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The Birds & The Bees & The Bots

Updated: Apr 19



Talk Description: Can AI technology promote better reproductive health? Laura Cusson and Diana Klatt discuss how Nivi, an AI-chatbot and digital health platform, puts people at the center of care for taboo topics.

Host: Susanna Harris, of Xontogeny and Biotech Clubhouse





Transcript:


Susanna Harris (SH):

We can get started. Thank you to everyone who is in here and listening, very excited for this chat, mostly because health tech, biotech, all these different things that end in tech it really, there doesn't think it'd be that much of a difference, right? Or there's this huge overlap and why can't they all be the same? I don't know. So I am very excited to learn about biotech, about health tech, about pharma, and just really hear about what people are doing in these different spaces. So I'm very, very excited to talk today to folks who are working at this company called Nivi and Nivi is an AI chat bot and digital health platform that puts people at the center of care to create better health outcomes. So that's kind of the tagline, but what does that really mean? And more importantly, maybe digital health platform.


SH:

What is digital health? And, and why is that any different from just a, you know, what, what counts as that is an app on your phone? Like sometimes there is a menstruation tracker app is that digital health is something that is tracking your heart rate, is that digital health? What, what, counts as digital health? So Nivi is a small team of around 10 to 15 people, but with a huge growing impact on users all around the world and specifically focused on this international view of how can they help people in totally different countries with totally different standards of care and standards of what is taboo start talking about reproductive health and getting access to the top lines of care. So we're going to be talking with, Laura Cusson the askNivi, product owner, and Diana Klatt, who is the insights senior product manager. We're going to talk about what exactly all of those things mean.


SH:

We do have it open, so people would like to ask a question, feel free to do so we're going to probably hold your questions until the end. So, first of all, I just want to know what your jobs are, what does product owner versus product manager mean? So I'm going to start with Diana. Diana, if you would give me a little bit of your background, you know, you, and I know each other from totally different space of leaving academia, thinking about that, but over the last few years, you've really transitioned into this new realm. So would you tell us a little bit about your background and then what you do at Nivi,


Diana Klatt (DK):

Yeah, it is. It's interesting because you, and I know each other from a very different time in the context for grad school and the, the sleepless nights, and the... It just, I, I don't like thinking about it.


DK:

Yeah. I am in charge of basically the data analytics, when you say insights senior product manager, insights quite literally insights into our data. But moreover, that means that, you know, I'm able to understand user behavior, human health behaviors, and how the data we collect from them can be used to better help the consumers and the people producing services and resources for consumers, right? So it helps on both sides. So my job really is to be able to look at how all that works together and how we can use our platform in a way to help better promote health behaviors, and outcomes for people and how we can get them resources and get them to resources. My background is in a lot of different tech. I went to the engineering school for my undergrad, so no shock that I'm here now working in health tech space. And then I went and did for a school for physical therapy. And then I ended up doing public health. So really everything was feeding towards me getting to the point of things that, you know, get people to the best services possible and to get the best health outcomes possible. And reproductive health is really important because that's how more people are made or not made.


DK:

But also we all have, we all have reproductive organs and know more about, than the knowledge that's there, but in our bodies. Right?


SH:

Absolutely. And then you brought that really important point of, you know, this isn't necessarily something that's talked about enough that people feel comfortable seeking out support and seeking out help. And that really brings over to you, Laura I'd love to ask you the same question about background and roles. And a big part of your role is that of making it so that people do feel comfortable asking these questions, but not really to a real person?


Laura Cusson (LC):

Yes. So my, my background much like Diana's has kind of culminated in, in leading me to, to this, this direction. I've spent the last 20 years in marketing and project management, which means I'm really good at cracking the whip and getting work done. And, and then product management. So it's been an interesting evolution of my career. And you know, I've worked with brands like Ikea, CVS Health and Fidelity investments that is exactly as dry as you think it would be. And you know, but really wanted to work for a startup that, that was actually impacting people at the end of the day. And so that's why I'm, I'm here at Nivi. My, my role is to lead not only just product where the chatbot itself but also marketing and also all of the content within our chat bot.


LC:

So crafting those end to end experiences from that first touch of the, of the consumer in social media or other types of advertising all the way through to, you know, hopefully getting to that line of care where they're going to a clinic to take up a new contraceptive or getting, getting an HPV vaccine. So really seeing through that end to end experience.


SH:

And, you know, talking about chatbots, I think we've all know engaged in some sort of chat bot. The first thing that comes to mind is when I have an issue with my insurance. And what is for you, what are the, what's worked for a chat bot to have, like, how do we, how do you... Do people actually engage with a chatbot?


LC:

They do! It's, it's remarkable. I think the nice thing about Nivi is that we're we're private or confidential.


LH:

So you can feel like you're sort of exposing yourself to us. But, and we're able to give you that personalized information without knowing exactly who you are. And so that confidentiality, I think puts people at ease to be able to interact with content that might be a little bit taboo or uncomfortable.


SH:

And so, so Diana, if I understand correctly, you know, a lot of your side is those insights is figuring out kind of who people are, but how do you do this? If it, it is, private? How do you, how do you get the information that you need to even make these suggestions?


DK:

Yeah. So in general for those types of research in settings that involve humans and people, and especially in healthcare, you do a process of de-identification. You know, so we don't have anything that you just use an ID and account ID, like a unique identifier for each person.


DK:

And we also don't, you know, mine any data. So it's basically up to you to decide what it is that you want to provide us with, which I think is an important thing in terms of protecting people's privacy. So, you know, we're not just creeping on you all day long. We ask you, what you want to share with us and what you what behaviors you're looking to do, what you don't want to do. Like what types of actions you take now, what types of, you know, in terms of sexual and reproductive health, what types of methods do you use now you've used in the past. So we're asking you for your history. But not in the way that you know a medical questionnaire is like in the last 12 months, have you done this?


*All Laughs*


SH:

No, absolutely. Well, and I would love either of you tell us a little bit more about the business model, right? Like both on the side of who is using this, who is your target user and then who is paying for this? Because the part of, part of it is like access to reproductive health and really in terms of all public health, usually the folks who need the access the most are the ones who can't afford to pay for all of the different gadgets and access. So how is your product specifically designed to increase access?


LC:

So we are still learning about, you know, smartphone access in some of our countries, but we definitely know that that's very accessible within India, which is one of our major areas of focus and, you know, people having access to Facebook messenger as well as WhatsApp. These are mostly installed on everybody's phones, so they can use those platforms for free and not necessarily need extra space on their phone to be able to download an app that they don't know that they're gonna use for very long.


LC:

So this is where it is great that we're able to deploy, Nivi, our chat bot into places where users already are. We're not forcing them to do this additional download you know, to, to come to us. We're, we're already where they are. So that's a big point on the, on the consumer side. And then on the customer side, how we make money is we currently are in a subscription modelwhere customers like non-profits and other NGOs will subscribe to our platform to be able to bring their users to our content. And then we we will work to behavior change those users who come in and hopefully get them to take up a method of contraception or go to the hospital for a visit and and, and get those users to our referral. Um and that's the end goal of the customer side.


SH:

That's so cool. And then one thing that we chatted before this discussion, that you brought up in that, going back to that point of meeting users where they are, I mean, this is both technologically and actually physically, so one thing that you, you both told me yesterday is like, when you get a phone in certain countries, like W hatsApp is actually on there and you're often limited in app space. Why is it important to consider where a person is by location in terms of their accessibility, or even possibly how, how they're approaching such a unfortunately taboo topic


DK:

Location comes in, especially for access and just in terms of whether or not they'd have a device or something that they could use for contact, but also in terms of access to actual service resources, right? So in terms of like the technology of things available, we actually did a study and the like Q4 of last year with Surgo Ventures and the Clinton Health Access Inititative - gotta get that acronym right in my mind... CHAI


*All laugh*


DK:

In India. And we found that a lot of users in rural locations actually have access to smartphones or phones that have capability of talking on messenger or WhatsApp, which I think a lot of people don't think is common, right? A lot of people think of rural places and not be reachable, but as technology continues to grow and becomes more accepted you know, just more produced and accessible in places have it in that people are connected. And in terms of becoming like personalized and location-based, you know, we, we ask users and consumers like where they're located so we can refer them to the best places located close to them. Right. We're not trying to send someone like to the next city over, how are they going to get there? We want them to be able to learn about this information, you know get answers to questions they've been asking and like, trying to figure out how to better take care of themselves or understand maybe myths or misconceptions about certain things like, you know, different contraceptives and then find what's best for their need. And then also where to get them and like, you know, either they're going to some place or even, you know possibly that comes to them.


SH:

Yeah. That's, and that kind of leads me to this next question. How do you, how do you make sure that this doesn't become spammy? Right. I think that one of my, when I hear about anything like that, it's almost too good to be true. It's like, Oh, well, I'm going to have this thing that I chat with and it can help me with my health. How do you make sure that people aren't just essentially just getting ads that are useful to them but you still have the financial backing to create this.


LC:

I think it's, you know, really leaning on our content and making sure that the content is relevant and it's, it's speaking to them in a way that is accessible and understandable. And frankly we try to, we try to have Nivi's voice kind of be like that trusted aunt. You know, who won't go to your mom and, and tell all your secrets but you know, she's, she's going to help you and she's going to tell it to you straight and give you real answers. So that's, you know, keeping her friendly and likable, but factual I think is, is the key to keeping, keeping her accessible and, and keep people coming back.


DK:

And then, I mean, in terms of like spammy-ness, it's, you know, it's something that's, we're also the privacy and having it in formats like WhatsApp and messenger, you can delete the messages and come back, right. You can delete it. And then when you want to talk with us, we're here for you.


LC:

We're even finding that some of our users share a phone in their household. You know, someone might share a phone with their spouse and, and need to delete that so that they don't see that, you know, maybe they're trying to take up more of a concealed form of contraception. So we, we try to be really sensitive to those needs of our users as well.


SH:

And I love that both of you bringing up this really important thing of meeting people where they are, and also that cultural sensitivity of not, not putting some of those westernized belief systems of, Oh, well, it should be this way. It should be reproductive health should be open and everybody should be able to talk about it. And she alleged promote that, but it's just not the reality in some places. You know, Diana, and I mean, you have this really interesting background and, and you have your own podcast Global Caveat where you have done some digging into thinking about cultural sensitivity. How, how has that overlap, shaped how you work within this company?


DK:

Well, first I love the optimistic thinking that you can talk about reproductive health in Western countries.


*All Laughs*.


SH:

Because you can't...


DK:

It's an optimistic statement. But it's definitely more open than it is in other places, but, you know, I think that you know, a lot of my personal work is aroundyou know, being cognizant of different cultures and understanding what is necessary in order to really make sure that everyone is not really assimilating, but cohesion and acceptance. Right. And I think that in terms of when I'm looking at data, I think there are a lot of trends that you see come up that might be a abnormal for some people. But if you take into consideration that the locations that you're looking at, you know, they're not that strange, they're like pretty common. So like, you know, things that related to um you know What are the, what is it called - arranged marriage, things like that that's very common in our locations, right? But it's not something that you might think of here. So when we're reading certain things at the comment that, you know, Laura made earlier about how some people might want a more concealed method, that's not something that is quite as common or frequent in Western cultures, that it is, and a lot of other cultures. Right. so it's a matter of being able to understand the backgrounds and when we're trying to impact user behavior and change user behavior for better health outcomes, we need to know what the societal norms are that help establish the baseline to each place because we're located in, I don't think that we've mentioned it. So we were located in India, South Africa, Kenya, Nigeria, and each place has a different baseline. You can't take values and ideas in one place and just blanket it and say like, this is the same and how we're going to run in each place.


DK:

While information is the same everywhere because human body, they're human bodies where we're starting from and where we're trying to get people to differs from, you know, city to towns, to villages to this country. You know, it's not quite the same everywhere.


LC:

And that's an interesting topic to, to bring up our content to Diana, like being, we don't just translate our content. We really do this process of transcreation where we're thinking about the sensitivities in each of the countries. And we use different words for things in different countries. So we say family planning in India where in Kenya and Nigeria, we say contraception. So we're really trying to be sensitive to the way that people talk about these topics. And, and you got that into our content as well.


SH:

And how does this, how does this differ from other preexisting platforms? I mean, I know that this is not the idea of maybe SMS messaging that that might not really be new. How, how is this, how is Nivi different?


LC:

So we do have a home grown platform for delivering all of our content to our companies which, you know, probably isn't necessarily new, but but we've kind of implemented it in our own way so that we can deploy our content in multiple channels. And we really were striving for that two way dialogue where we're not just blasting messages out to the user, they can respond. Right now it is menu based. But we have big aspirations. We're getting this platform more more integrated with natural language processing and artificial intelligence and to be able to respond to users, speaking about these topics in their own words. So that's the future of our platform and what we're building toward. We not be so different right this moment, but we are who we have big aspirations.


DK:

And just to put some context in there, you know, traditionally the use of chat bots or digital health in the context of public health, it is it's changed quite a bit. Originally, you know, we were talking about like SMS versus a bot or different things. So traditionally public health has used digital health and health as SMS or voice recognition technology. Right. Which is just like on the phone. And I sent you some kind of message or some kind of robot on the phone, which as I'm sure we've all experienced is the least favorite thing. I don't, you know, you can yell like, no, that's not what I said, like, did you mean this? No, that's still not what I meant. Like moving so far, you know, getting rid of the barriers that exist around that, but it's really like they're individual tech and engineering and health and the possibility that we can have moved forward and where we're moving towards really, you know, make that's what differentiates us. Right. That's what helps make us, like we're moving forward into the future of technology and how technology is growing instead of being kind of stuck in this spot where we're like blocked by transitioning from SMS to bot to AI, to full on everything. Right. I mean, AI bot, but they're like the next thing and incorporate each thing to like, you know, GPT-3, the future, like keep moving forward as technology grows.


LC:

We're also sort of creating this unique intersection of health, tech and behavior change. You know, one of our, one of our co-founders is a, is a psychologist and a professor. And so, you know, he's trying to, you know, help move us in that direction of not just not just saying here's the content. Well, how can we, how can we change your knowledge and your attitudes to get you to do this behavior change over time? So we're, we're kind of repeating these journeys that will take users through. And we want to understand where they currently are in their mindset, on, you know, family planning or vaccine hesitation and trying to change their minds over time.


SH:

And I guess for both of you - why is, why is this venture so important? Right. Like working at a startup is a lot of work, you're both wearing a a ton of hats. Um you're working probably kind of some weird hours. I don't know, but it's what you're doing is, is a lot of effort. Why is this important? Why is this different than, you know, any other app.


DK:

I've had a lot of experience working in different types of public health and global health settings. I've worked on the ground in places, I've worked in non-profit you know, some other industry type places and I think that, you know, everyone kind of has their part that they're contributing to move us as a whole, like, as people toward better health outcomes. But the biggest thing that we do that I think is what was really motivating for me and why I choose to work as yes, weird hours sometimes, you know, I work at night and by night, I mean, like at 11pm or that's when it's, that's when the thoughts, right, me, like this is what I have to do. But the reason that this is so big is because of the combination of, you know, combating misinformation, myths, misconceptions, and educating people in a, in a way that, you know, free to them and easy to understand. And then also getting people to resources in places that, you know, they might not even realize that they have access to these resources.


DK:

We've seen things where people are saying how they've had community members or family members talk them out of something. And then afterwards learning from us, Oh, you know, they consider getting an IUD. They just didn't know that it was an option before. And just knowing that we're able to make an impact at such a great scale. You know, we're currently in four countries and likely expanding in the future and going beyond sexual health and reproductive health at some point, and, you know, it really makes a huge impact. And at the base of it, you know, reducing maternal mortality rate is a big deal. There's a lot of things that say not if you take care of a woman's health, you're basically able to improve the health or the longevity of an entire village. Right. And I don't think that's like and understatement, like women's health is a big deal.


DK:

They do a lot of work for communities for everyone. And I think that making sure that they have access to information and these resources is very important. And I also feel this way personally, I wish I had this. Right. Like, I don't remember my sex ed class, but I don't remember learning anything. Right. Sometimes there are some things that we kind of, like, there are some things that I've learned in our own app when I first started working here and being like, wait, what? I didn't know what it was.


LC:

What's your favorite? What's your favorite one? Diana, your favorite? Well, now I have mine.

I think yours is the same as mine. It's that an IUD can actually be a form of emergency contraception.


DK:

YES! That one! I didn't even realize


LC:

I did not know that either. And I've had an IUD before. TMI TMI.


LC:

I, I think a lot of my why is very similar to Diana's. You know, with, with all like caveat of, I've worked in very big companies before, and, you know, you just feel like you're just a tiny little cog in the wheel. And you know, even at CVS Health, you know, is impacting millions of lives, but this almost feels more impactful knowing you're, you know, impacting real people and, and that person took up an IUD or that person was able to get emergency contraception.


DK:

Um so it's like, it's like, I'm the cool aunt.


*Laughs*.


SH:

That actually brings up the question if I had just hire really to be the cool aunt and why not just have like a text bank of people. So that's not actually what you call it, but why not?


DK:

The, the scalability of that would the insane I don't know how other people feel, but during this pandemic, just being more available and on my phone now, sometimes when I see texts I'm like, I don't want that.


DK:

I don't want no more phones. Right. So I can't like, you know, it it's something that we Nivi at the, at the very beginning, if he did do the IVR voice recognition and there were call center, right. And then we slowly moved away from that. Because as you need to scale, you have to realize what aspects of things will scale on what will not and things that require you know, having people on the other ends of phones available at all different times does not scale. Even as much as you would hope that it could or wish that it could the best thing to do, you know, is to create some kind of tech, which is what we've done with their chatbot, that sorts, that everything gives you the information that you need and then helps direct you to the best person for what you're looking for. Right. Having it constantly go to like a text, like, you know, call center, whatever the text version of the call center is. Um I don't even remember what word you said earlier for that, but like.


SH:

I think called it like a text..text bank.


DK:

You know, it doesn't, those people aren't... We have so many responses to you, right. If someone like messages suddenly being like I'm bleeding uncontrollably, like I took the abortion pill two weeks ago, I hadn't stopped bleeding and it's normal. Like, why is this still happening? If noone's on the other line, that person going to be there continuously bleeding. Right. But if they have information going into it and they have someone guiding them along the way on that journey, then they know like either the signs I need to be watching for, and then I need to go back to the person that, you know, helped me get this.


SH:

So, yeah. I mean, Diana, in terms of the actual logistics of this, and we've talked about WhatsApp, Facebook messenger so you're doing this. All through WhatsApp is that other than the fact that it evolves is that is that a good thing? Does that make things easier or harder? What's the balance of that?


DK:

It's funny because Laura and I actually had a meeting earlier today where really angry about WhatsApp... Sometimes it's great. It's great. Whatsapp is available everywhere. But it's really helpful, like connect to so many people on me. If you have the ability to have this like amazing ability to talk to you on WhatsApp, FB messenger is not so great, which I think is hilarious because FB owns WhatsApp... But


DK:

You know, it's a really interesting thing I'm sure. Laura may have some things to say about it because really when it comes to implementing things, there's, it's great to be on people's phones in such an easy way. And I honestly think it is better than SMS, that because SMS gets cutoff in all sorts of weird ways. So you can really see what the format of a text will be, but in terms of implementation, like I would, I would go bonkers if I was in Laura's shoes. Like I just have to see the results at the end.


LC:

Yeah. There, there are challenges with trying to reengage people within the sessions and time limits and all that fun behind the scenes stuff that you've got to learn along the way. You know, and we're, we're, we're working to work within those bounds. Again, it's not easy, but as long as we understand the restrictions, then we can attempt to move the needle within. So it's, it is a constant struggle to keep up with all of the changes within Facebook and all the things that they allow and don't allow. So it's important for us as a technology company, they keep up on, on all the changes within these platforms and some of them are quite positive. But others, others can be a pain.


SH:

And for both of you, I think you need to be fed data to know of things they're working to, to improve, to iterate. And it's kind of this forwardfeeding cycle, right? Where you have the users who are going to be getting the information, and they're going to be asking the questions interacting. You also have the customers who are service providers, essentially, who are going to fund this service so that they can have a space online where their potential clientele, the people that they are trying to help in their region and get access to them, but to get the data, to get the right information to the users, you need the users there and you need the customers there, and you're not going to get the customers until you have users. How do you, how do you start each cycle?


DK:

A good question. You know, as I mentioned earlier, each place has a different way of trying to contact them. Like, no, if you tried to talk to anyone in the U S the same, you try to talk to someone in like, you know, Kenya, it would not work, right. You can't talk to people in different countries in the same way. And as soon, like what we got them they're going to buy that thing, you have to customize a little bit. Right. So a lot of what we do in terms of getting users is we use Facebook and Google advertisements, and we also have in-person campaigns on the ground, right. So of course with COVID everything, we can't do the same again for, through campaigns all over the place, if people are safe, that the boulders story, but, you know, it's gotten a little bit more of going back towards having that in-person and that in-person type thing. It looks more like booths and like ad service places.


DK:

And now we even have our logo and a QR code attached to stuff pads and different thing in Kenya. And it's a matter of being able to get users where they're at and then trying to catch them with something that speaks to them. Right. And then getting them into the system which is difficult. Laura, Laura has directly made the ads. I have just observed.


LC:

It's almost like self-fulfilling. So once we get some users to onboard into our platform from Facebook, then we can take that, that subset of users, and then feed that back into Facebook to do a lookalike audience. And so it's kind of like this endless cycle, but there have been times where we felt as if we might be tapping out a certain demographic. And that's when we have to get creative. And so we are on, on a big push right now for more organic content.


LC:

We have just started up a consumer facing blogm which we're excited about and doing a lot of, you know, search engine optimization and all of these feel like really old tactics, but that, that have been around for so long, but they're new to Nivi.


DK:

And it's not like there's a one thing that's all right, because over time you constantly have to shift anyways, because you hit saturation. It doesn't matter what industry you're in, what you're marketing or advertising. You can't use the same thing. Otherwise, I mean, the only thing that seems to work is Geico's like little green thing. Like, I don't know how that, I don't even know.


SH:

It's a gecko.


DK:

Oh! A gecko, maybe it doesn't work for me.


LC:

You knew it was Geico. *laughs*


DK:

Yeah. I knew it was a Geico. But you know, both people have to switch up the marketing over time because you can't just like constantly have the same thing and then.... People get tired.


SH:

Yeah. And I mean, I guess one of the things that might be nice about the Facebook WhatsApp platform situation is that I find if I haven't used an app in a while, I'll kind of forget about it. And then eventually when I refind it, it's like a 50/50 shot of if I just get rid of the app, even if it was useful when I needed it. And then once that's happened, I'm not necessarily going to download that app. So I guess my question though is for you, it's how, what do you see as the biggest challenges for implementation, as you know, you're in these four countries, which are very large, India that has quite a sizable population how did you get to get them implemented? How do you get this to stick? And to grow?


DK:

India is actually, we have over one and a half million users yet. But you know, the big thing is that we work with so many different organizations, ministries of health, government, different things. So it's not just like we're working with private organizations, right. We're helping to spread the word for public entities as well. So it being able to have such a wide range of things that we're working, we're working within what we're offering, whoever helping direct people to and information we're giving. I think that in itself helps spread the word. Right? So as you gain trust, I mean, this is like with anything, the things that become more well known are the things that have more trust, right? So in India, as we grow, it becomes easier to grow. And as we are connected with more organizations, it also becomes easier to grow up because we were becoming more and more well-established, we're known, like we're not just a random name and another person in India, right.


DK:

Where, like, when you say, you know, Nivi or something, someone might not want that bit. Right. And they might have chatted with it. They might've seen something. Or they may have seen us in one of the local newspapers. Right. So that helps a lot. We do a lot of different things with news outlets as well. And I think that helps grow in different places. So recently we launched in Nigeria and then a very different thing because it's like starting from scratch and trying to understand a brand new market and that, you know, it's, it's hard to break into someplace and then start growing. But it's definitely easier once you're already established, because then you can just continue to expand, assuming that product is good. And I'm not going to just tell everyone out there, like, Hey, you got a product. Just like talk about it for a long time and it'll all work out.


SH:

Yeah. And you know, to, to that point, I think especially a lot of this goes back to the trust of, do you, do you feel like you trust this bot and do you feel like you trust this company? And so I wanted, I mean, from my perspective, this seems like where sometimes digital health does fail, right? You look at something even, even something like 23andme, which most people know of as you send in your DNA and they do a sequence that they look for, all of your they look for a bunch of different single nucleotid polymorphisms or other markers that you might have genetic diseases. And they actually recently went public and through going public, it became a little more obvious what the busines model is and how they might be continue to going. And, and it turned out that he start pitch to investors was we are mining data and we're going to use the data we're going to sell the data. So this is not just about, okay, a lot of people's concerns were, are they going to, is this going to become a pre-existing condition? Right. But there is now this understanding that maybe people are going to be targeted by services. You know do you have any, you find people having concerns about how you're using their data?


LC:

I don't know that we've gotten any, any feedback, very specific to that, but we did have some interesting findings when we were launching in Nigeria. Because we knew that, you know, more people were onboarding through Facebook than through WhatsApp and our challenges with actually continuing to engage users on Facebook. We actually started asking for their phone number. So in the onboarding process so that we could send them an SMS to continue these longer conversations to follow up if they did go to a clinic to see how their experience was and see if they ended up taking up a method. And we saw a giant drop-off and onboarding when we were asking for phone number, people would just stop. So that, that was, that was very eyeopening to us. And I think, I think they, consumers in Nigeria were a lot more skeptical than we've seen in other countries.


SH:

That's so interesting. I mean, I, from my perspective, I completely understand that it's like, even when I'm out buying something at a store in the olden times when they went to stores where they're checking out yet and they're like, okay, I need an email to send you a receipt. Like, okay, whatever I have to give it to you. And then they asked for phone number like, no, I don't need you to text me. I definitely don't want you to anybody to call me. And so, and I mean, when they want to do, if they get one to send me offers, they want to send me ads. And a lot of times those ads benefit me if I ever want to buy something on a discount. But I think that just looking across and looking at how health tech is expanding you know, what do you think maybe other groups could have learned from Nivi? What do you think that you have as you're working with maybe about how to engage with customers or users in these different settings and to make them feel comfortable?


LC:

I think we're still learning. You know, I think that there, there's still a lot to learn from an onboarding perspective, bringing users on we're getting to a good point but we can always be doing better. And so I think at least since I joined in September, so I'm still pretty new, I've been heads down building, building, building, and I haven't had that moment to like come up for air and be like, I need to see what's going on around me. *laughs* Um and, and so I think, I think we're close to that point where, you know, we're at, we're at this point where we're starting to shift away from the subscription model and into this marketplace model. We are trying to learn a lot more about what potential marketplace customers are going to want out of this platform in order to, you know, form a partnership with us.


LC:

And I think we'll have a lot of experimentation to do as far as how much we've put in front of a user in a given session. You know, how, how we're able to successfully bring them back into the platform and continue that same health journey or asking them that they have another health concern. So I think, yeah, an interesting point.


DK:

And even just to go off of one of the things you mentioned that we have learned, and I've seen change over time with, you know, you coming on and doing your magic, versus who we had working on content before that, we used to send out a lot of texts, like a lot of messages... Like what fits in a SMS, like character with a text and like coming out, like, you know, you start having the conversation and like you get seven texts and it's like all the information, like that's too much, that's just too much.


DK:

I'm never going to look at this thing again. Right. And it's changed to be whittled down. So that way, like here are like, you know, one to three messages, not even that, not even three, usually, you know, it's like, here's some information here's like, yeah. And then here's a question, you know, like, do you need more information? Do you want some other information? Like, do you want to know how to get this, right. And it just immediately moves on instead of sending you just like all of that information. And that's definitely something that's like changed and also, you know, to be less spammy.


SH:

Well, and it's yeah, I mean, I think this is such great product. And are you, are you going to be expanding to different platforms or countries? What does the future of maybe just like, just tell me the next 10 years.


DK:

10 years? We're not even 10 years old! As a five year old, I would like to be an astronaut and as an adult. So we're going to space. Does that answer the question? Isn't that were all tech companies go? Space. Space. *laughs*.


LC:

Yeah. Family planning in space.


SH:

I mean it's going to be in zero gravity. You never know? Well, you're a little baby startup going on, still be a baby startup.


*Laughs*


SH:

What are you planning for? What are you excited for with Nivi specifically?


LC:

I think from my perspective on the, on the chatbot products side is really taking this from a fairly static platform that doesn't use a lot of its prior knowledge that it's about the user in a previous session and taking that forward to become more dynamic as well as you know, that NLP part data, being able to have the user express in her own words, what she wants to talk about and, and taking the platform in that direction is, is very exciting to me. And we have some, some great brains on the team who are going to help to get us there.


DK:

Yeah. I'm really excited for the future of more uses NLP and, you know, hopefully future use of, I have no idea when, when in the timeline, this falls in, but you know, the use of GPT3 because I think that was just amazing technology.


SH:

What is GPT3?


DK:

That's just um like, you know, automatically replying to you. I don't know if you've seen these things where you can start feeding, you know, essentially a robot these like some start a text and it will finish writing a whole essay for you in your language. Right.


SH:

That's basically gmail for me. It's like, it's like, yeah. The tab button.


DK:

But yeah, I think that that would be great, but something where we can immediately, you know, it's not just using like natural language processing, but also being able to like meet people and have it like automatically fill out to be more directly answering their question. And you know, GPT-3 is not, it's like still, you know, relatively new and it's, I mean, in terms of implementation, it's quite new in terms of other things it's been around enough for people to start implementing it, but we're definitely not quite there yet, but I'm excited for that int he future. And I'm also really excited for when we get to work beyond reproductive health and go more into discussing more things that are maternal and children's health and be able to deliver more information, to help get people more educated and be more empowered to make their own health decisions and be more comfortable asking for things that they didn't know before.


DK:

And you know, where they can even ask those questions and to who and how to get things.


SH:

I love that you're making kind of this true confidant where people don't need to know you have it, even though you're talking to it, they don't need to know where you're getting information. It's not logged in your search history on Google so anyone find it. And just to hear that you're looking at kind of sticking with people through the, through the life cycle of dealing with reproductive health and what that looks like. And once there has been the baby delivery, do you keep following it? I think that that there's so much potential to just continue changing how people are empowered to take control of, of their life, of their living situation of their family's future and stability. So my final question to both of you is what are you excited about in general in the field of health tech? And maybe kind of like can be related to Nivi, but if you're also like really jazzed about this, what are you excited about and maybe why, why would people want to join health tech?


LC:

Um I mean, I'm excited to be in this space because I've, yeah, I've been in software for so long. So I feel like I know how to lead software teams to getting things in production quickly. So it's just, it's, it's these muscles that I have and, you know, doing it for good and not for evil is great. And I think you know, technology isn't going away and we're,


LC:

I feel like, especially with the pandemic and things, you know, people have been putting off health care and I think they need to be putting it in a more on the forefront of their lives and making sure that they're taking care of themselves. And so I think there's just going to be the need for more people in this field. So they shouldn't be scared of it. Like I've never worked in public health. I've only worked in software, so you don't have to be scared of the content. You'll learn it, you'll learn.


DK:

Yeah. In terms of, you know, what I'm really excited about health tech is honestly just the growth of health tech. Having been more on the health side and the public health side, so many things existed in silos before a lot of things were blocked by just honestly, governmental or academic bureaucracy.


DK:

And I think one of the beautiful things about health tech is that it allows us to advances things in, you know, keeping up with humans and keeping up with the progress that we're making and the leaps that that technology makes. And, you know, so many things are not easily accessible. So many things are blocked by funding, blocked by access, blocked by insurance, all these things people get so tired of all these things, or, you know, people have amazing intentions and they get burned out and things like nonprofit and academia, you know, you just end up not wanting to make an impact anymore because you just get so tired. And I think the growth of health tech that allows us to take these ideas that we've had this education, this learning, all of this stuff on what we can do to advance our health and actually find a way to implement it and get it moving forward.


DK:

Right. And technology is moving, like the tech industry move at such a fast pace and health industry is just so behind honestly. And I think that the merging of the two in the health tech space really is going to help improve so many things and our health outcomes and just help increase people's literacy, understanding, everything, and access. Yeah, I'm just like super jazzed about it existing in general. And even just, you know, the way that the vaccines for COVID were produced so quickly, it's because we broke down these walls. Right. And like allowed different people to work together and like, look at what we do create when we work collaboratively and forward with the pace that, because using everyone's combined knowledge to move forward.


SH:

Yeah. I mean, I think she, or my about just this space, it's a lot of hard work that you see that impact at any other team of somewhere between 10 and 15 people and you're impacting literally millions of people's lives and that's just the users, right? Like that's the thing too, is that if you have going back to where you started and what you said at the very start, if you are supporting women's health, you are supporting humans health, you are supporting the family, you are supporting the future of that family. And you're supporting even for women who get the opportunity to continue their education or so any outcomes of this that reminds me of one quote that I, someone said to me once it was just always going to stick there where they worked. They said they work in, they work in biotech, but they work in industry rather than in these other spaces because they see that, that the paper, whether it's a white paper or an academic journal that's just to start that abstract of a paper saying, this is how cool these products could be, these services could be. And that's really where industry picks up and starts running. Okay. So before I let you go, let people know what, you know, how did they learn about Nivi, who should be learning about Nivi? How, how do we follow along also, how you all along with both of you got some pretty cool careers. I'm sure people would want to know a little bit more about that.


DK:

Maybe you can follow us on LinkedIn and Twitter on Twitter handle is @askNivi, one word and you know, something that we have, we have coming up, we have the challenge that we're going to be announcing in conjunction with USAID. So please do follow along and find out more about that and how you can make impacted people's lives through the power of chat.


DK:

And for my personal use, follow me at @DianaKlatt on Twitter, or if you want to learn about cool cultural things and you know, human rights and social justice, you can also follow me on Instagram at @Klattalyst. I suggest you find me on Twitter and go to Instagram from there because spelling of Klattalyst is tricky.


LC:

Uh I'm, I'm boring, I'm not on socials.


SH:

That's, you know, where I think like with this discussion be where you are, do it well, and also work with people who are in other spaces. So thank you both for being on here. I'm sure listeners got to learn a lot about what it can mean to be in different spaces and health tech, especially startup spaces where small startup making a huge impact to going really big places. And I think, you know, the information that you're going to gather there, it's just very clear that there are implementations all across different health sectors. So thank you both so much for being here and hope everyone online and listening to this in the recording has a great rest of their day. Thank you.