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A series of blog posts highlighting an important topic or trend in the development through enterprise community. In the most recent Big Idea series, NextBillion partnered with Ashoka to showcase affordable housing innovations.

Thursday, December 27, 2012

The Best of 2012: Using Mobile to Reach Scale

By Josh Cleveland

A Living Goods Community Health Promoter records a client visit.

 

Editor's Note: As we wrap up 2012, NextBillion is republishing some of the most-read and most commented-articles of the year. These posts illuminated new modes of thinking and new practices for improving low-income peoples' lives through market-based solutions. This post was originally published on August 30. 

 

This is one in a series of Big Idea articles that examines how businesses are using mobile applications to develop and serve base of the pyramid markets and customers. This is the first of two articles focused on Living Goods' SMS program. Part two can be found here   

The number of mobile-connected devices will exceed the world’s human population in 2012. With those SIM cards, cheap Nokias, and ubiquitous top-up kiosks come myriad possibilities for enhanced services catering to the world’s base of the pyramid populations.

Yet despite the explosion of tools and applications, few organizations have taken mobile deep into the heart of their operations to drive sustainability, scale, and impact. While social enterprises can adopt one tool with relative ease –M-PESA for example – integrating mobile platforms into core operations requires a significant investment of energy. For Living Goods, the Avon ladies of life-changing products for base of the pyramid consumers, the hard work and constant iteration to get such a platform in place is paying off.

Kampala, Uganda

In the minutes it takes Armando Huerta, Living Goods’ East Africa Business Officer to explain the origins of Living Goods’ SMS program, over 30 text messages had been sent to Living Goods clients. All of these messages were automated. Each one carried text custom tailored to different client segments, geographies, and health needs. The automated texts provide a plethora of information including drug adherence reminders, stage-appropriate health education for pregnant women, age-appropriate child development information for newborn children, agent performance feedback, product promotions, agent performance tracking, clinic referral reminders, and client follow-up reminders.

The messages go both ways: using simple SMS codes, Community Health Promoters (CHPs) submit data on treatments and field visits to Living Goods headquarters. Living Goods’ cloud-based platform then delivers both CHPs and clients targeted text messages to improve treatment adherence, improve follow-up, and promote health behavior change.

Approximately 21,000 households are currently registered to receive SMS messages from Living Goods.  With an average household size in Uganda, where Living Goods operates, of five people, Living Goods is already reaching over 100,000 clients in the first three months since the platform launched. On the one day I visited Living Goods’ Kampala office, by mid-morning tea time over 320 expecting or recent mothers had already received an SMS about proper healthcare practices from Living Goods.

The platform

At the core of the platform is a proprietary system based on Rapid SMS. The data resides in the cloud. While Armando analyzes trends in malaria treatment in Kampala, Living Goods staff in San Francisco can pull real-time impact reports and product updates seamlessly. Living Goods pays for every message sent by CHPs and received by clients. It sounds pricey but the costs are quite reasonable for a social enterprise on its way to reaching scale. And from what I saw in Kampala, the investment has paid for itself already.

Improved service quality

With the right messages going out at precisely the right time - and monitored centrally from the cloud-based platform - clients receive the most accurate, relevant information to help them make healthy choices. 

Each messaging cascade for Living Goods’ main targets (the biggest killers of children under five: malaria, diarrhea, and pneumonia) includes messages about treatment, referral, and prevention. For example, once a CHP sends the SMS to record they treated a client’s three-year old child for malaria, the client receives reminders to take and finish the medication:

-     [Treatment registered] Smart choice! You saved your child’s life by treating your child’s malaria right away.

-     [Treatment +8 hours] One pill does not kill malaria!  Remember to give the full course of treatment.

-     [Treatment +24 hours] You child may feel better but you have not killed all the malaria. Give the full course of treatment: 2 times a day for 3 days.

-     [Treatment +48 hours] Today is the last day for your child’s malaria treatment! If your child’s fever is not going take the child to a health center today.

In addition, these at-risk clients receive reminders about preventing malaria from recurring altogether linked to the bed net product CHPs sell:

-        [Treatment +7days] Here come the mosquitoes! Don’t let your child get sick with malaria again! Sleep under an insecticide treated bed net every night!

Improved operational efficiency and better data

Going paperless – a long-term goal of the SMS endeavor – will save both CHPs and branch managers significant time while enabling timely, data-driven decision making by management.

Living Goods CHPs currently log all patient visits, sales, follow up, and referrals on paper forms. These sales agents then transfer this data to Branch Managers at training meetings at the beginning of every month. Living Goods’ management then waits until the 15th of the following month to get last month’s data.  Now, the mobile platform gives Living Goods access to real-time, high-quality data on trends in diagnosis, treatment, product sales, branch product stocks, branch activity, and CHP activity.  All can be cut and sliced readily in any number of ways.  Branch managers and Living Goods management can now identify leading and lagging CHPs in real-time to address potential problems and ensure that CHPs perform in line with their monthly targets.

(Pictured left: A CHP sends an SMS).

Beyond the improvements in daily data collection, the SMS platform will allow Living Goods to gather better pilot data. The company constantly tests the viability of new products and promotions with subsets of clients and CHPs. Pilot data – like client transactions – has traditionally been confined to written reports. The ability to easily target specific client and CHP subsets with test messaging sent via SMS provides dramatically expanded opportunities for A/B testing of messages, products, and promotional approaches.

Increased impact and sales

Interviews with CHPs and their clients demonstrated the value provided through the Living Goods SMS service. Targeted information and helpful reminders increase the impact of each sale to a Living Goods client while building stronger customer relationships that drive more treatments and sales. Increased sales translate into more consumers at the base of the pyramid in East Africa who benefit from the life-saving products that Living Goods sells. And the women of Living Goods benefit from bigger profits to help them lift themselves and their family out of poverty.

Challenges

Despite the aforementioned leaps in service quality, operational efficiency, and data collection, the platform was not ‘plug-and-play.’ The average age of a Living Goods CHP is over 40 years old. More than 60 percent of these sales ladies had never used SMS just three months ago. Sending thousands of typical SMS messages could be prohibitively expensive for a social enterprise like Living Goods. Mobile networks in Uganda go down constantly. So does the electrical grid. It’s hard to send SMS messages when you have nowhere to charge your phone.

The organization continues to make strides in spite of these odds. In the first three months after the platform’s launch, Living Goods has already reached 50 percent user adoption. Through ongoing training, mentoring, and clever incentive programs Living Goods plans to achieve universal and routine usage of this powerful platform. Stay tuned for a follow up article in the coming days on how.

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