Using WhatsApp to improve family health

Guest post from ​Yolandi Janse van Rensburg, Head of Content & Communities at Every1Mobile. This post first appeared here.

I recently gave a talk at the MERL Tech 2018 conference in Johannesburg about the effectiveness of Whatsapp as a communication channel to reach low-income communities in the urban slums of Nairobi, Kenya and understand their health behaviours and needs.

Mobile Economy Report 2018. Communicating more effectively with a larger audience in hard-to-reach areas has never been easier. Instead of relying on paper questionnaires or instructing field workers to knock on doors, you can now communicate directly with your users, no matter where you are in the world.

With this in mind, some may choose to create a Whatsapp group, send a batch of questions and wait for quality insights to stream in, but in reality, they receive little to no participation from their users.

Why, you ask? Whatsapp can be a useful tool to engage your users, but there are a few lessons we’ve learnt along the way to encourage high levels of participation and generate important insights.

Building trust comes first

Establishing a relationship with the communities you’re targeting can easily be overlooked. Between project deadlines, coordination and insight gathering, it can be easy to neglect forging a connection with our users, offering a window into our thinking, so they can learn more about who we are and what we’re trying to achieve. This is the first step in building trust and acquiring your users’ buy-in to your programme. This lies at the core of Every1Mobile’s programming. The relationship you build with your users can unlock honest feedback that is crucial to the success of your programme going forward.

In late 2017, Every1Mobile ran a 6-week Whatsapp pilot with young mothers and mothers-to-be in Kibera and Kawangware, Nairobi, to better understand their hygiene and nutrition practices in terms of handwashing and preparing a healthy breakfast for their families. The U Afya pilot kicked off with a series of on-the-ground breakfast clubs, where we invited community members to join. It was an opportunity for the mothers to meet us, as well as one another, which made them feel more comfortable to participate in the Whatsapp groups.

Having our users meet beforehand and become acquainted with our local project team ensured that they felt confident enough to share honest feedback, talk amongst themselves and enjoy the Whatsapp chats. As a result, 60% of our users attended every Whatsapp session and 84% attended more than half of the sessions.

Design content using SBCC

At Every1Mobile, we do not simply create engaging copy, our content design is based on research into user behaviour, analytics and feedback, tailored with a human-centric approach to inspire creative content strategies and solutions that nurture an understanding of our users.

When we talk about content design, we mean taking a user need and presenting it in the best way possible. Applying content design principles means we do the hard work for the user. And the reward is communication that is simpler, clearer and faster for our communities

For the U Afya pilot, we incorporated Unilever, our partner’s, behaviour change approach, namely the Five Levers for Change, to influence attitudes and behaviours, and improve family health and nutrition. The approach aims to create sustainable habits using social and behaviour change communication (SBCC) techniques like signposting, pledging, prompts and cues, and peer support. Each week covered a different topic including pregnancy, a balanced diet, an affordable and healthy breakfast, breastfeeding, hygiene and weaning for infants.

Localisation means more than translating words

Low adult literacy in emerging markets can have a negative impact on the outcomes of your behaviour change campaigns. In Kenya, roughly  38.5% of the adult population is illiterate with bottom-of-the-pyramid communities having little formal education. This means translating your content into a local language may not be enough.

To address this challenge for the U Afya pilot, our Content Designers worked closely with our in-country Community Managers to localise the Whatsapp scripts so they are applicable to the daily lives of our users. We translated our Whatsapp scripts into Sheng, even though English and Kiswahili are the official languages in Kenya. Sheng is a local slang blend of English, Kiswahili and ethnic words from other cultures. It is widely spoken by the urban communities with over 3,900 words, idioms and phrases. It’s a language that changes and evolves constantly, which means we needed a translator who has street knowledge of urban life in Nairobi.

Beyond translating our scripts, we integrated real-life references applicable to our target audience. We worked with our project team to find out what the daily lives of the young mothers in Kibera and Kawangware looked like. What products are affordable and accessible? Do they have running water? What do they cook for their families and what time is supper served? Answers to these questions had a direct impact on our use of emojis, recipes and advice in our scripts. For example, we integrated local foods into the content like uji and mandazi for breakfast and indigenous vegetables including ndengu, ngwashi and nduma.

Can WhatsApp can drive behaviour change?

The answer is ‘yes’, mobile has the potential to drive SBCC. We observed an interesting link between shifts in attitude and engagement, with increased self-reported assimilation of new behaviour from women who actively posted during the Whatsapp sessions.

To measure the impact of our pilot on user knowledge, attitudes and behaviours, we designed interactive pre- and post-surveys, which triggered airtime incentives once completed. Surprisingly, the results showed little impact in knowledge with pre-scores registering higher than anticipated, however, we saw a notable decrease in perceived barriers of adopting these new behaviours and a positive impact on self-efficacy and confidence.

WhatsApp can inform the programme design

Your audience can become collaborators and help you design your programme. We used our insights gathered through the U Afya Whatsapp pilot to create a brand new online community platform that offers young mothers in Nairobi a series of online courses called Tunza Class.

We built the community platform based on the three key life stages identified within the motherhood journey, namely pregnancy and birth, newborn care, and mothers with children under five. The platform includes an interactive space called Sistaz Corner where users can share their views, experiences and advice with other mothers in their community.

With a range of SBCC techniques built into the platform, users can get peer support anonymously, and engage field experts on key health issues. Our Responsible Social Network functionality allows users to make friends, build their profile and show off their community activity which further drives overall user engagement on the site. The Every1Mobile platform is built in a way that enables users to access the online community using the most basic web-enabled feature phone, at the lowest cost for our end user, with fast loading and minimal data usage.

Following the site launch in early August 2018, we are now continuing to use our Whatsapp groups so we can gather real-time feedback on site navigation, design, functionality, labelling and content, in order to apply iterative design and ensure the mobile platform is exactly what our users want it to be.