Together for Her is a social business and maternal healthcare platform that improves access to affordable quality maternal healthcare in India. By means of technology, we empower women to increase their knowledge on their pregnancy, nudge healthy behaviour, increase adherence to the recommended antenatal and postnatal care and provide access to affordable care. At the same time, we work with over 1000 hospitals to improve their quality of care, based on objective feedback women have provided. So far we have received 33K reviews, on over 1000 hospitals and can proof significant improvement of the Quality of Care at hospitals.
Problem: India has one of the highest maternal mortality rates in the world. However, if less than 40% of Indian women visit more than 4 antenatal care appointments (due to a lack in knowledge, behaviour, access or affordability) it is hard to improve the state of maternal healthcare. Moreover, there is no trustworthy source to find quality hospitals. Consequently, diseases such as anaemia, hypertension or gestational diabetes are never diagnosed before delivery or treated wrongly at the time of birth.
Solution: The main causes of preventable maternal mortality & morbidity can be detected in the 9 months before pregnancy or immediately after delivery, but women do not visit their ANC & PNC appointments. By eliminating the barriers to access maternal healthcare (knowledge, behavioural, access & affordability) through tech-enabled knowledge provision & bundled services from high quality providers, we believe that we can diagnose & treat MH challenges early enough, resulting in reduced maternal mortality & morbidity.
Target Group: Every year there are 12 million pregnancies in the private sector in India. These 12 million women, & specifically the women in SEC B and C (monthly household income between 12K to 40K INR) living in urban sectors are the initial target population for Together for Her's bundled services. The women in this target population visit or want to visit private healthcare institutions and aspire to good care quality at affordable budgets. The women that they are addressing also have access to at least 1 smartphone in their household, either owned by themselves or their husband.
TfH also targets pregnant women in the SEC D & E population with awareness programs on MH and QoC. These women visit public health facilities, but still lack awareness & advocacy to demand full antenatal care. A planned expansion in 2020 is to target SEC A, where despite affordability not being a barrier, access to personalised patient-centric healthcare is still limited. This expansion is important from a sustainability point of view.
The Impact: The impact so far has been on the improvement of QoC at hospitals, through TfH's mother review platform. The feedback comprises a set of 9 standardized QoC indicators that were developed based on the WHO Maternal Care Guidelines. TfH conducted a retrospective longitudinal evaluation to assess whether hospitals demonstrate improvement in care quality after registration on the platform. Results showed statistically significant improvement in hospital performance for 6 out of the 9 QOC indicators, i.e. skin-to-skin contact, early breastfeeding, danger sign counselling & family planning guidance. The odds of improvement in these QOCs increased with every month after hospital registration with TfH. Their research shows the positive impact of feedback loop created through TfH platform on improving the quality of maternal care extended by hospitals (1000+) registered with them. It also provides an approach that can be replicated & scaled to create a real-time mother-driven QOC metric for hospitals.
Business Model: The review platform is free, to build up a distribution network & improve QoC. Partnering with the best performing providers, TfH offers bundled services to pregnant women. By bundling healthcare & wellness services for a large group of women, they negotiate better rates with providers. We function as an aggregator & keep a margin, while passing on most of the savings to the women. At scale, they will be able to monetise the data and market additional services or products to the mothers.
Partners: TfF collaborates closely with a range of NGOs, as well as the Indian Government. They are part of the Government’s Maternal Health Taskforce. Their platform has been developed together with the Federation of Gynaecologists & Obstetricians Societies of India (FOGSI), JHPIEGO & MSD for Mothers. TfH works closely together with Manyata & Laqshya (Maternal Hospital certification programs), as well as Mera Aspataal, the review platform for public hospitals. They also have an advisory board of doctors.
Technology: There are three key technological elements enabling bundled care delivery:
Mother and provider App
Together for Her bundled service has a digital platform for both mothers and providers. On the mother’s end the app allows them to:
On the providers end, the app enables providers to:
Care Management System: TfH has developed a care management system to support in management of mother’s care journey including appointment booking, payments, and tracking of adherence data, behavioural data, as well as clinical data.
Learn more on their website.