatest barrier to getting an HPV vaccine across all ages, genders, and geographic locations, willingness to pay was not an impediment to getting the vaccine, either.
Willingness to pay not linked to intention to schedule appointment
Rather, a steady 30% or so of users were willing to schedule their HPV vaccination appointment immediately, through askNivi—regardless of their perception of barriers or knowledge level. Of that 30%, 30% responded to a follow-up message reporting that they did visit an HPV vaccination provider.
These results are significant on two levels: (1) askNivi is not only proven to efficiently divide users into different groups based on any demographic, it’s also (2) an incredibly convenient, accessible tool to deliver an intervention when convenience and accessibility are the most influential barriers standing between individuals in Kenya and the HPV vaccine. When the biggest hurdle for health ministries, NGOs, and other actors in this space is just getting people to take the vaccine, that’s a huge win. If all they need is a convenient, nearly instantaneous way to learn where to get it and schedule an appointment, then askNivi is the perfect solution. Demonstrating, yet again, that askNivi not only converts health information to knowledge, it bridges the gap between health knowledge and action—the end result being meaningful improvement of health outcomes in any target population.
Thanks for reading. To learn more about what Nivi can do for you, explore below or contact us today!