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TOMBEY: Improving access to quality SRH for adolescents in Cross River state

Improving access to adolescent friendly sexual and reproductive health (ASRH) services using mobile and web technology

Photo of Rhoda Robinson
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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 2022, our aim is to have TOMBEY covering all 36 states in Nigeria including the Federal Capital Territory, thereby increasing access to quality adolescent sexual and reproductive health services and improving the sexual and reproductive health of adolescents across the nation.

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

A full time project team of 3 staff members will be created to manage both offline and online implementation of the project as well as communication and collaboration between all key partners. Within the state, youth groups will be engaged in each senatorial district who will be responsible for the implementation of the project in the state. The youth groups will directly engage with project beneficiaries and partners. A larger project team will be created within the state comprising of all key partners to facilitate communication and collaboration on the project.

How has your idea changed based on feedback?

Based on feedback from partners, we have included the involvement of school based counselors through the Ministry of Education. Every state secondary school has an assigned counselor who is direct contact with the students. By involving counselors, not only will they be able to recommend the platform to students who may require further sexual and reproductive health services, they would also be able to use the information provided to improve their service provision and relation with adolescents

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?

ASRH is one of the key areas of HACEY's work in Nigeria. Human-centered design approach is used in all our interventions and as such has helped us in factoring in the process of reviews and changes to our interventions based on beneficiaries input. If there is a need to change an aspect of our strategy or intervention, the project team (including beneficiaries) discuss what can be done better which is approved by the project or executive director and donor (if applicable) before implementation.

How long have you been working on the project?

2

What year was your organization or group started?

2007

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

3

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

The opportunity to share our idea with a larger pool of minds and get feedback on what can be done better. Also, being able to learn from other individuals and organizations different innovative ideas being implemented is very exciting.

Share the URL for your Business Model Canvas Here

https://canvanizer.com/canvas/rIKB7bM5HWyyT

Opportunity Areas – Select those that apply

  • mHealth

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

Finding a place that offers comprehensive and non-judgmental SRH services and information is difficult especially for adolescents in Cross River state. It is more challenging when they travel long distances only to find out the center doesn't have what they need or won't attend to them in time.

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

Our unanswered questions are specific to the project state because it has the highest rate of unwanted teenage pregnancy in south-south Nigeria. The question tries to find if the gap exists between what young people need and what is being provided. -What do adolescents ask for most when it comes to their sexual and reproductive health needs? -What stops them from getting it from service providers?

Who are your end users? (1000 character limit)

The end users of this intervention are unmarried adolescents (15-19) living in Cross River state, Nigeria. Cross river has one of the highest rates of teenage pregnancy and STI transmission in Nigeria, majority being in rural areas. Through TOMBEY, adolescents can quickly search for the nearest ASRH service with the service they need. They can also check what other users have said about the center and decide if it is worth taking the trip. Adolescents can recommend centers and says what they liked, didn't like or what they would like to get. This makes it easier for adolescents to ask for and receive SRH services such as contraceptives and STI/HIV testing and treatment and also generates enough real data that governments and NGOs can use to improve service provision. Cross river state has approx. 400,000 adolescents aged 15-19 (NBS, 2012) in- and out-of-school with less than 100 PHCs offering SRH services. Our estimated reach is 60,000 adolescents over 2 years.

Explain your idea. (500 character limit)

The intervention is based on the theory that if we increase availability of quality adolescent SRH (ASRH) service, more adolescents would request for SRH services. We identify centers that provide ASRH services and then create a directory based on what services they have available. Adolescents can look up centers on a website, app or by text. Those who visit can provide feedback through same means on the quality of service they received, what other service they need and what can be improved.

What is your value proposition? (500 character limit)

The main value proposition is that it makes it so much easier to find SRH service as an adolescent who mostly depend on peer information, unorthodox providers or quacks for their SRH needs. They also have the opportunity to determine what kind of service they need and ask for better service through their feedback. The feedback system also helps to ensure that service providers are conscious of providing quality service as they know that users can now report poor service on a platform.

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

Current initiatives are focused on teaching adolescents what sexual and reproductive health is for them and pays little attention to helping locating services or creating platforms that adolescent can always trust for information. A young boy might know he needs a condom to have sex but may have no idea where he can get it from for free if he has no money to buy. TOMBEY fills that gap. Rather than providing just one source, it provides as many as are available to choose from without pressure.

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

  • Customization: Tailoring to specific needs

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

Adolescents make up about 25% of cross rivers 3.7 million people. In 18 months, we hope to reach 50,000 adolescents and 185,000 in 3 years. TOMBEY would be successful when adolescents can - Find a close center close that provides the service they need - Visit the center and receive adolescent friendly SRH - Improve sexual behaviors because of information on our platform. - Provide feedback on their experience so the center can improve their services and adolescents know where to find ASRH

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)

- Performance indicators include number of young people using the app, service providers mapped, interactions on the app, referrals via the app, feedback from young people, service providers and state ministries. Impact would be assessed by improvement in ASRH provision and health seeking behavior of young people. Another metrics that would be used is data from the centers listed on improvement of service provision based on recommendations from adolescent users.

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

By working with media influencer on social and traditional media, youth community groups and students’ associations. Also, using fliers distributed to young people at places like football viewing centers, music shows, talent, community youth meetings, on and off campus, cinemas and shopping malls

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

We will partner with local organizations, government agencies and ministries including health, education, and youth. We will work with local online and offline media to reach as many end users as possible. We will work with a technological solutions company that will help us effectively manage our intervention. Also, youth groups within communities will play a major role in helping us reach the adolescents in the communities.

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

HACEY Health Initiative

Tell us more about you: (750 character limit)

HACEY is a development organization focused on improving the health and productivity of under-served populations. We work with communities, government institutions, private sector companies, civil society groups and the media to design and implement sustainable interventions aimed at creating lasting impact for our beneficiaries. Our programs have a goal of effecting a positive behavioral change in members of societies that would lead to a drop in negative SRH outcomes. Our team is comprised of young individuals with years of experience working in the areas of SRH and with young people. We have presence in 7 states across Nigeria including Cross river state proposed to benefit from this project.

Organizational Characteristics

  • Youth-led organization

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

Cross river state, Nigeria.

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

Financial support. We have the technical knowledge, media partnerships, community and government buy-in to achieve great success with this project. We have engaged local radio and television station in this community and also the ministry of health. However, we need the financial support to deploy and manage the technology and human resource that will drive this project.

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)

Lagos state, Nigeria

What is your organizational status?

  • We are a registered non-profit, charity, NGO, or community-based organization.

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

http://www.hacey.org

7 comments

Join the conversation:

Comment
Photo of OpenIDEO
Team

Hi Rhoda 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:
The idea will provide a good opportunity to discuss feedback with service providers to potentially improve quality of ASRH service. 
Focus on a very key segment of population (hard to reach) 

Questions experts had:
1) How might you get buy-in from the government and service providers, and co-designing with the young people to enhance feasibility and scalability of this idea?
2) How will the app be financed overtime?
3) How will HACEY Health Initiative will manage the project with no local presence in Cross River State? A distance of 800km from Lagos. 2. The evaluation plan is not sufficient to measure impact - what are the performance indicators and how will impact be assessed? 3. Is there a plan to create demand for ASRH in the project using the app or any other approach? 4. Provide detailed sustainability plan including financial plan to sustain operations over time 2. Is the app interoperable?
4) Would like more clarity on metrics of success: "an adolescent would be able to...". Providing specific indicators such as how many adolescents, by when, would make the submission stronger. 5) Although the team mentions that "Existing Prototype or Pilot: I have tested a part of my solution with users and am iterating.", the submission doesn't provide any details about prototype or pilot. Finally, the unanswered questions section seems to be off: they look like questions the team should have an answer for.
6) There is need to provide information on what will motivate young people to use the app over the existing social media apps.
7) Are you considering expanding your reach to country wide in the future?

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 Rhoda Robinson
Team

Hello,
Thank you for the questions, hope this clarifies the project

Government and service providers buy-in, and co-designing with the young people
TOMBEY content and design is developed with the audience in mind. When we develop the initial platform, it goes through a period of use and review by the intended users. During this time, we collect online and offline data, comments and suggestions from them on what to make better, how to improve its user interface and functionality and what content they would like to have on it. We have campus representatives in tertiary institutions across this state and also maintain good relationship with youth bodies such as Nigeria Medical Students Association, Junior Chamber International, Student Union Governing Council, community youth groups and young media influencers.

Getting buy-in is achievable because we have a good relationship with state ministry of health, especially with related to youth health matters. We’ve also worked with a number of NGOs and community based organizations on SRH which makes networking and working with service providers easier. Also, because this project is in line with current effort by both state and non-state efforts to improve the health of young people, securing buy-in would require little persuasion and more of sharing joint objectives. To achieve this, we would hold project information session with them that would show mutually beneficial outcomes of the project and the viability in integrating this into their existing efforts to improve access to information and service of sexual and reproductive health of young people in the state.

2) App finance
Initial app cost will include maintenance for the next 2 year. As part of our ideas to sustain the app, we are looking into hosting ads on the app and getting sponsorship for it. Also, to encourage young people to use the app we are also exploring partnership opportunities with telecommunication companies to make the app work with little or no data charge to users.

3) Project management in Cross River State
HACEY maintains on-ground partnerships in project states. We will work with our campus and community representatives to lead and manage the project in the state with supervision from HACEY. Our technical staff visit the state once a month to provide support on the ground. Lagos is 1hour away from Cross river.
- Performance indicators include number of young people using the app, service providers mapped, interactions on the app, referrals via the app. Also, feedback from young people, service providers and state ministries. Our impact would be assessed by improvement in service provision and health seeking behavior of young people
- Demand creation will be achieved through working with media influencer to promote ASRH and the app on social media, radio and television; youth community groups and students’ associations to promote with their members. We have also created fliers that can be distributed to young people at places like football viewing centers, music shows, talent , community youth meetings, on and off campus, cinemas and shopping malls.
- For sustainability, TOMBEY is incorporated into the organization’s SRH programs which covers for personnel costs and ensures the project is monitored and funding sourced and managed.
- We intend the app to be interoperable

4) metrics of success
Adolescents make up about 25% of cross rivers 3.7 million people. In 18 months, we hope to reach 50,000 adolescents and 185,000 in 3 years. TOMBEY would be successful when adolescents can
- Find a close center close that provides the service they need
- Visit the center and receive adolescent friendly SRH
- Improve sexual behaviors because of information on our platform.
- Provide feedback on their experience so the center can improve their services and adolescents know where to find ASRH.

5) Our prototype web platform can be found here: www.tombey.org (in progress)

6) Motivation for use
- The app will help young people answer key questions they have as regards their sexual and reproductive health. In past we have placed anonymous boxes in communities around the state encouraging young people to ask questions anonymously and we pasted answers to questions on the notice board near the boxes. We noticed that over 80 percent of the questions is related to the sexual and reproductive health of young people.
- The plat will be highly interactive and engaging
- The platform will also host conversations from media influencers that young people want to speak to
- We also hope to partner with private sector organization to donate products and promotional materials, this will help young people win items by participating on different activities/conversation and debates on the app.

7) It is our goal to cover the entire country in 5 years; we have had project update session with over hundred NGOs and 6 state ministry of health in all southwestern states in Nigeria.

Photo of Dolapo
Team

The advantages of technology cannot be over emphasized. Its a general knowledge that adolescents feel more comfortable sharing their problems with people outside the family box. Giving them easy access to these people and places that can answer the numerous questions in their heads is a laudable one. I strongly believe this approach will fly and produce good results and effective feedback approach.

Photo of Rhoda Robinson
Team

We agree wholeheartedly

Photo of Iliriana Kacaniku
Team

Hey Rhoda Robinson 
As the deadline to refinement phase is only 4 days away, we look forward to reading your refined idea afterwards. To this end, we highly encourage you to respond to the experts’ feedback in the comments part and upload the completed business model canvas as a separate document. The template for the canvass is available in the following link: https://d3gxp3iknbs7bs.cloudfront.net/attachments/11ed3970-7b4b-4168-95e4-42f44cf1bf72.pdf?utm_source=UNFPA+Shortlist+Announcement+%28To+Shortlisted+Ideas%29&utm_campaign=35344cc5a0-EMAIL_CAMPAIGN_2017_11_14&utm_medium=email&utm_term=0_19296933e1-35344cc5a0-

Should you have any question regarding the canvass, please feel free to reach out to us and we’ll make sure to respond to you timely.

Best regards,
Iliriana

Photo of Isaiah Owolabi
Team

leveraging on technology is key to accelerating the impact of SRHR projects

Photo of Ashley Tillman
Team

Hi Rhonda, Thanks for your contribution! Important reminder, don't forget to have your Idea finalized, answer all the questions and published by November 5, 2017 at 5pm PST to be considered for the Challenge.

You can publish it by hitting the "Publish" button at the top of your post. You can also update your post by clicking on the "Edit Contribution" on top. We're looking forward to seeing your contribution in this challenge.