This post is the second in a six-part series featuring Dalberg’s contributions towards achieving the goals discussed at the 78th session of the United Nations General Assembly (UNGA), held 18 to 26 September 2023.

The event ‘Roundtable on Accelerating Equitable Digital Innovations for Women’s Reproductive Health’ was held at the American Heart Association’s New York City offices during the 2023 UN General Assembly (UNGA). Dalberg, Re:Solve, The Case For Her, and the Global Task Force on Women and Noncommunicable Diseases brought together innovators in the women’s health space to share learnings on the role of digital solutions in advancing equity in sexual and reproductive health. The discussion drew from the experiences of digital health initiatives including the Helm, Vitala, Nivi, Intrahealth, and Oky.

Below are six takeaways from the conversation on how best to accelerate digital innovations for sexual and reproductive health and address disparities in access. We also include a call to private investors, public funders, and innovators to put these principles into practice and scale the impact and learning that these initiatives each offer across the sector.

1. Fund women-led solutions for women

Currently, only 2% of venture capital globally is allocated to women, and only 4% of R&D funding is directed toward women. Women are underrepresented in medical research, the tech industry, and the datasets that underpin artificial intelligence. This lack of representation perpetuates a longstanding legacy of medical systems designed “for men by men,”, resulting in significant disparities between women’s actual health needs and the products and care provided. Actively funding women-led solutions stands as one of the most effective methods for addressing these compounded biases. The Helm has been a pioneer in bridging this divide through its venture capital model, which focuses on directing funding directly to women-led solutions addressing women’s healthcare challenges. Their portfolio includes female-founded startups like Tia, a “one-stop-shop” for women’s health, focused on gynecology, primary care, mental health, and wellness services, including telehealth options and digitally enabled care coordination. 

2. Design with the hardest to reach user in mind

Centering equity in solutions hinges not just on what you design, but for whom. Innovators emphasized the critical importance of designing for the most excluded individuals to create inclusive products. Vitala’s Aya Contigo app provides a practical model for achieving this goal, supporting women seeking abortions in Venezuela. By first designing for women in a legally hostile, highly stigmatized, and challenging humanitarian context, they have been able to increase access for some of the most marginalized and are now adapting and scaling their offering to reach more individuals in other settings. To design the product, they conducted interviews with over 1,000 Venezuelan women to understand their needs for accessing abortion safely. Based on these conversations and in collaboration with feminist grassroots organizations, they co-designed every aspect of their app, from the services offered to the type of Spanish used, with an all-female development team. As co-founder Genevieve Tam explains, “When you place gender-diverse and marginalized women at the center of the design process, you can advance gender equality on a broad scale.” 

 3. Leverage the power of digital to create highly individualized patient experiences

When used correctly, technology can offer personalization of health information and services at scale. Doing so correctly requires involving diverse voices in training AI and a willingness to iterate those models based on diverse input and feedback. Ask- Nivi, a WhatsApp chatbot offering women’s healthcare referrals and support services, offers a compelling example. Using AI, the chatbot can rapidly deliver health information to women at different reading levels, tailored to different local contexts, and offering care options based on the individual’s location. As the CEO, Siddhartha Goyal highlighted, “We don’t design upfront and hope for the best – we invest in iteration. We listen to what people are saying.” By working with content developers to train AI in a culturally relevant way, Nivi is able to deliver this kind of personalization rapidly and at a lower cost, expanding from a women’s health referral system into a holistic, life cycle support service for women at every step of their healthcare journey. 

4. Get creative with pathways to profitability and revenue generation

Many of the innovators we convened shared challenges around securing funding across different stages of their business life cycle. Creatively leveraging philanthropic funding to demonstrate proof of concept and reach profitability was seen as a key strategy. For example, Nivi leveraged different types of funding at specific moments in their scaling journey, starting with philanthropic funding to demonstrate value to local payers (i.e., government, pharmacies) and then securing longer-term funding streams through integration in public health systems. Doing so requires education amongst funders and governments about the social benefit of these innovations and the potential to serve women at scale once initiatives reach proof of concept.  

 5. Create coalitions to counter digital censorship 

Almost all the innovators we convened had been affected by digital censorship, including having ads pulled, payments blocked, and other barriers to their work. These experiences are consistent with data from the Center for Intimacy Justice, which found that 100% of businesses surveyed serving women’s health and health for people of diverse genders had experienced Meta platforms rejecting their ads. Topics of censorship included menopause, pregnancy and postpartum care, pelvic pain, and fertility, among others. There is an acute need for innovators and funders to support the work of the Center for Intimate Reproductive Justice and others to create coalitions and combat the suppression of women’s health information, including through their petition to act against Meta’s discriminatory policies.

6. Recognize that digital is not a panacea

Finally, one of the most resounding lessons was the importance of recognizing where digital can drive scale, personalization, and impact, and where human touch remains essential. IntraHealth’s model offers a strong example of the power of leveraging digital tools to expand the impact of healthcare workers. Recognizing that digital cannot replace human connection – particularly on taboo or stigmatized topics –digital health has the potential to support health workers delivering family planning services with planning, education, training and supply-chain management tools they need to do their jobs most effectively. Intrahealth’s approach leverages “blended learning”, combining human engagement with digital content, reminders, and coordination, to help health workers reach and impact a greater number of families. 

Looking ahead

Essential to putting these principles into practice is having the coordination, financial support, and information-sharing mechanisms to support change across a coordinated group of actors. Below we outline key actions each stakeholder group can take to implement these principles and help scale inclusive innovations across the sexual and reproductive health space: 

• Private investors: Invest in female founders and amplify calls to tackle digital censorship, ensuring that women’s health innovators can thrive and scale. First, private investors should focus on rapidly increasing investment in women-led health tech ventures, tackling head-on the disparities outlined in learning #1. Additionally, private investors should leverage their influence to advocate against digital censorship and help fund initiatives to combat suppression of women’s health information, ensuring that innovators across the ecosystem are able to freely share information and reach their client-base.  
• Funders and government: Provide catalytic funding to help innovators prove their models and create spaces to help build the ecosystem and foster experience sharing. Connecting innovators at different stages of their growth journey both to one another and other sources of funding is essential to help strengthen and grow the ecosystem. Funders and governments should also provide funding that allows and encourages innovators to design for equity, which is often more costly and time intensive.  

• Innovators: Design for equity from the get-go, with the hardest to reach consumer in mind. Ensuring equity remains front and center across innovations is critical to leveraging the power of digital innovation to drive positive change. Centering the voices of historically excluded users, the talent of diverse developers, and the visions of gender-diverse founders will remain central to scaling solutions led by women, for women.

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