As COVID-19 swept the globe, it quickly became clear that health systems everywhere had a communication problem. Overwhelmed and under-resourced health systems, including frontline health workers, had to contain not only the virus itself but also health misinformation and inaccurate rumors that were spreading rapidly as well.
To empower citizens with the right information and to support the response of health systems, the World Health Organization (WHO) turned to WhatsApp—the free messaging app with more than two billion users across 180 countries—for help. In turn, WhatsApp pointed WHO towards Praekelt.org, a South African non-profit organization that was already using its technology to target aspects of various health crises, including the COVID-19 pandemic.
How was this small organization able to implement a ground-breaking communications strategy so quickly, in the midst of an unprecedented global pandemic? The answer has its origins in work started nearly a decade earlier.
A ground-breaking maternal health initiative
With 12 years of experience in digital health as part of their HealthConnect strategy, Praekelt.org has developed a number of technologies, tools, approaches and partnerships to allow them to respond rapidly and effectively in a time of crisis.
One of these partners is the Johnson & Johnson Foundation, which has supported Praekelt.org for a decade. Initially, the partnership focused on maternal and child health through a program called MomConnect, a mobile health initiative launched in 2014 in partnership with the South African Department of Health to help more women gain access to vital information and care needed to help ensure a safe and healthy pregnancy and labor. In its first two years, MomConnect grew into the largest program of its kind, serving approximately 65% of women in South Africa. MomConnect, which started out as an SMS service, was one of the first programs to pilot WhatsApp’s enterprise solution in December 2017, adapting to meet the needs of the women it supported.
“MomConnect was our first project using WhatsApp to scale with a specific country or market,” says Neville Tietz, a service designer in the HealthConnect team at Praekelt.org. Based on the success of MomConnect, the South African Department of Health asked for Praekelt.org’s support in communicating with citizens about the pandemic. “We had all of the infrastructure in place, which made us uniquely positioned to launch a COVID-19 service extremely quickly. We managed to do it in about a week!” The result was HealthConnect for COVID-19, a set of interconnected services to support patients and health workers, each with the potential to strengthen health systems in the long-term.
Harnessing the power of communication
As the pandemic has evolved, so too has Praekelt.org’s technology to reach as many people as possible with vital health information. At first, HealthConnect was a curated space for citizens to access COVID-19 information, such as symptoms, prevention advice and protocols in place. As time passed, the team introduced other features such as a symptom checker and, at the beginning of 2021, outbound alerts.
“So far, we’ve had one million users in South Africa sign up to receive important announcements and that model is being adapted for other countries as well,” says Tietz. Governments across Africa and beyond have been drawn to HealthConnect as a fast and cost-effective means to share important updates with their citizens. Now over 20 million people globally engage with their health systems via HealthConnect for COVID-19, making it one of the world’s largest digital health services.
Utilizing this expertise, Praekelt.org and WHO worked together to develop WHO HealthAlert, a dedicated messaging service in 11 languages, which had 12.6 million users in the first two months and has the potential to reach two billion people across the world.
Investing in technology for the long term
The success of HealthConnect illustrates the importance of consistent investment in technology that strengthens the core functions of a health system. “We don’t always want to use new technology in a crisis,” says Dr Joanne Peter, Director of Social Innovation with the Johnson & Johnson Center for Health Worker Innovation. “We need to build core infrastructure that is relevant for health systems before, during and after a crisis. In other words, by investing in technology that’s useful for routine health services, you are also building a solid platform that can be leveraged in an emergency.”
The success of HealthConnect also illustrates the important leadership role governments play to create a framework within which technology providers can operate. By vetting and endorsing particular technology services like HealthConnect, citizens can trust in their safety and effectiveness, leading to greater impact at scale.
Embracing these technologies also helps governments gain a valuable understanding of the public health landscape to shape their approach. In South Africa, for example, Praekelt.org has introduced sentiment analysis to better understand citizen thinking around the COVID-19 vaccine. This data is shared with the Department of Health, who can then use it to provide more targeted messaging to support vaccine uptake. HealthConnect’s symptom screening feature also provides a useful feedback loop, building an early-warning heatmap for governments on emerging COVID-19 hotspots. The infrastructure used to support these features is applicable across many other public health scenarios, including offering digital vaccine passports and immunization reminders.
Easing pressure on the health system
As HealthConnect demonstrates, allowing consumers to access health services directly through digital platforms removes the burden of education and advice from frontline health workers, allowing them to focus on urgent treatment. The goal is to empower individuals to take control of their own health by setting up a seamless communication channel between the system, government, health workers and citizens.
While it is still early days, Praekelt.org is focused on exactly that. As Tietz explains, “We have an innovation space where we are prototyping what a non-COVID service could look like for citizens and how we could help them achieve health goals by improving access to health systems generally.”