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How a Kenyan health startup is transforming the lives of families — one SMS at a time

How a Kenyan health startup is transforming the lives of families — one SMS at a time

May 04 2016

By Guest

This blog, by CAST Director Kieron Kirkland, was first published by Ventureburn and can be read here.

Your children’s health is probably the most important thing in the world to you. But how do you know if your child is developing the way they should be? Even in the UK where there’s the NHS, innumerable child development internet sites, or a gazillion baby books, it can be a difficult time. But imagine living in rural Kenya, where health clinics might be difficult to access, there’s no internet and in some cases you might not even read or write.

That’s the problem Nominet Trust 2015 winners, Totohealth is solving, and it is solving it very well indeed.

Totohealth is best-known for its SMS platform, which sends SMS messages to mothers and fathers during pregnancy and for the first five years of a child’s life – offering health tips and simple diagnostic questions to help parents keep track of their child’s health. But what’s perhaps less known is the incredible levels of design, passion and knowledge that go into making such a neat system.

The diverse team behind Totohealth are the pillars of their success – a charismatic founder Felix Kimaru who can speak personally about the issues they’re addressing. A co-founding CTO, Joseph, who quietly drives the platform ensuring that technology isn’t outsourced and misunderstood, but is at the heart of business development. Fonda, a paediatric physiotherapist, positively brims with passion and care as she speaks about the 12 years experience working with disabled children and their families that she brings to the team. It’s this sort of in-house medical skill that means Totohealth can develop simple diagnostic questions that fit into a 160 character text message, such as asking “does your child’s foot point up or down”. Simple as it seems, knowing this at the right time is the difference between early detection of clubfoot or not.

Totohealth is growing fast, and their second stage of development shows that they are able to break away from the traditional start up bubble and transform themselves into a viable, investable business. It’s exciting to see that they’re as innovative with their business model as they are with their service. Finding that 80% of their users refer other parents to the Totohealth SMS service, they’re moving away from traditional top down mHealth business models – where you expect to sell the service to health facilities, or rely on grant funding to grow – and instead they’re focussing on a B2C model, enabling parents to buy into the service themselves. It’s a brave but logical step for the team to break with tradition and shows their lean character, working with the data and iterating their services as they grow.

This willingness to adapt and change reaches into the heart of Totohealth’s product offering and how they go further to meet the needs of hard to reach clients. The eastern provinces of Kenya have some of the world’s highest rates of maternal and child health problems. To increase access and spread of their service to those who don’t read or write English or Swahili, Totohealth are translating their messages into more local languages and offering messages by voice. This means that even the hardest to reach will be able to access support.

What makes Totohealth exciting, and a world away from many earlier mHealth interventions, is their agility and ability to deliver consumer focussed health services. This permeates through every aspect of their business, whether it’s their move to test a B2C business model in a world dominated by top down expenditure and donor supported interventions, or their focus on providing voice access to the SMS service for hard to reach users in regions where literacy is low. All this shows Totohealth are managing to occupy that golden area of mission driven businesses, where better customer service and social impact are inseparable from sustainable revenue growth. Where doing good doesn’t cost the business, but in fact sustains it.

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