Author(s): Roopan Gill MD MPH (Vitala Global Foundation), Genevieve Tam MD MSc (Vitala Global Foundation)
Digital self-care has the potential to bridge gaps between the formal and community based models of service delivery for sexual and reproductive health (SRH). It has the potential to remove barriers that vulnerable women and girls face to access quality SRH care. Digital platforms can facilitate and promote self-care that provide privacy for individuals who may otherwise be subjected to stigma and discrimination when seeking care and services in the formal health care system. For example, accessing quality comprehensive abortion care continues to be a challenge and unsafe abortion continue to be one of the top causes of maternal mortality and morbidity that is completely preventable. To realize UHC for all, community-led and user-centric digital solutions that are contextually relevant is essential, particularly for stigmatized SRH issues like abortion.
Throughout the last 18 months, Vitala Global, a Canadian not-for-profit organization, was founded with the aim to co-design open-source self-care digital solutions with women, girls and their communities addressing the most stigmatized SRH issues. Through a process of design thinking, user-centered research, community engagement and a multidisciplinary team, Vitala Global is demonstrating the feasibility of localized digital self-care solutions to be an opportunity that can improve SRH outcomes for the most vulnerable living in the most challenging contexts.
An example of our work has been the co-design of a digital platform, Aya Contigo. Aya is an evidence-based progressive web application, which accompanies Venezuelan women and girls as they self-manage their medical abortions and advises them on contraceptive options. It emphasizes physical and mental health support through self-care advice and connects users through a live chat platform to an Aya Care Team that is available to provide support in real-time and refer users to trusted local providers. Through our user-centered research, more than 1000 Venezuelan women and a dozen feminist grassroots organizations identified the need for reliable information and digital accompaniment to support women and girls through a safe abortion and family planning experience. Through an iterative design and development process, the digital platform was created and a pilot feasibility study was done with 40 Venezuelans seeking abortion. Initial results highlight that Aya Contigo is proving to be an essential resource to reach those in hard to reach parts of Venezuela. We are learning that through Aya’s connected care to grassroots partners, women and girls’ lives are being saved who would otherwise resort to unsafe methods.
Venezuela has one of the most restrictive abortion laws within the Latin America region. Coupled with this, Venezuelans are facing a complex humanitarian crisis, in which the humanitarian response has failed to address the SRH needs of women and girls. The rates of unplanned pregnancies, maternal morbidity and mortality from unsafe abortions in Venezuela are unprecedented. If we are to truly achieve UHC, the challenges and barriers to care that women face in settings like Venezuela needs to be understood. From the experience of co-designing Aya Contigo, we are garnering evidence to show that digital self-care has the potential to transform healthcare by making it more accessible, equitable and user-friendly.
What we have learned is that digital self-care solutions can be valuable to improve access to information and services but they are not the panacea. As we continue to co-create solutions and expand our work throughout Venezuela and to neighboring Colombia, to achieve UHC through digital self-care, particularly in challenging contexts where the health system is fragile, it is vital to work with local partners when designing and developing an SRH intervention. The development of a digital solution like Aya Contigo is a first step to bridge the gap between people’s needs and the supply of services of the formal health system. However, non-discriminatory access to quality comprehensive abortion care, using digital tools, to all who need it – including self-managed and facility-based abortion – requires that more factors are in place. This includes well functioning and supportive health systems, supported by laws and policies that promote and protect SRH and human rights. This is how we will truly achieve UHC for all.
For more information about Vitala Global’s work on digital self-care, please check out www.vitalaglobal.org
Instagram: @ayacontigoapp @vitalaglobal
LinkedIN: Vitala Global Foundation
Stay tuned for our official launch of Aya Contigo early 2022!