Paving the way for a bustling health marketplace

For centuries, marketplaces have been synonymous with efficient, productive, and optimal exchange of goods and services. They have served as bustling, convenient spaces where producers showcase and sell their wares, and consumers compare and choose products best suited to their needs, budgets, and preferences.

Recent technological advancements and the unique challenges that countries, economies, and societies faced in the last few years have altered the way marketplaces operate. Most marketplaces today have gone digital, providing producers and consumers with an anonymous, convenient, reliable, and cost-effective experience. But what about the health marketplace?

Inadequate harnessing of digital opportunities

The digital tools and channels available today have the potential to also revolutionize how prospective consumers are reached with life-enhancing health products and services. However, the new possibilities that digital technologies have opened up have not been as effectively leveraged as other sectors to link consumers with the sellers of health products and services. This represents a missed opportunity, especially for a market category like sexual and reproductive health (SRH), where the discreetness and anonymity of purchase that digital offers are highly valued by consumers.

There are multiple reasons for this gap. One, whether due to policy regulations or the unwillingness of key healthcare players to be available on one platform, consumers have to spend more time researching what they need and find out where they can get it. Critically, consumers also lack the information and support necessary to make informed decisions about what is appropriate for them. Health product distributors and service providers are compelled, due to limited budgets, regulatory constraints, or target audience familiarity, to depend on traditional advertising and word of mouth to reach more consumers and expand their reach.

Sub-optimal health marketplaces negatively impact producers and consumers, ultimately leading to poor population-level health outcomes. This hits underserved communities in low- and middle-income countries (LMICs), where good-quality healthcare and products are typically more challenging to access, and sociocultural barriers to uptake far more prominent. In the absence of a bustling health marketplace, nearly all aspects of healthcare are defined by individuals’ social, financial, and geographical realities.

Fixing the broken connection with partnership and innovation

Given the transformative impact access to SRH information and products/services has on women’s health and well-being and that of their families and communities, it represents an area where urgent action is needed to augment reach and address need. This is a broken connection that digital can help fix. The Women’s Health and Livelihoods Alliance (WOHLA) initiative is working to make that happen and to create a thriving marketplace for SRH products and services in India. The wide array of partners that are part of the WOHLA alliance are working
together to revolutionize how women access SRH information, products, and services.

One of WOHLA’s multi-sector partners is Nivi, a digital health company that works to empower individuals with the right information, tools, and resources to make informed decisions about their health and connect them to local products and services. Nivi collaborates with health system actors like health promoters, payors, service and product providers, and manufacturers to create interventions that target, reach, and engage health consumers for different health domains and therapeutic areas, especially women’s health and wellness. Continued connection with these health consumers across their life course/journey (a continuum-of-care approach) and diverse health needs enables Nivi’s partners to understand consumer behaviors and barriers, design and validate tailored solutions, and drive behavior change while promoting accessible and preventative care.

As part of the WOHLA initiative, Nivi is running awareness campaigns on digital media channels to spread information about SRH to young women (19–29 years) starting from five states (Delhi NCR, Maharashtra, Karnataka, Assam, Meghalaya). Through these awareness campaigns, Nivi onboards and engages individuals on its artificial intelligence (AI) powered chatbot—askNivi—where they initiate engagement around the contraceptive use journey. The askNivi contraceptive journey is crafted using a human-centered design (HCD) approach
grounded in behavioral science principles. AI is used to identify an individual’s stage of behavior change and mindset and tailor content accordingly. To reach the broadest possible audience in India, askNivi is accessible in five languages (Hindi, English, Kannada, Marathi, and Assamese).

In addition to onboarding prospective consumers and raising awareness about the basket of choices available to them, askNivi also connects them to the healthcare system. To make this connection possible, Nivi is also onboarding healthcare providers (chemists, clinics, hospitals) to the askNivi conversational marketplace in the five states. As details and geo-tags for providers in the rest of the states become available, Nivi will on-board them as well. For users that go
through the contraceptive journey and are primed for action, askNivi gives a personalized referral to three nearby facilities that provide contraceptive products and services. Through coaching and nudges based on behavioral science principles, askNivi motivates users to take action, including visits to healthcare providers and continued consideration of contraceptive options post-visit.

The askNivi contraceptive journey provides visibility into the consumers’ thought process, their readiness to act, their provider experience (e.g., method-mix availability, facility counseling, and consumer satisfaction) and their post-visit FP journey. The anonymized data and insights are critical in strengthening the healthcare marketplace in these target geographies.

With WOHLA, Nivi aims to reach 20 million individuals and engage 200,000 across five states (24 districts) in nine months by running creative, sensitive, and target-group-focused content. As of May 2024, these ads have garnered 24.4 million impressions, reaching 6.25 million unique people. Over 70 percent of those engaging on the chatbot are women in the 19–29 years age group. More than 2,000 providers are on-boarded on the chatbot for location specific referrals
for products and services.

Lessons to shape and strengthen digital health marketplaces

Nivi’s experience of connecting young women with contraceptive information provides valuable insights for other initiatives and organizations operating within the contraceptive awareness and advocacy landscape. Here are a few key takeaways that can help enhance their program efficacy:

• Transparent and direct communication: To effectively navigate social stigmas surrounding SRH, messaging must be unambiguous and relevant when addressing contraceptive topics. Ensure that digital health platforms are user-friendly, accessible, and tailored to the needs of diverse user groups. This includes designing intuitive interfaces and providing multilingual support.
• Addressing knowledge gaps: It is essential to acknowledge that many users lack foundational knowledge about contraceptive products and services. askNivi is deliberately designed to fill the knowledge gap for those who need more information.
• Sustained user re-engagement: Behavior change is often not immediate. Developing strategies for re-engaging users based on their stage of behavior change and addressing motivation to overcome specific barriers to contraceptive method adoption is paramount. Making the chatbot available 24/7 to provide support whenever users need it, ensures that users can access information and assistance at their convenience.
• Differentiated content strategy: Developing content that caters to distinct user needs is crucial. Younger demographic groups may prioritize information on inexpensive short-term methods conveniently available over the counter, while older women may be more receptive to learning about long-acting reversible contraceptives (LARCs).
• Interactive storytelling techniques: Utilizing engaging digital formats such as carousels or other interactive storytelling methods can significantly enhance user interest and maintain sustained engagement.
• Cultivating trustworthy provider relationships: As much as Nivi targets consumers, it also regularly expands its provider network. Building trust with healthcare providers is time-intensive. Organizations should anticipate that multiple interactions may be necessary to successfully onboard a healthcare professional, such as a physician or pharmacist.

Navigating the SRH space to provide correct, supportive, and engaging information and motivation to act is a tough and sensitive task. However, as Nivi’s work with WOHLA has demonstrated, the use of digital technologies with a well-thought-out, structured end-to-end approach can make it possible to create new markets where girls, women, and their partners are empowered to make the right decisions.