The Council is conducting research to identify factors that improve access to family planning via Nivi, a digital marketplace that enables individuals to receive personalized recommendations and referrals for family planning, as well as rate their experiences.
Meeting the unmet global need for contraceptives would prevent more than two-thirds of maternal deaths and two-thirds of unintended pregnancies, while also advancing women's empowerment and well-being. But among the people who would benefit most from family planning, particularly young people, usage remains too low and high rates of discontinuation suggest dissatisfaction with the services that are received.
Studies show that women and girls worldwide often lack easy and confidential access to contraceptive information and services, even where local providers and products are available. Challenges include distance, convenience, stigma, taboos on sexuality discussion and women's fear that caregivers will humiliate or criticize them or not respect their privacy. Recent research also highlights the need to improve quality of care and increase consumer knowledge of contraceptive methods.
Such challenges and others have held down family planning use in many areas – the Family Planning 2020 goal of expanding services to an additional 120 million women and girls by 2020 is off pace – and innovative scaled solutions are needed to accelerate progress.
The use of digital technologies has untapped potential to accelerate the scale up of family planning services much more quickly than traditional strategies alone. With its partners in 2015, Population Council created an early proof of concept in Kenya, originally called mPango and later renamed Nivi, to demonstrate that consumers can learn about various family planning options and make informed choices through a personalized recommendation and referral engine.
The Nivi platform delivers its results through SMS and interactive voice response services via any basic feature phone. It interacts with callers in a friendly tone, asks about fertility preferences and contraceptive history, and then sends each caller personalized recommendations for up to three contraceptives and three nearby providers. Users can thereby learn privately about available contraceptive options to make cost-effective and informed choices. In addition to contraceptive recommendations and referrals, Nivi lets clients rate the quality of their experience and can reimburse facilities on behalf of subsidized clients.
Meanwhile, health providers also have a steady source of referrals and can also stay better connected to their customers and understand their behaviors and needs through use of a Short Message Service that overcomes geographic limits.
Through a pilot in the Webuye region of Bungoma County in rural Kenya, the Council tested whether the availability of a low-cost, automated voice phone system might allow women and girls to interact privately with family planning providers at their convenience and learn about and choose services and products without risking public observation or stigma.
Following its initial success, Nivi, Inc. was officially incorporated in 2016 with a social mission to improve access to reproductive health services for women and men in need, and is now being scaled up across Kenya as the first digital consumer-facing contraceptives screening and provider referral engine in East Africa.
As a pilot, Nivi successfully demonstrated that a well-designed client digital platform can screen, refer, and follow up with clients interested in contraceptives. During the nine-month pilot, Nivi platform achieved:
- More than 8,700 unique callers, including 1,500 callers who were able to use the product through basic-feature phones at the same level of efficacy as a smartphone or web browser;
- More than 1,500 callers empowered with personalized contraceptive information and suggestions prior to seeking any provider intervention;
- More than 1,500 callers referred to local providers for a recommended set of family planning options;
- Real time access to anonymized data about family planning uptake, including user demographics, user location, family planning methods used; and
- Templates for automated suggestions to healthcare providers on their family planning service quality.
Currently, the Population Council is conducting research on public health and programmatic outcomes associated with the operation of Nivi in Kenya.