Health care literacy among Kenya’s lower income population is poor, especially in rural areas. Because of many parents’ inability to access health care or medical advice, maternal and infant mortality rates in these communities is high. Totohealth, a Kenyan innovative application, aims to improve Kenya’s maternal mortality rate by providing information on maternal and child health care through personalized SMS and voice messages to expectant mothers, parents, hospitals, and NGOs. Ayiba’s Joy Mwaniki chatted with the Totohealth team to find out more about its revolutionary social impact.
What’s the goal of Totohealth? How does it work?
Totohealth was founded to help parents monitor danger signs during pregnancy, monitor their health and that of their children from conception to when a child is five years. Starting out, our desire was to help parents detect different disabilities. Now we have expanded our content scope to ensure that a parent is able to monitor a child from pregnancy until they are five years old. We do this by sending very targeted and action-oriented SMSs. Every Monday, a parent receives a message on the health of their child, and every Thursday, they receive a message in relation to their own health and what they need to do within the home to ensure that the child develops well. The beauty of our system is that it’s a two-way helpdesk that allows parents to ask and get accurate responses to questions from a panel of child specialists.
Why did you decide to focus on family planning, something that might be seen as an unusual focus for two men? How did you get the idea for the start-up?
Our founder, Felix Kimaru, was initially with a software development company called MobiDev, and one of the assignments that we were able to undertake was working with an organization called Therapies for Kids which helps in therapies for kids with certain disabilities. We asked the doctor why so many children had disabilities that were detected when it was too late. Most of the parents didn’t know what to look out for, so we set out to help parents detect that. With time, it moved towards assisting parents to monitor the health of their children. We have different content areas, not only on family planning, but also on nutrition, breastfeeding (we promote exclusive breastfeeding for the first six months), and development milestones which cover the main disabilities (spinal bifida, club foot, and the other disabilities that children face).
What are the most common challenges faced by mothers using your services?
It varies. We have parents from across the country, so challenges vary according to where a parent is. For example, two months ago in Kibera, there was a cholera outbreak and we were able to inform the community about that particular outbreak. In Garissa, where we have the SMS service as well as a voice interface, the challenges are more about literacy and hygiene. The different counties represent challenges in themselves.
You’ve been successful at raising funds via crowdsourcing. Why do you think you’ve been so effective?
It all boils down to hard work. As a startup, you have to do so much to accomplish some level of success. We really applied ourselves. The team is passionate and committed to ensuring that whatever we decide to do, we do it as a team. That teamwork has translated into that kind of success, not only with the crowdsourcing platform but also with us at this point in time, being only a year old, and being able to serve more than 15,000 mothers across the country.
What has been your strategy to roll out the program successfully in rural areas?
Partnerships are important. You need to realize that as a startup, you need to find people who you complement, and who complement you. What we are doing is complementing what the national government is trying to achieve. We positioned ourselves in such a way that we help counties manage the child and maternal space, so it becomes very easy for us to come into that. The counties that we are in have seen tremendous success in relation to mothers who are using Toto Health and mothers who are not.
How has the government supported your efforts?
I think we have a very progressive government right now. The president is really keen on seeing startups in the country. We were involved in the Pre-Global Entrepreneurship Summit (GES) and the GES event. Enterprise Kenya also exclusively supports enterprises. We are part of the Ministry of Health Think Tank on health. So, the government is really trying, in partnership with the ICT Authority to really make sure that we develop solutions that we can export to other countries. If there is a time that startups have government support, it’s now.
What challenges has Totohealth faced? What restrictions does the SMS tool have?
Different counties have different disease burdens and infrastructural challenges, so trying to map our services according to the biggest challenges within those particular counties. It is county specific. SMS doesn’t that have many restrictions because we look at mothers within those marginalized communities, and most of the mothers do not have access to smartphones. It therefore becomes very easy for us to use SMS as tools to reach out to those particular mothers because most of them have feature phones. The beauty of it is that even in Nairobi, you would still find that the mothers who use smartphones prefer to get information through SMS. But, we are always on top of things in terms of checking out if there is a need to develop an app for these types of interactions.
What has been the most valuable lesson learned so far?
No matter how good a product is, it is more or less about the people. You need to make sure that you continue to develop a team that is in line with the vision you are trying to achieve as an organization. That is important to us, so we try to develop a co-team that knows what we are doing and is able to do these things on their own.
What are some of the most rewarding moments you’ve had since launching the company?
Last year we were announced as the overall winners for the East Africa Innovation Awards so that was really exciting for us. At the Pre-GES, we were able to present our solution to the president, so that was really cool. We are in the process of launching in Tanzania right now. We have received recognition which is also good, so I think the future for us has really opened up and that is something that we are really excited about.
What role do you think mobile technology has in the development world? In the public health world?
The beauty of mobile technology is that it enables you to take solutions to places that you initially would not have been able to because there was no channel to do that. Look at the success stories, including MPesa, and the successes that we have had within the financial sector, just because of the ability to access services through a mobile phone within the comfort of your own house. As we go forward, it’s all about access to the things that you need at your fingertips. That concept translates into a lot of things, for example, within the health sector, there is now Hello Doctor, where you can get expert advice from the comfort of your own house. The greater the number of solutions on a mobile platform, the easier it is for individuals to access service.
Where do you see Totohealth in the future? Any plans to expand to other countries in East Africa, other than Kenya and Tanzania?
We are vigorously looking into other markets. The idea is to be in as many African countries as we possibly can, but also do that in a sustainable way. We continue to explore new markets and find means that we can be the African champion for child and maternal health. Our vision – no mother should die giving life and all children should live to celebrate their fifth birthday.