NB Health Care
The Ticket to Ride a ‘Smart’ Bus Includes Public Health Info: Engaging, educating and learning from Nairobi commuters via SMS
Although mobile phones have driven down the cost of person-to-person communication in most developing countries, interactive, mass communication remains costly and logistically challenging. This is a barrier for businesses and organizations, both which need to communicate with and learn from their customers and target audiences. Last November two technology startups (FlashCast and Echo Mobile) and an NGO (PS Kenya, formerly PSI Kenya) decided to try a new communication strategy leveraging a unique and untapped captive audience: bus riders in Kenya. (Disclosure, I co-founded FlashCast and Echo Mobile.)
Transit as a platform
There are a number of reasons why public transit can be an ideal platform upon which to build services and reach out to users.
1. It’s a well-integrated aspect of daily life? -– ?around 35 percent of Nairobians commute to work via public vehicles.
2. The time spent in transit is a sunk cost, and is by and large inefficiently used. Passengers are not only a captive audience, they’re also accessible. Unlike transit users in the U.S., in Nairobi, where smart-phone penetration is much lower, most passengers don’t withdraw into private worlds defended by earbuds and touch screens.
3. Transit riders are a diverse group. Public transportation is a necessity for most low-income individuals, but is also an option for wealthier passengers who might own cars but want to avoid dealing with traffic.
4. Public transit is immediate and communal. This opens the floor for designers to build live (read: human), real-time social experiences. How often do you get to connect with 35 strangers in a room together?
This project was a partnership among three Nairobi-based actors. FlashCast is a startup that deploys location-aware digital displays on buses in Kenya and offers advertisers an engaging communication channel. Echo Mobile is a cloud-service that enables organizations to leverage free, two-way SMS to connect with and learn from the people that matter to them. PS Kenya is a local NGO that works to measurably improve serious public health challenges in areas such as HIV/AIDS, family planning and malnutrition.
The team designed three, three-to-four-question health quizzes on topics of contraceptive myths and misconceptions. The in-bus digital displays invited passengers to take the quizzes and earn an instant airtime top-up to their mobile phone. Interested passengers sent an SMS to the free shortcode to begin receiving questions to their phone.
In the field (and on the road)
On Nov. 26, 10 buses on three Nairobi routes began displaying the survey invitation. Over the course of five days, 476 transit passengers:
- Read the invitation scrolling through the digital billboards installed at the front of their buses;
- Completed (free of cost) 1,223 SMS quizzes on topics of family planning;
- Spent on average of 4.6 minutes per survey (from opt-in to completion);
- Were informed of myths and facts about contraception; and
- Were awarded 10 KES (12 U.S. cents) in airtime to compensate them for their time.
The information below summarizes selected results from the three health-quizzes.
Can contraceptives make a woman unfaithful or kill her sex drive?
Source: PS Kenya (N=353)
Which of the following is not an effective option for contraception?
Source: PS Kenya (N=394)
Following are some open-ended SMS answers to the question: “Have you heard any stories about side effects from contraceptives?”
“Yes. E,g they can delay one from conceiving, can alter menstrual cycle and also can make a person experience uncontrolled bleeding”
“Yes. Wrong procedural use of contraceptives can cause complication of the uterine track”
“No. But have fears about it.”
“Sometimes a woman may end up having children without knowing”
Source: PS Kenya
Why it worked
There is a common adage in design: Don’t make your users do anything different. In other words, it’s likely that the success of this survey method is greatly related to its near-seamless integration with existing behaviors. Inviting commuters to an SMS survey as they ride to work is an incremental change from an experience passengers are already familiar with.
This project provides additional evidence that the promise of even a nominal reward can motivate someone to try a new service. As little as 10 KES (equivalent to about 10 minutes of airtime), was enough of an incentive for our nearly 500 participants.
The combination of analog and digital experience is a powerful way to build trust and comfort with a new technology. Though this kind of transit media is heavily weighted toward the digital end of the spectrum, we benefit from the fact that the in-bus displays are physical objects that passengers can see and touch. The displays provide an analog presence that grounds what otherwise would be an invisible, cloud-based service.
The largest source of friction when conducting any sort of shortcode-mediated SMS interaction (whether in transit vehicles or not) is a well-justified distrust from the user. In Kenya, shortcodes are not new, but businesses have made money by offering premium rate services that charge the user 5 cents to a dollar not only when they send an SMS to the code, but also when they receive (usually unsolicited) messages.
This project proved the efficacy of reaching out to bus riders, but is just one use-case for public transit as a unique platform for engagement and communication. In order to prove the validity of this platform for larger studies it would be useful to better explore the demographics of public transit users in Nairobi and to identify potential sampling biases. Ultimately, this project is like a pilot opening the discussion for future iterations and applications.
We’re actively seeking partners who have innovative ideas for how to leverage the platforms we’ve built, especially organizations that have important messages and important questions for this market.
Beyond research and education, however, we believe there’s a huge opportunity to provide a wide range of services through the transit platform. One of the things that has always made our work exciting is the opportunity to give small businesses an effective communication and marketing facility that previously only large companies could afford.
Our vision is to offer businesses of all sizes, down to the smallest street vendors, a loud and effective communication channel with which to reach the mass market.
Jeremy Gordon is a Nairobi-based designer and entrepreneur.