To meet needs from a distance, NGOs turn to chatbots

SAN FRANCISCO — StrongMinds, an organization focused on treating depression among low- income women in Uganda and Zambia, has suspended its in-person therapy groups.

Recognizing the need for these services would only grow during the coronavirus pandemic, the organization rapidly pivoted to a public education campaign to teach people about depression.

It also created a chatbot — a software program that uses automation to interact with people through voice or text — featuring Amani, a gender-neutral personality that can answer questions related to depression, provide simple coping strategies, and connect users with additional help.

StrongMinds was one of the organizations selected for the Chat for Impact Accelerator, a program taking place virtually this week from Wednesday to Friday. The goal is to assist social impact organizations in setting up chat services on WhatsApp so they can have conversations at scale despite social distancing measures.

NGOs that invested in chatbots before the pandemic are now finding messaging at the center of what they do, while those without programs in place are working to catch up.

Chat platforms including WhatsApp, which is owned by Facebook and has 2 billion active users, allow NGOs to meet their users where they are versus asking them to visit a site or download an app.

Still, the key to success is not just scale of reach, but whether interactions with those users lead to real-world behavior change.

“It’s building a service, connecting with your audience, engaging with them, getting them to take some kind of action, and measuring whether they did something in real life,” said Gustav Praekelt, founder and CEO at the Praekelt Group, which includes the nonprofit Praekelt.org and the software as a service company Turn.io, which is organizing the Chat for Impact Accelerator.

He mentioned MomConnect, the digital maternal health platform Praekelt.org runs in partnership with the department of health in South Africa, as an example. The question is not just how many pregnant mothers opt into the service, but whether that two-way dialogue improves the health of mothers and their infants, as well as experiences of service delivery, he said.

The Praekelt Group launched the Chat for Impact accelerator as part of an effort to expand its focus from implementation of programs to support other NGOs that seek to leverage mobile phone technology including chat services.

“Maybe you’re sophisticated as an organization, but you’ve never built large scale digital tools, or you don’t know how to turn your theory of change into a causal chain of behaviors,” Praekelt said.

The Chat for Impact accelerator draws on lessons from consulting that Turn.io has done with a range of partners to test ways that WhatsApp might be a useful platform for their work.

For example, Turn.io worked with partners including AgriFin, a Mercy Corps program that develops digitally enabled financial and information services for smallholder farmers, to rapidly deploy a WhatsApp service called the Shamba Shape Up Hotline to allow for citizen reporting of desert locusts.

Following the Chat for Impact Accelerator this week, the Turn.io team will organize additional accelerators in different verticals, including education, a sector with a sudden increase in demand for messaging services as schools close down.

Nonprofit Dost Education has tried several strategies to reach parents in India who want to improve their child’s school readiness. The organization walks parents through daily activities they can do with their 3 to 6 year old, like using lentils to teach their children colors and shapes. Eighty percent of their users are mothers, who tend to be the primary caregivers, and often have to share one smartphone with other family members.

SMS was a failure, as the service is often flooded with spam, and messages can get lost in the shuffle, said Sindhuja Jeyabal, cofounder and chief technology of Dost Education. One-minute phone calls have proven to be popular, particularly for illiterate parents, and recently the organization has built on its 24-week learning at home curriculum with a two-week COVID-19 program. With increasing access to smartphones, WhatsApp has emerged as a compelling option for Dost Education, because the platform allows for interactive content and the opportunity for feedback. But the transition to smartphones brings opportunities and challenges.

“We’re really competing with entertainment options on smartphones,” Jeyabal said. “It was not a problem in the flip phone model. But if they switch on the data on their smartphone, do they want to teach their kid, or do they want to watch a video on YouTube?”

One of the major reasons that WhatsApp has emerged as such a valuable tool for health is because of its end-to-end encryption of messages, Praekelt said.

“WhatsApp can’t see it. Facebook can’t see it. Your government can't see it. Only you and the organization you’re dealing with can see it,” he said.

The platform does share some information with Facebook, and some NGOs have opted for alternatives citing privacy concerns, but others see WhatsApp as the best way to reach the communities they aim to serve.

“This is the way all of India is communicating,” said Shahed Alam, co-founder and president of Noora Health, which provides the families of patients in India and Bangladesh with the tools and knowledge they need to provide care. “The vast majority of families we work with have at least one phone with WhatsApp on it.”

Noora Health evolved from the Design for Extreme Affordability course at Stanford University.

Initially, the co-founders were skeptical of technology, but over time they saw the role that messaging could play as an extension of their in-person programs.

The team started by copying and pasting messages from Excel into WhatsApp and setting reminders to follow up with users, but they kept getting blocked because they were trying to reach people at scale using the same techniques individuals use to chat with friends or family.

Turn.io helped Noora Health navigate how to use the WhatsApp Business API developed for nonpersonal use of WhatsApp.

Now, this scheduled follow-up with family members of patients is automated, Alam said. And in addition to providing information to patients and families, Noora Health is now serving health care workers looking for information on COVID-19 in the states where they are working. Alam said that by using WhatsApp, they can access this information not from a text-heavy PDF, but a user-friendly bot.

Update, August 7, 2020: This article has been updated to clarify what information WhatsApp shares with Facebook.