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The Bitness Project

The Bitness Project is a creative DIY toolkit for women and girls to learn about their intimate health.

Photo of Teresa Almeida
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Tell us about your vision for this project: Share one sentence about the impact you would like to see from this project in five years

By 2023, we aim to 1) bring our Textile Toolkit/local health directory combo to all ten islands of the Cape Verde archipelago, reaching over 50% of the country’s population (youth under 24); 2) begin testing in other Portuguese-speaking African countries; 3) launch an Augmented Reality app to accompany the toolkit and reach a global audience; 4) create a first functioning prototype to transform the toolkit into a remote diagnostics tool with wearable sensors.

Who will implement this idea? Or what’s your strategy to implement in the next 6-18 months?

• Implementation:Bitness team members Teresa (created toolkit; experience in e-textiles, design, woman/centered research); Veronika (experience in startups, app design/development, digital healthcare) with help of contractors and local partnerships • Production (toolkit): based on feedback received in Cape Verde. • Toolkit pilot: Led through partnership with local organizations Womenizeit, SelfCare, CVTelecom • Digital component (Local health professionals resource site: up & running, AR app to accompany toolkit-first prototype): design/development by Bitness and 1PT developer (track record of working with Veronika at another startup).

How has your idea changed based on feedback?

The original Toolkit idea has evolved based on feedback from participants in workshops, data analysis, continuing presentations in multiple contexts. OpenIDEO’s feedback really pushed us to think about the specific logistics: choosing site, local partnerships, as well as scaling the project both on the ground and digitally. During the short period of refinement we took a giant leap from academic research to figuring out the steps and timeframe for bringing the project into a real world setting.

Using a human-centered design approach, you may uncover insights that lead to small or foundational changes to your organization’s existing strategy or processes in order to unlock the potential of your idea. How would your organization go about making such changes?

HCD forms the backbone of this idea from the very beginning, and feedback from potential users has been critical in shaping it over time. Operating in the framework of “how the solution can help” rather than “what it is/ how polished it looks” moved the project forward; that HCD approach applies not only when listening to users and iterating accordingly, but also on how we interact as a team between ourselves, who owns which parts, which collaborators and partners we chose, how we set our goals.

How long have you been working on the project?

1

What year was your organization or group started?

2017

How many full time staff are needed to implement your idea?

6

What most attracted you to the UNFPA Young People's Sexual and Reproductive Health Challenge?

Bitness was founded on passion for humanistic approaches to designing technologies that support socio-cultural change and break taboos; with a focus on empowering women and girls, a commitment that aligns with UNFPA’s mission. The opportunity to work with UNFPA’s support and recognition at such an early stage is pivotal to help creating solid and meaningful relationships within countries where limited SRH education and rights continue to impact girls and women’s lives deeply.

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Opportunity Areas – Select those that apply

  • mHealth
  • Last Mile Sexual and Reproductive Health Commodities
  • Data

What specific problem(s) are you trying to address? (300 character limit)

Education and preventative care in pelvic awareness: The pelvic floor in women is crucial for SRHR, as it impacts sexuality and reproduction. Knowledge of the pelvic floor among women and girls is limited, and for the most part only heard about briefly during pregnancy or after childbirth.

What are some of your unanswered questions about the problem(s) you are working to address? (500 character limit)

Designing for societal challenges: Limited understanding of the body and lack of access to intimate health information perpetuate stigma and taboo, misinformation, and continued practices that are harmful to women and girls. Learning devices: The lack of education and the limited educational resources and its contents impact women and girls’ health across the lifecourse. My goal is to find solutions that can include novel approaches/designs that promote sociocultural change.

Who are your end users? (1000 character limit)

The main target are women and girls aged 10+, young people whose resources and access to information are limited. The toolkit will also be a valuable aid for health and community workers, community centers, and NGOs.

Explain your idea. (500 character limit)

The Bitness Project includes a series of tools that uses interactive imagery and a do-it-yourself piece of underwear. This pattern (DIY underwear) is the main educational tool: topics of intimate health and care can be unravelled as it is hand-sewn/assembled; situated on the body to reflect directly on bodily issues. Girls get a – sometime much needed - extra piece of underwear. Further along, the Bitness Project aims to integrate a mobile app to augment the underwear textiles.

What is your value proposition? (500 character limit)

The project proposes a personal and intimate tool (DIY underwear) that aims to transform the way pelvic fitness is assimilated into a healthy lifestyle and in a timely fashion; importantly, prior to e.g. pregnancy or incontinence. It is both a catalyst for conversation/information, e.g can be passed from mother to daughter/ between friends/health workers in community centers/schools. The toolkit is a playful product that promotes learning in a fun and self-caring way.

What's different about your idea compared to current solutions? (500 character limit)

A creative toolkit has previously been deployed in a series of hands-on research workshops about pelvic fitness in women and girls (research attached). It explored innovative approaches in smart textiles as material for health and wellbeing; possibilities for wearables to encourage healthier lifestyles. Here, I continue pushing forward these innovative approaches. To my knowledge, there are no similar initiatives or solutions at the moment.

What are the key reasons why end users would turn to your organization over another?

  • Newness: Satisfying a new set of needs

What would success look like for your end users? (500 character limit)

Long-term, the outcome of this project can have a significant impact on lives, trusting that bodily education with an emphasis on SRHR is fundamental and has the potential to, e.g, increase women’s chances of pursuing school and breaking out of poverty, therefore making progress towards gender equality.

How would you measure the impact your idea has on your end user(s) ? How will you measure the success of your program? (500 character limit)

This solution will help educate and empower women and girls in a wide variety of contexts worldwide to learn more about SRHR and take better care of their pelvic health. Quantitative approaches to use and distribution can include surveys, more in-depth measures to include field data.

What strategies will/are you testing to acquire end users? (300 character limit)

Research network and online/offline product PR. Personal research network to reach out to health workers and community leaders in varied countries (Global South); pilots with local refugee community (Sweden).

Key partnerships - Who will you partner with to make your idea work? (500 character limit)

I am in search of an underwear designer/service interested in women’s health and care, for example, menstrual health management (MHM), who would be interested in collaborating with this project.

What is your organization’s name? (150 character limit)

Bitness

Organizational Characteristics

  • Women-led organization

Where will your idea be implemented? (200 character limit)

Starting in Sweden, where I will be based from January 2018 on. Product to quickly reach the Global South via personal network of research, e.g countries to include: Egypt, Cape Verde, India.

What do you need to get started? (500 character limit)

Human and financial resources.

What is the current scale of your proposed innovation?

  • Community - one or a few communities within one country

Experience in Implementation Country(ies)

  • Yes, for more than one year.

Expertise in Sector

  • I've worked in a sector related to my idea for more than a year.

Organization Location (200 character limit)

Bitness is registered in the UK. Team/existing collaborators: Sweden, Portugal, New York, USA.

What is your organizational status?

  • We are a registered for-profit company (including social enterprises).

What is the maturity of your innovation?

  • Existing Prototype or Pilot: I have tested a part of my solution with users and am iterating.

Website

Bitness: http://www.bitness.care Original toolkit (documentation): http://www.banhomaria.net/intimatecare/DesignKit/index.html
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Attachments (6)

TheBitnessProject_UserExperienceMap.pdf

[REFINEMENT][UPDATE] Three accounts oriented toward the context of use we envision in Cape Verde.

TheBitnessProject_FeedbackinCapeVerde.pdf

[REFINEMENT][UPDATE] Feedback gathered during interventions in Cape Verde, November 2017.

TheBitnessProject_Prototyping.pdf

[REFINEMENT][UPDATE] Initial developments in conceptualizing the next stage in prototyping.

TheBitnessProject_Story_2013Now.pdf

[REFINEMENT][UPDATE] An account of how and why The Bitness Project came to be.

ExploringEtextilesWIP_TeresaAlmeida.pdf

This work-in-progress paper introduced the creative toolkit and explored the potential of eTextiles as catalysts for conversations around pelvic fitness and intimate health in girls.

PhDThesis_TeresaAlmeida_Chapter6.pdf

This is a PhD chapter in which I discuss an early creative toolkit for exploring female pelvic fitness. The toolkit was deployed in a series of workshops with women and girls, age ranging from 15 to 63.

4 comments

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Team

Hi Teresa and Team,

We’re excited to share feedback and questions with you from a set of experts that are supporting this Challenge.

We encourage you to think about this feedback as you continue to improve your idea, whether that’s refining it or adding more context. You are welcome to respond in the comments section and/or to incorporate feedback into the text of your idea. Your idea and all associated comments will all be reviewed during the final review process, but we recommend putting all critical information in the body of your contribution somewhere. It's ok if you don't have all the answers, we know you are tackling really hard problems and are also interested in how you are thinking about these challenges.

Experts were excited about:
It is a novel application of digital textiles and a great way to increase awareness and have conversations around sexual and reproductive health.

Questions experts had:
1) A question that came up multiple times was, “This idea meets an existing need for information, but does not make a link to broader SRH information and services needed for sustainable impact on SRH outcomes.” How might you link your idea more directly to sexual and reproductive education or services?
2) Is the education aspect only focused on pelvic awareness or are you looking at comprehensive sexual health education? How might you measure success?
3) How will you link to scalable programs or platforms in order to grow impact and sustainability of work?
4) Do you have evidence that others be willing or excited to use it?
5) Can you provide more details and context in how this idea will be implemented in the different areas mentioned?

In case you missed it, check out this Storytelling Toolkit (ideo.to/OZznV4) for inspiration on crafting strong and compelling stories. Storytelling is an incredibly useful tool to articulate an idea and make it come to life for those reading it. Don’t forget - the last day to make changes to your contribution on the OpenIDEO platform is December 10 at 5:00PM PST.

Have questions? Email us at youthsrh@ideo.org

We look forward to reading more, and thank you for the important work that you are doing!

Photo of Teresa Almeida
Team

Dear OpenIDEO team,

Thank you for your thoughtful feedback and comments. This project aims to bring to life an existing academic study on the use of digital textiles to promote awareness and spark conversations around SRH. We are extremely excited to be working at refinement stage of this call.

Several key developments happened since the Idea Phase of the challenge:

1) In November, the team leader (Teresa Almeida) was invited to attend and present at the Women’s Summit in Cape Verde, Africa. While there, she not only gave talks about the Bitness project at the Women’s Summit and the University of Cape Verde, but also made valuable connections to local activists, journalists, policy makers, entrepreneurs, and health professionals involved in tacking different SRH problems. These encounters led to finding collaborators and partners and brainstorming about using the ten islands that form the Cape Verde archipelago as the initial test site for The Bitness Project toolkit. During the visit Teresa also discovered that the Portuguese speaking regions in Africa tend to be overlooked in terms of developing innovative educational solutions due to language barriers. Her native fluency in Portuguese will give her a necessary advantage when interacting with local communities on the ground and makes Cape Verde a natural first test site.

2) The team brainstormed around the idea of having a “3 point solution” for SRH education comprised out of the 3 interconnected elements a) Digital Textiles toolkit b) Directory for local Health professionals c) Digital solution to supplement the toolkit. The details are incorporated into the answers below.

Responses to your questions and concerns 1 through 5 (1/2):

Q1. The Bitness Project aims to introduce a comprehensive set of resources regarding SRH, including information regarding intimate anatomy, which has been identified as critical to girls and women’s reproductive health and sexual wellbeing. We are proposing a "3 point solution” for SRH education that will allow for both utilization of modern digital tools and hands on personalized learning and interactions using the Bitness textiles toolkit.

Part 1: How does my body work: A) Digital Textiles Toolkit Shortage of resources and access to health providers early on and throughout one’s lifetime can have a significant impact on girls and women’s perspectives of their sexual and reproductive health. The toolkit is a fun, interactive game-like hands-on experience. It will not only be a learning experience but will also help foster the conversation about the “hidden” parts of the body, what is often a taboo subject in many cultures. The initial pilot site for the project will be the Cape Verde archipelago, and will be done through a partnership will local health professionals, community centers and entrepreneurs. The following companies in Cape Verde already expressed interest in partnering with Bitness: networking platform Womeniseit, healthcare platform SelfCare, telecommunications service provider CVTelecom. As we continue our pilot on the archipelago we are planning to attract many others, especially in the education and healthcare sectors. B) At the same time, we will also begin initial prototyping of an Augmented Reality iOS app that we envision will supplement the digital textiles toolkit in delivering a more accurate visualization tool for educators. Since the app will be freely available at the App Store, it will facilitate the expansion of the Toolkit/App combo worldwide.

Part 2: Where can I get help: Creating a location-based online resource directory to accompany the kit—so people can contact health care professionals even after the workshop is completed. The online resource will be developed concurrently with the pilot, so the information will be naturally added for each pilot site as we move along. In turn, the health care and SRH educational services listed can use our Toolkit/App as a visual aid in their own practice. Developing those reciprocal relationships will be very useful once we move to Part 3 of our project.

Part 3: Textile tool as sensor: Basic self-monitoring. Following the successful implementation and adoption of Parts 1 and 2 of our project, we plan to transform the toolkit into both educational and diagnostic tool by including wearable sensors that will collect data, and thus possibly use it as a tool for remote patient monitoring.

Q2A. The Bitness Project aims to tackle SRH education in its diverse components. The project starts as a platform for pelvic health education but down the road it will expand into other areas. Pelvic awareness is a natural starting point since the foundation for this project is a comprehensive academic study in which Teresa spearheaded an investigation into pelvic fitness in young women. At the time, the goal was to understand how pelvic awareness could contribute to continence care and prevention (published research attached).

Photo of Teresa Almeida
Team

Responses (2/2):

However, through deployment of the original toolkit in multiple workshop settings (with women and girls aged 15-52, at the time living in the UK, and representing a multitude of backgrounds), we understood that practical knowledge of the body, when directly associated with reproductive health and sexual health education, was missing, and misconceptions about different body parts were plentiful. Links to published research:
https://dl.acm.org/citation.cfm?id=2858187&CFID=776684051&CFTOKEN=69636615
https://dl.acm.org/citation.cfm?id=2858119&CFID=776684051&CFTOKEN=69636615

All in all, pelvic health is crucial to SRH: it is key to sexual wellbeing and integral to reproductive function. We use pelvic awareness to ignite the discussion of a multitude of issues relating to SRH.

Q2B.
- Successful completion of the initial pilot with the e-textiles toolkit in Cape Verde;
- Number of users/returning users on our Resource site;
- Number of users for our accompanying iOS Augmented Reality app.

Q3. 1) Scaling on the ground via collaboration with local educators and health professionals:
Bitness has established ongoing collaborations within Cape Verde, which include Womeniseit and Self Care. Womeniseit works towards the empowerment of women. It is a platform that promotes networking, meetings, coaching, giving a voice to each and every Portuguese-speaking (Lusophone) woman. We envision working together in developing and disseminating this project across the ten islands that form the Cape Verde archipelago, but also to reach further and across other Portuguese-speaking countries and the Diaspora. Furthermore, we are currently in conversations with CVTelecom, the biggest telecommunications service provider in Cape Verde, whom has already shown interest in establishing a partnership for further developments, which will include a mobile app feature for SRH awareness and education in women and girls.

2) Scaling digitally: The idea/component for which we would be so excited to have the support and recognition of OpenIDEO and UNFPA’s, is design-led and emphasizes a ‘learning by making’ approach. We also see this approach fit to bringing digital to the utmost rural and disconnected areas in the country, whereas a digital resource directory (Part 2) and an augment app component will add-on and certainly prove resourceful within communities with wide internet access/where telephone density is higher. Integrating a technological component and the collaboration with CVTelecom will allow for the project to reach a wider audience at national scale. We will also establish links with local startups in Cape Verde. Currently, we are collaborating with Self Care, which is a platform that envisions a novel and disruptive approach to health care and the existing healthcare system in the country.

Q4. 1) Initial interest during academic research phase: Through deployment of the original toolkit in multiple workshops in the UK, we understood that practical knowledge of the body, when directly associated with reproductive health and sexual health education, was missing, and misconceptions about different body parts and were plentiful. This research resulted in presentations and awards in multiple international conferences (ACM CHI 2016, Augmented Human 2015, ACM SIGCHI Designing Interactive Systems 2014, and invitations to curated shows at Parsons School of Design, New York; muca-Roma, Mexico City; Piksel, Norway. Press included interviews with Racked, Visão, Activa; mentions in diverse health and lifestyle online media, such as HelloFlo, iafrica, Mic, Bustle, Glamour, SELF.

2) Local site Cape Verde: When in Cape Verde, the team leader introduced the project at i) a workshop in the University of Cape Verde and ii) Women’s Summit. The introduction of and novelty of the medium (digital textiles) and nuanced application in relation to the female body (associated with taboo) also led to multiple press interviews: Expresso das Ilhas, Sapo CV, UNICV, Record TV, TCV Televisão de Cabo Verde.

Q5. Teresa has done research work and has ongoing collaborators willing to support novel technologies for women in Egypt, Cape Verde and India. However, and based on recent feedback and networking in Cape Verde, decision was made to narrow down the initial scope (for R&D and beta testing) and do the initial idea pilot within the context of Cape Verde. Here, we will collaboratively design and develop the textile resources included in the toolkit; disseminate the toolkit with the support of existing team/health professionals network. Currently, the existing network spans the islands of Santiago and Fogo only. By 2020, the vision is to have expanded to all ten islands that form the archipelago. Further down the line, the ultimate goal is to, via Cape Verde, expand the utility of this toolkit to all six Portuguese-speaking African countries: all of which currently have UNFPA’s support in improving SRH.

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