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Healthy message - The start-up that dispenses well-being advice via text

Phone application Mobile afya seeks to bridge the digital divide in health awareness in Tanzania. The internet is not necessary to access the app’s government-approved advice on topics such as sexual health, family planning, first aid and nutrition written in Swahili by Mobile afya's team of medical professionals. Launched in October last year to be accessible and affordable to all, the app has the potential to change and even save many lives. Founder Mariatheresa Samson Kadushi talks to Paa, revealing how the idea for the start-up was born, the medical and tech expertise involved and plans to expand the app’s reach across East Africa

Mariatheresa Samson Kadushi describes the beginnings of Mobile afya as an “accidental innovation” that came to her while working with homeless children on the streets of Singida, in central Tanzania, for her charitable association Kids of Africa…

“M-afya was established as a result of a mere curiosity. In late 2015 I was in Singida where I noticed a high number of homeless children living in poverty. I decided to start a case study to investigate what was causing such large numbers of street children in the region and found the main reason was unplanned pregnancies. Many young parents were having more children than they were able to take care of. The average number of children per household was six. This factor exposed the underlying problem – a lack of sexual and reproductive health information and education, including family planning.

“From there we started the process to develop an easily accessible solution that provides sexual and productive health information to women in rural and semi- urban areas. Building a dedicated team, we expanded to include more general health information and Mobile afya was born.”

The Mobile afya team has grown to include leading experts in the fields of medicine, health and technology…

“In 2017, I along with co-founder Dr Hilderruth Allan Shoo, who is a medical doctor and public health specialist, started to build Mobile afya. As the start-up took shape in 2019, Farah Rida, Ina Sclie and Anja Witte joined forces with us to bring resources, new skills and knowledge that was lacking in the team.

“Now we have 12 health professionals – including medical doctors, clinical officers, public health specialists and medical students – out of a team of 21 members.”

User-friendly

The app has been designed for all - Images: M-Afya

The team creates the app’s health advice content from scratch and it all goes through a rigorous reviewing process…

“The team develops content from their knowledge then it gets reviewed by different stakeholders and our advisors. Lastly content has to go to the Government’s Ministry of Health, Community Development, Gender, Elderly & Children to get reviewed and approved. Once all this is completed, we can upload content to the app and start disseminating.”

Images: M-Afya

It costs just 3,000 TZS for an annual subscription to Mobile afya, which allows the user to access the regularly updated database of information as many times as they want over the year…

“After paying the annual subscription there’s no additional costs or limits. We are constantly improving Mobile afya and collecting feedback from our users on information that they want to see on the app and the topics are updated on a monthly basis. We have an impact evaluation research underway to measure knowledge improvement and the impact that the app is having on its users. For the future we are exploring possibilities of expanding to voice messages, WhatsApp chat bot and smart apps as well.”

With the app aimed at a mostly rural or semi-urban population with limited familiarity with technology, it was crucial to make it as user-friendly as possible…

“The importance of making Mobile afya user-friendly has been a crucial part of its development since the study in Singida. All our work has been grounded by human-centred design (HCD) methodologies with five stages –empathy, ideate, define, prototype and test. I was lucky to be mentored by a professor who is anexpert in HCD, which helped a lot.

Images: M-Afya

The only way to fight misinformation is to counter it with correct and accurate information

Leaders

Mariatheresa Samson Kadushi - Images: M-Afya

Leaders

Dr Hilderruth Allan Shoo - Images: M-Afya

In many communities, healthawareness is hampered as much bymisinformation as lack of informationwith traditional healers andsuperstitions holding sway…

“This is the case not only in remoteareas. Misinformation is a big problemthat we have come across in most ofthe communities we have interactedwith during our research phase. The only way to fight misinformation is to counter it with correct and accurate information. We believe Mobile afya serves this goal by making sure that correct information is widely spread and is easily accessible by local communities through their mobile phones. People who encounter misinformation will now have a point of references to oppose it and educate others as well.”

Mobile afya was made available to the public in October 2020 and already has more than 1,000 Tanzanian users and there are plans in place to expand into neighbouring countries…

“For Dr. Hilderruth and I, Tanzania is our home country hence the best place for us to pour our knowledge and passion into. Kenya and Rwanda are our next destinations. We are looking to start expanding in the third quarter of 2021.”

Outreach

Spreading the message - Images: M-Afya

It has taken more than three years to get Mobile afya off the ground and it has become something of an obsession for Kadushi…

“It has taken over my life. Before starting to work full time for Mobile afya in 2019 I was balancing building it with my day job [as chief operations officer of Dar es Salaam start-up ecosystem Safe Space Group] so it was a lot to manage. The experience of building Mobile afya has been the most challenging task I have embarked in my career but also the most important work of my life. Strong will, consistency and persistence have carried me through the moments of exhaustion and many frustrations of building a start-up throughout the years. I believe that I am part of the team that will transform public health as we know it by capitalising on the impact of mobile technology for health inclusion.”

Initial funding came from family, friends and the team members’ own savings, but the rising profile of Mobile afya has attracted the interest of international investors…

In late 2018, a Hamburg-based company Freiheit.com gave their Christmas donation to our work so that we can prototype and test the app. In late 2019 and early 2020 we secured our pre-seed funding from two European female investors who believed in the potential of our work. We are hoping with the new funding this year we will be able to venture out more to different regions and rural areas to spread the word on the app and reveal its benefits.

“In February we will be launching our second round of fundraising to accelerate our impact and expand our reach in Tanzania and beyond. We are looking for investors and partners from all over the world who are interested in digital health, mobile technologies and mobile apps.”

Instant advice

A member of the M-Afya outreach team shows off the app - Images: M-Afya

Covid-19 may have made everyone more aware of their health, but launching Mobile afya in the wake of the pandemic brought challenges…

At the moment the role of educating and disseminating Covid-19 information is managed by the

ministry so we do not offer any expert advice on the disease.

“Covid-19 slowed down every aspect of our work. It took longer to finalise legal and regulatory processes that we had to comply with. Also during the pandemic, we had to close our offices for some time and work from home. It brought a new challenging reality that we had to adjust to.

Mobile afya may be the project she’s in charge of currently, but Kadushi says she has always been a leader…

“I spent the first eight years of my life living in the Udzungwa Mountains where my father was working as an engineer at the Kidatu Hydro Power Plant. Being a first born in a family of six girls, three of them being triplets, I had a lot of responsibilities from a very young age. My first ever lessons on leadership and organising were learnt at home. I grew up loving to step up and to do things that seemed hard. I took on my first role leading a kids’ church group when I was nine, later I was a choir master and went to my first conference alone when I was 10. In character, I’m still the little girl I was but now leading a start-up and impacting lives through the work that I do.

Apart from work I love travelling, spending quiet time in mountains and listening to audiobooks and podcasts.”

Health help

Mobile afya offers advice on the symptoms, treatment and preventive measures for a wide range of health conditions and diseases. Among them are:

• Non-communicable diseases such as diabetes, cancers, sickle cell and heart conditions.

• HIV and AIDS

• Food and nutrition (for the general public and for people in special groups such as pregnant women or those who live with chronic diseases)

• Sexual and reproductive health including adolescent health

• First aid

‘I want my family to subscribe’

“During my pregnancy clinic visits I was told I had gestational diabetes, this was a shock to me and my family since we have never heard of gestational diabetes. Little was told to me about the condition at the healthcare facility where I went. Through Mobile afya I was able to learn more about the condition. I would also like for my family to be subscribed to the service so that they can also get information and learn about different diseases and health conditions.

Testimonial from a 35-year-old woman in Mbezi, Dar es Salaam

Images: M-Afya

Easy to use

When a Mobile afya user dials *147*47# they get a menu with a list of health conditions topics and they choose the number of the one most relevant to them. This prompts options – for example symptoms or treatments for the chosen condition – and the user will receive texts with the information requested. For a video demonstration of how the app works, scan the QR code on the right or go to qrs.ly/lycbrxx

Images: M-Afya

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