The femtech industry has been changing the way we think about women’s health and fertility in recent years. It’s already democratising fertility treatments, raising awareness, removing stigmas. It also has a huge potential to make women’s health more personalised, accurate and help reduce the research gap and underfunding.
Femtech can also have a huge impact in developing countries. According to the World Health Organization more than 800 women die of pregnancy-related complications every day, particularly in rural areas of India and Africa, where healthcare facilities are in short supply.
Could apps, wearables and portable devices provide valuable support in these areas?
Improving women’s health worldwide
Recently, I attended the Royal Society of Medicine event on FemTech in the developing world. The event explored how digital technologies are promoting women’s health and improving maternal outcomes in developing countries. The webinar was run by Mr Edward Morris, a consultant in Obstetrics and Gynaecology at the Norfolk and Norwich University Hospital NHS Foundation Trust, who expressed the excitement about innovations in the field of women’s health.
The first speaker, Thérèse Mannheimer, the CEO of Grace Health shared her vision of a digital health clinic for the next billion women. Thérèse talked about their mission to improve the health of women worldwide and support them throughout their lives from puberty to menopause. How? By acting as a digital female health assistant. They utilise Facebook Messenger for period and fertility tracking so that users are able to track and monitor symptoms, feelings and energy levels, and ask questions about their own health. At Grace Health, the user-centered approach is crucial. This means, they are working towards taking into account factors like everyday problems and level of education of their customers while creating content and working on new features.
Thérèse also shared some insights from the field work in Nigeria, Ghana and Kenya. For example, in Nigeria there are 214 million of women without access to modern contraception and 50% of pregnancies are unwanted. She also shared with us some of their findings from data analysis collected during the COVID-19 pandemic which revealed a significant spike in abortion which lead to an interesting discussion during the webinar.
Here are my key thoughts:
- Femtech can leverage the widespread use of mobile phones in developing countries.
- It can provide interesting insights to governments and NGOs.
- Femtech can also work with local pharmacies and shops, not only to make women’s health more accessible but also to support the local economy.
Harnessing the power of AI
The second talk was delivered by Leon-Ariel Boston, the CEO of Mobile ODT who told us about their mission to transform women’s health with AI. Mobile ODT created an intelligent system – The EVA System – an FDA-cleared/CE-marked reproductive health tool that enables clinicians to perform high-quality and affordable cervical cancer screenings. Leon gave us some insights into the problem they are trying to solve. 80% of cervical cancer cases occur in the developing world, causing around 190,000 deaths each year. Apart from extreme shortage of doctors or skilled healthcare professionals who could perform cervical screenings, the current standard is usually a visual inspection, which is not always accurate. The EVA system lets clinicians photograph the surface of the cervix, record what they see, track progress, compare images and upload them to the company’s portal. AI enhanced software then helps users complete the clinical documentation and diagnose the patient (89.5% sensitivity, 85.6% specificity). This means that AI could bring specialist expertise to the hands of less trained physicians for example midwives. We’ve also had an interesting discussion about the therapy options available in developing countries and how
Here are my key thoughts:
- AI has a huge potential to be an assistive tool in developing countries and support healthcare professionals to deliver high quality of care.
- Early diagnosis is crucial when it comes to cervical cancer as treatment is cheaper when the cancer is still in the early stage.
- Whenever possible, screening results should be delivered to women as soon as possible, so she doesn’t lose touch with the system.
- I’d be interested to see a study which compares the outcomes of women with cervical cancer in communities who had access to the EVA system vs those who didn’t.
Misinformation around fertility
Another speaker during the event was MacGregor Lennarz, Co-Founder or Lily Health – a Nairobi based startup working on a mobile interactive fertility chat for women. Lily Health’s team is on a mission to create a trusted, discrete and easily accessible reproductive health resource.
MacGregor shared with us some interesting insights about fertility in developing countries.
Fertility rates in sub-Saharan Africa are twice as high as the global average, but that doesn’t mean women in the region find it any easier to get pregnant. For example, in Kenya there is 1 gynecologist per 64,000 women and the cost of fertility specialists is prohibitive for most women. Apart from a poor access to assisted reproductive procedures, women have to cope with the devastating social and emotional consequences that come with not being able to bear children in many countries (Benjamin Chiou,2019). Lily Health found that it can lead to harmful self-medication, depression, anxiety, stigma and even suicide.
MacGregor not only explained Lily’s approach to consumers, but also their learning along the journey and the results of their work. The main issue the team has noticed is misinformation. Often, women do not calculate their cycle days correctly, or have an incorrect definition of “regular cycle” – eg. Some women believe that the period should start on the same day each month. Another example of misinformation is the lack of knowledge about male infertility issues or suspicion towards contraception. Moreover, women are often misdiagnosed incorrectly with diagnoses like “hormonal imbalance” or “tube blockage” but they haven’t had any test that it would prove it. Another problem was a misuse of medication, especially those accessible without prescription which can sometimes be harmful. Regarding the outcomes of their work, they found that an impressive 96% of women felt more confident thanks to Lily.
My key takeaways:
- B2C business models can work well in developing countries. Sometimes, if customers are not willing to pay for the product it may mean it’s not delivering enough value for them.
- Apps and other solutions can be delivered in English.
- Chatbots can be an engaging tool to spread awareness and fight misinformation.
- The insights the companies can provide to NGOs, researchers and policy makers can be invaluable.
- I’d be interested in learning more about how to ensure the advice we are giving women is relevant and accurate – what scientific evidence should be incorporated? What additional factors need to be considered (eg. influence on stress/diet/ethnicity on contraception/cycle length…)
The importance of data
The final speaker – Shantanu Pathak – Founder and CEO of Care Mother – which so far supported >35,000 pregnant women in India and are about to launch in Nigeria and Bangladesh. 20% of the 800 preventable maternal deaths occurring globally every day are from India (Kulkarni et al. 2019). Care Mother is helping to detect high-risk pregnancies in early stages through mobile monitoring tools and an algorithm that screens the data collected. CareMother consists of a portable diagnostic kit used by a health worker for home-based point-of-care antenatal tests (eg. foetal heart monitoring via CTG), and a smartphone application with a ‘decision-support tool’ for detecting high-risk pregnancies, delivering specific counselling messages and referral to doctors via real-time results for prompt clinical decisions. The trained frontline workers can deliver personalized pregnancy care. This means local healthcare professionals can engage with patients and disseminate governmental health information in a personalised, patient-centric format. Shantanu shared some frontline stories. For example, one family has been denying any test in the past, however since they were able to listen to foetal heart sounds for the first time in their lives, their attitude towards antenatal tests changed completely. Shantanu also gave us some insights into India’s femtech start-ups and the challenges they face.
My key takeaways:
- Solutions and specific problems that are being solved by femtech start-ups vary, but the core of their work in developing countries is focused about education and awareness.
- Empowering women by giving them knowledge and understanding of their own health and pregnancies is a step towards challenging some cultural and social norms as well as traditional gender roles. However, challenges like financial dependency cannot be ignored.
The use cases for femtech in developing countries do not stop here. UNICEF’s team – Oky – has developed an app to help girls in developing countries learn about menstruation in an entertaining and positive way. “To make a period-tracking app accessible, it must be shareable among friends via Bluetooth, or downloadable via a link or QR code. It must also be usable offline, and require minimal data storage, otherwise it may be deleted for taking up too much space”, explains Greta Binder, UNICEFs advisor on gender.
Optimism for the future
The webinar filled me with enthusiasm as the speakers were all working on projects which were making a huge impact for women’s health in developing countries. I hope that femtech could be a helpful tool in creating better access to healthcare and empowering women to take more control of their health and well-being. To achieve that, it will have to cross social, cultural and economic barriers, which can often be deep-routed. I believe it not only requires efforts from entrepreneurs but also a collaborative action of NGOs, educational and governmental institutions.
At Parla, we are excited to see that femtech is growing and making an impact globally. We are devoted to empowering women and we hope that one day, all women will be able to have knowledge and insights about their own health to make the right choices for themselves on their fertility journeys.
