1. CycleTel™: Where are we now? 26 April 2012 Meredith Puleio, IRH/Georgetown mHealth Working Group Meeting

2. Q: Can we leverage the growing telecom industry and ubiquity of mobile phones to expand access to and address unmet need for family planning in India?

3. A: Research on CycleTel suggests “yes.” But research, strategic planning, and partnerships are key. … And “begin with the end in mind”!

4.  What?  A mobile health service that uses text messaging to facilitate use of SDM  Unique: Goes beyond unidirectional provision of health information  How?  Alerts woman of her fertile days via SMS during each menstrual cycle  Requires a woman to send in the start date of her period each cycle  Where?  Tested and built in India CycleTel ™ Family Planning on the Mobile Phone

5. Proof-of- Concept Automated Testing Business Planning Partnership Development Product Launch & Scale up Model: Formative Research to Scale TECHNOLOGY DEVELOPMENT & ITERATION PARTNERSHIPS Sep ’09 – Jul ‘11 Jul ‘11-Jan ‘12 Jan-Feb ‘12 Planned 2012

6. Automated Testing Results Methodology: 715 users recruited; 197 follow up interviews; 653 exit interviews and 131 male exit interviews conducted What did users like most about CycleTel (n=653)? As a family planning method… % It is low-cost/free53.9 Doesn't affect health80.1 No side effects88.4 My husband opposes using another method17.2 Religious/moral reasons9.0 It is easy to use72.9 It is effective56.5 It is convenient49.2 Other6.3 % Easy to use78.7 It maintains my privacy79.5 Timely reminder87.4 Messages come when expected66.6 Right amount of messages65.5 Accessible helpline27.6 Frequency features9.2 Other36.6 As a mobile health service…

7. How do we scale-up CycleTel and reach sustainability?  We worked with a management consulting firm to develop a business plan and go-to-market strategy for CycleTel. The process helped us understand the inputs (target market size, go-to-market strategies, prospective partners, financing, etc.) needed for CycleTel to be a sustainable venture at scale by 2017.  The analysis was based on: 1)Pilot results 2)Interviews with industry experts 3)Secondary data sources 4)Rigorous financial analysis

8. Business Plan: Steps and Key Questions StepsKey Questions (Examples) Identify target segments and size the market  How many women of reproductive age in India (1) have an unmet need for birth spacing, (2) own a mobile phone and (3) use SMS?  What age group would be most attracted to CycleTel? Industry analysis to develop core business assumptions  How many users does the service need to attract corporate donors?  What % of mobile phone owners use and pay for mHealth services?  Would telcos be interested in launching CycleTel? Why?  What is the role of the aggregators and other stakeholders? Develop a Go-to- Market strategy  Prospective partners—who will work with us to acquire/sustain users?  Prospective donors—who will be willing to provide seed capital?  How do we market the service?  Operating model—how will the venture operate? Identify possible business scenarios based on assumptions/risks  Define a high achievement and modest achievement case. In each case, what level of resources is needed to reach target # of consumers within a specified period of time?

9. Business Plan: 3 Key Findings  Several capable aggregators with mHealth focus keen to partner with IRH on CycleTel. In the India context, it is more attractive to work with aggregators than telcos.  Need to reach critical mass of users (100-200K) before attracting other donors. Anchor funding is required to reach that critical mass.  Success would require investment in broad based promotion via mix of channels. High engagement approaches (face to face) early on are key to attract customers.

10. “ How can CycleTel be made available to women at the Bottom of Pyramid considering their low literacy level? ”