Send ‘HAPPY’ to 12345

Last weekend I saw an ad on the train about getting free mental health advice via SMS. All I needed to do was to send ‘TIPS’ to a shortcode.  I decided to sign up for two reasons:

1 I am quite a typical A-type neurotic millennial living in the big city. Stressed out is my default.

2 I am interested in mhealth (mobile health) and I was curious about the service itself.

So I texted TIPS.

And then nothing. Nothing happened. I checked my phone 4-5 times within the following hour ( I’m disillusioned about my phone habits, it was probably closer to 20 times). I didn’t get any confirmation that I had signed up. This was Saturday.

Monday morning I receive this text message. In the meantime I had completely forgotten about the whole thing.

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I end up getting a text message every day..

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until Friday I get this one.

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And I’m like…

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This was all a fundraising trick. I thought they were out to help me but instead they sneakily acquired my number, gained my trust but all they wanted was my money!

Don’t get me wrong, giving to charity gets a big thumbs up from me. However, I want to be part of the process. I don’t want to conveniently get something for free and then I am suddenly asked to give money. It’s comparable to the cards, coasters and pens I get from charities before Christmas. They send me free stuff I never asked for and then ask me to donate. Two things happen then:

  • I don’t want to donate anything because I feel blackmailed
  • I feel guilty for not giving and for the waste of stuff on me, but I cannot give into blackmail and now all I remember is that charity making me feel guilty!

When I got the final SMS, I felt tricked and foolish for believing that the service was there to help me.

Overall, I learned two key lessons:

  •  Feedback is not optional. It is essential to any service operating in this day and age, especially in relation to technology. How often do you pay attention to the ticks (Screen Shot 2016-12-04 at 08.33.21.png) on your messenger app ? This kind of feedback makes me feel satisfied and in control.
  • Don’t make an mhealth intervention a gimmick. I seriously believed that these text messages were going to make me feel better. They didn’t really and by Friday I understood why. They were sent by the Marketing department. There is a place for such interventions and when there are real people with real expectations on the other side, it’s dangerous to put it out without a comprehensive plan behind it.

Anyway, at least it encouraged me try my own little mood booster service. More on that later!

Why NGOs never fail

Ask any NGO workers about failures in their organisation, it’s likely they are going to struggle to come up with an answer. Especially if they are business development people, they probably won’t tell you about a failure. However, many NGOs fail, and often. But the way the system is constructed doesn’t allow for the concept of failure. No, NGOs don’t fail, they learn lessons.

Don’t mention the F-word

Most NGOs depend on funding from their donors. Whether it comes from big international organisations or individuals, NGOs must show that they are doing ‘good things’ with the money they have been given. But there is something really nice about the phrase ‘good things’ – it’s incredibly vague. So are often the commitments of NGOs. If you say that you commit to build the capacity of 200 women in business skills; that sounds like a real thing. Yet often it’ll be measured in the number of people attending a course – rarely in measuring the actual capacities of the women – and even when they measure it, academic rigour isn’t always the norm.

When you depend on showing results to keep your business going, but results are really difficult and therefore really expensive to get, making your results vague is a good way to continue getting funding for the work you believe is doing good.

If you are being vague as to what you want to achieve, chances are you’ll be able to write a positive report regardless of what happened. If your vague results really aren’t great, then you are going to do what the NGO sector loves: you’re going to learn lessons. But make sure they are lessons you have overcome or are in the process of overcoming.

The increasing pressure – both financial and political – on NGOs means that they are cutting corners. Don’t get me wrong, they are still pursuing their good work –  this is in no form a critique as to what NGOs are doing (that’s for another time!). This is simply a critique of the reporting and accountability mechanisms.

If an NGO fails in a project – e.g. doesn’t meet its expected target – they will be worried about getting further funding. To ensure that more funding is secured, they won’t frame it as a failure. They will instead explain the reasons they didn’t achieve what they wanted and explain how they adapted their programme or will change further programmes. And it’s true. Military coups happen, floods happen, ebola outbreaks happen (these are all real examples).

However, a lot of the time, the reason why NGOs don’t meet their targets is because they set unreasonable goals. More and more NGOs compete so they have to overpromise to get a grant – and it’s easier to ask forgiveness than it is to get permission to reduce your targets. Forgiveness is also a lot easier to ask for when you’re learning lessons from your mistakes.

Why failure can be a good thing (even if society is saying it can’t)

The start-up sector is all about ‘failure’ – if you haven’t failed once, can you really call yourself an ‘entrepreneur’? Of course you can, but the start-up sector is well known for learning from its mistakes. Quick product development cycles means quick shipping, means quick failing means quick re-building – all very lean.

For people outside the sector may have difficulty understanding the value of failure, because it’s engrained in our society that failure is bad –

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I can tell which Mum I’d prefer…

I think we need to revisit the whole structure of the NGO sector. Accept that failure is ok – but constant mediocrity is not. I don’t think that investing more in evaluation is necessarily the solution, because it only means that for every million you spend on a project, you pay a million and a half on an academic study. I may be exaggerating here, as I don’t have the exact figures. However, what is key is that it’s not simply a question of evidence – it’s about how donors allocate money, how NGOs work together and how much duplication could be avoided if the NGO sector wasn’t a political competition for resources but rather a concerted effort for creating good in the world.

Why UX design matters in ICT4D interventions

UX design

Joe Dollar-Smirnov, UX Trainer at General Assembly, defines user experience (UX) design as the act of designing an intuitive and rewarding product or service around the needs of the end user. When working on products at OneWorld, I keep two objectives in mind: When interacting with the technology, the user needs have a successful and a positive experience.

To fulfil the first objective of creating a ‘successful experience’ is a pretty straightforward element of ICT4D interventions. Each ICT4D intervention has (or should have) a clear objective as to what the technology is supposed to achieve. This can be providing information on crop prices for farmers or giving community health workers access to their patients’ health records. It is key to the ICT4D intervention that the user experience of the technology is successful, as this will mean that the intervention is reaching its objective.

It is however also important to create a positive experience, because it means that the chances that the user will come back and recommend the product to their friends, family and neighbours are much greater. Bad first user experience will put users off. In the case of data collection interventions, this may also lead to incorrect or incomplete data.

Additionally, it is important to work closely with your users, because you aren’t creating a product you would use yourself – at least in most cases. When you are designing for users who have a different relationship with technology, you need to spend considerable amounts of time testing and retesting. Else, you can easily fall into the trap of creating a product for the elites, who are more technologically-able and therefore more adaptable to new technology. Spending time and effort on user experience design will make sure that your product fits with your target audience.

A successful and positive user experience means that your product is more likely to have a larger reach, engage people and be meaningful, and is not a token product that ticks the ICT box.

If it is so important, why aren’t we talking about UX design in ICT4D interventions?

It is quite easy to convince engineering and management teams to create successful user experiences, since it’s essential to the objective of the product. But what about tweaking and adapting your product through series of user testing to create a positive user experience that leaves the user with a good feeling that means she’s likely to come back and recommend the product?

The eternal iceberg of development interventions – funding models – is a major obstacle in this case as well. With restricted funding and often-unrealistic expectations from funders as to how much time it takes to fine-tune a technology product, bug fixing and actually making the technology achieve its primary objective overrides any attempt to create positive experiences. While funders are easily impressed by products that fulfill their objective, they fail to see the importance of really good UX design in order to create meaningful products, that are constantly improved.

I really don’t want to name and shame some of the products I’ve seen out there, because I know a lot of hard work has gone into them and there are probably people at these organisations frustrated just as I am that they weren’t able to spend more time to improve these products. But if I see one more mobile data collection form with 20 drop-downs, I may change my mind.

I believe it is important that we talk about user experience in ICT4D projects and that we should build a community of practitioners who care about good UX and share the learnings from the for-profit technology sector with development practitioners. We need to increase the amount of training on UX design available to project and field staff, and put pressure on funders to allow us to improve products.

What about the men?

ICT interventions to prevent violence against women more often than not work with… women

In the last decade Information and Communication Technology (ICT) went from being a buzzword to representing an essential tick-box in the development community as more and more donors and NGO professionals see opportunities in ICT to add value to their existing projects, to ‘conquer the last mile’ and to scale up projects faster than ever before. Projects addressing violence against women (VAW) are no exception. There is indeed a plethora of ICT solutions that aim to fight VAW. A recent post by Hera Hussain on ICTWorks talks about some of the missed opportunities to address violence against women and also about some of the projects that are addressing VAW. Her article however highlighted to me an essential problem: too many of these projects target women.

I understand that women need to be informed of their rights, because they need to know that violence – in the household and elsewhere – is always unacceptable and that there is legal and social help available.

In the same way, creating better ways of notifying support services or the police can be helpful for survivors of violence against women.

Finally, gathering data on VAW helps to inform policy decisions and to increase awareness.

But all this will not change the fact that there are people perpetrating violence against women – many of them men. Yet most projects that are involving men to reduce levels of violence against women remain at the community-level. They often come in the form of training, workshops and peer education. They also require a long-term commitment.

While ICT is not the magic bullet some make it out to be, I think that the one missed opportunity in addressing VAW using ICT is the fact that men are not involved enough as part of these interventions. I find it a shame because it’s been widely acknowledged that we can’t address VAW without men on our side – whether that is for addressing rape culture on university campuses or intimate partner violence in the household.

One of the few examples I heard about was from GoJoven Belize at the YTH Live conference last April in San Francisco. They partnered with the Center for Digital Storytelling for a project called ‘Youth Leaders Speak‘, where young people are trained to create their own videos on a variety of issues linked to adolescent sexual health and rights. The presenter worked with a particular group that reflected on male values and masculinities in the community to create their own videos, which they then showed to their community to start a dialogue.

I would love to hear about more ICT projects addressing VAW prevention that also involve men! Are there maybe:

-> eLearning modules for groups of men and boys to learn about concepts of masculinities and VAW?

-> eLearning modules for parents to rethink the values they are passing down?

-> support groups and call-in numbers for men who display aggressive behaviour?

-> SMS advocacy campaigns to raise awareness about values, gender roles and culture?

If you know of any projects, I would love to hear about them!

How can mobile technology improve health in LMIC? (UCL conference)

Today I attended the first day of the mhealth conference at University College London on ‘How can mobile technology improve health in low and middle income countries?’. Here are just a few thoughts based on the presentations and discussions I heard today!

Some key points from the day

– Account for disabilities in mhealth interventions: they can be easily overlooked, even low eyesight which we may not think of as a disability needs to be addressed in text-based interventions

– Governments and Ministries of Health are key players – especially good if ‘early adopters’ are in charge

– Motivation to get people to use mhealth tools in the long term can be increased through:

  • Incentives (monetary or other)
  • Feeling valued and trusted (e.g. by giving them the mobile device)
  • Regular checks, especially when data shows there is drop in usage
  • Empower some as ‘experts’ or ‘supervisors’ to help others with technical aspects

– We need to get better at describing what exactly interventions do in research papers – and if any of the people who voiced that concern are reading this – could you give examples of studies who do it well?

Further thoughts

Content vs. tech evaluation: There were quite a few questions about the content of some of the mhealth interventions that were presented (e.g. motivational messages for community health workers (CHW) or the maternal health messages for families in Bihar). Both speakers made it clear that their messages had gone through a lot of testing and, for the messages in Bihar, had been approved by a government committee. Sandeep Ghosh from BBC Media Action also made the point that their intervention has shown very positive results, which in a way shows the success of the content. While this is great, and I’m sure that for both projects, they had very capable people (and the budget to get these people on board) where is the learning for other organisations and charities, who want to replicate this type of project? I think that additional research specifically on content would be beneficial.

Health outcomes: Throughout the whole day, it became clear that the focus on health outcomes is crucial in the field of mhealth evidence, as process and usage data only gets us that far. However, I see that if you are a big research institution like UCL, focussing on health outcomes is great. Yet, what can smaller NGOs do when their M&E budget doesn’t allow for a sensible sample size to measure all these health indicators? How can research institutions reach out more to NGOs?

Health communication: I felt that a lot of the discussions were about mhealth as a way to strengthen health systems, while health communication wasn’t center stage. I think it would be interesting to look a bit more at health communication interventions which use mobile devices, and their evidence.