Aussie startup Shifra has taken home the top gong in the health category of the Techfugees Global Challenges competition in Europe, for its app giving refugee women better access to sexual health services.
Founder Rebeccah Bartlett, a nurse and midwife, first conceived of the app while working overseas.
Through working in remote communities she realised the concept of mobile health could help improve access to information and care in the hardest-to-reach communities.
“I wanted something that was going to connect women,” Bartlett says.
For refugees and migrants living in Australia, the best result is for these women to visit a doctor, but if they don’t know how to access those services, “they should still have a right to that information”, she adds.
“A lot of women have no idea of what they need, or what they have a right to, because no one has told them.”
At the same time, it had to be evidence-based and trusted information, “not just gossip on the internet”.
Currently, the app provides local health information in Arabic, and directs women to trusted clinics and services, as well as offering information on their entitlements in Australia, all without assuming any level of language or health literacy.
In October, Shifra was one of 25 startups from across the world selected to compete at the Techfugees Global Summit 2018 in Paris.
Finalists were selected from more than 100 applicants, all focused on addressing the needs of displaced people.
Shifra took home the top gong in the health category, based on its adherence to Techfugees’ guiding principles, its business model and its potential for impact on the lives of refugees.
However, for Bartlett, it’s not the be-all and end-all solution.
“The app is a platform, but it’s not the cure,” she says.
If women know about the service, they may well look it up. But otherwise, they may not ever ask about how to access sexual health services, she explains.
“The cure is building the awareness that women need access to sexual reproductive health info in their own language.”
Not a charity
Based in Melbourne, Shifra was co-designed with women from refugee communities, and is currently run by a team of volunteers.
However, as it builds its user base, the app is able to create datasets on the community.
“Building a really sophisticated back end was important to us, so we could make sure we were demonstrating a need,” Bartlett says.
Currently, the founder is working full time on Shifra, while also working as a midwife, studying for her PhD and working with another organisation focused on low-income women.
The plan, however, is to get to a position where Shifra is run as a profit-for-purpose business.
“From the beginning, I was conscious of not making it a traditional charity,” she says.
“We want to be more of a social enterprise,” she adds.
Once the startup has enough users to build a real dataset, Bartlett will be able to build revenue by analysing and selling that data.
“We will be able to develop a sustainable stream of revenue — enough to translate into other languages.”
The data the startup is collecting is valuable, Bartlett says, “and it’s not being collected by any other organisation”.
If a council knows there is a certain number of women looking for information on family violence in Arabic, or looking for information on vaccinations in Punjabi, they can better understand where to direct services and information.
“Now, they don’t have anything that specific,” Bartlett says.
“We have to be smart”
Winning the Techfugees competition meant Shifra has been able to work with the organisation to start scaling the startup.
For Bartlett, this meant replicating the app in other languages, and working with communities in Europe to figure out how it can be implemented there.
“We have to make sure the way we’re engaging is appropriate,” she says.
In Germany, for example, while the level of care a woman receives in pregnancy is similar to that in Australia, the benefits she’s entitled to may be different.
There are small things that need to be tweaked, “even though the universal standard is pretty similar,” she explains.
At the same time, however, as Shifra grows, Bartlett is aware there may be challenges when it comes to cultural differences.
Issues like family violence, mental health and sexuality may have to be addressed in a culture- and country-specific way.
“In a lot of communities these are not terms people are comfortable with, or know exist,” she says.
And in some countries, women may not have the same legal rights.
Figuring out how to address these cultural differences is “one of the harder things, but the most important thing”, Bartlett says.
“We won’t be successful if we can’t do that.”
Shifra is based in Australia, where women have certain rights, and “we still unapologetically support and acknowledge those rights”, Bartlett says.
However, if a woman accessed the service looking for information on abortion in a country where this was illegal, “I can’t ethically tell them to go to their hospital”, she explains.
“We’re not going to put anything on Shifra that says abortion is illegal or wrong … We may not be able to connect them to a service, because might endanger them, but we can connect them to something online where they can find information,” she says.
“We have to be smart, and I have to make sure the work I’m doing doesn’t hurt people.”
“I’m terrified of having it all fall apart”
Bartlett came to the startup lifestyle with no tech experience to speak of.
“I still can’t code,” she admits.
The founder launched Shifra “with a lot of naivety”, she says, thinking she would just be able to build an app and go from there.
“It’s been real trial and error,” she says, featuring a string of hackathons, student developers and different design organisations.
“While I know the specs and what’s gone into making this app, and what costs what, I myself couldn’t sit down and make an edit,” she says.
“I’m terrified of having it all fall apart.”
However, she’s working on learning how to change things, and has specifically had the back end built to be “more of a CMS than code”, to make it more user-friendly.
“When you work with tech people they often forget not everyone understands what you’re saying,” she says.
Bartlett’s number-one piece of advice is not to automatically assume that an app, or a digital product, is the right way to go. It’s usually the most expensive solution, she says.
“Pay for a prototype until you’re sure, and then invest,” she advises.
She also urges prospective founders to get to know their audiences “inside and out” and “have them tell you what they think the solutions are”.
This doesn’t mean canvassing the opinions of one or two people, she explains.
“Know your landscape more than anything else.”
Finally, she notes startups should be multidisciplinary as possible, partnering with different organisations that bring different areas of expertise to the table.
To pull this off, “you have to be a good project manager”, she says.
And, while it means you may not grow quickly, you will grow in terms of reach.
“That’s actually more important in the long run,” Bartlett says.
“Once Shifra really finds its feet and is successful it will be more supported and more trusted because it will be across all of Melbourne and not just one hospital, university or not-for-profit.”