With FollowApp, Children in India Receive Vital Vaccinations

The pinch of a vaccination can save lives. Now, with the ping of a reminder, a technology solution called FollowApp is helping caregivers in Mumbai track and stay on schedule with their children’s vaccinations.

Created by a Morgan Stanley technology team working together from offices around the world, FollowApp makes automated, personalized voice calls to remind caregivers about their children’s scheduled vaccinations, with follow-up calls after seven days if confirmation hasn’t been given. So far, the app has reached 4,000 caregivers in Malwani, one of Mumbai’s poorest neighborhoods—and the numbers are climbing.

FollowApp is the result of a global team effort: Technologists from Morgan Stanley’s offices in Mumbai and Bengaluru coordinated with coding colleagues in Montreal to develop the health-care app in their spare time.

“The process by which we developed FollowApp is a reflection of how collaborative, innovation-focused and purpose-driven the technology organization is here at Morgan Stanley,” saysKartik Pai, who leads the tech development of this product . “Our team came together across multiple continents to use best-in-class technology to address an urgent health problem. We’ve been very gratified by what we’ve been able to accomplish and by the firm’s support for our efforts.”

The health-care app addresses a significant challenge. An estimated 38% of children in India fail to receive all basic vaccines in the first year of life, making timely vaccination against deadly diseases a critical health-care priority.

The idea for FollowApp took root while Morgan Stanley technologists were volunteering with SNEHA, a Mumbai nonprofit that focuses on neonatal and infant health development. During field visits with the nonprofit, it became clear just how difficult it would be for caregivers to keep track of their children’s vaccinations, given how much they struggled with more basic needs.

“These are mothers who are focused on more fundamental issues, like getting food and clean water, rather than following a vaccination schedule,” says Sathvik Shetty, who coordinated with the nonprofit. “We wondered if we could use technology to solve the problem of vaccinating children on time.”

Health-care apps such as FollowApp are helping to transform and democratize health care in India and other developing countries. By harnessing tech advancements, such apps make it easier to reach isolated or mobile populations, which may lack education and basic awareness of infant and child health but havesmartphones and mobile accessto India’s robust telecommunications network. Indeed, 80% of Indians access the internet only through their phones, ranking India first among G-20 nations for mobile-internet usage, according to a2017 study by StatCounter.

“In the poorest neighborhoods, you may not have your own washroom, but you definitely have access to a mobile phone,” Shetty says, adding that, to build trust with the caregivers, FollowApp delivers highly personalized calls in the recipient’s regional language.

The team’s research found that most families had two phones, one for each parent. “The phones typically aren’t fancy and the users aren’t well-versed with technology. This is why we did not create FollowApp as a mobile app, but as a simple web app that generates calls and tabulates responses,” says Pai.

Developing the app wasn’t just an academic in-house exercise. The team proceeded to test FollowApp in 2017, initially with 100 caregivers to improve compliance with three major vaccines. Now, in addition to serving thousands of caregivers, the app covers seven types of vaccinations—diphtheria/pertussis/tetanus, polio, measles, mumps, rubella, vitamin A dose, and hepatitis B.

The app’s effectiveness largely rests on its simplicity. After a caregiver signs up for the app, it will call and ask the caregiver to press “1” to acknowledge that a child has received a specific vaccination or “2” if the child hasn’t. If the caregiver doesn’t respond or presses “2,” the app follows up with scheduled reminders. In this way it captures critical data points, like the vaccination status for each participating child per each disease and dosage..

The team has learned valuable lessons in global collaboration, building relationships with external service providers and organizations, dealing with the real-world scarcity of resources, and thinking about its target market—in this case, India’s urban underprivileged.

This is just the beginning. Most recently, FollowApp has been open sourced on Github, and the FollowApp team continues to improve the application and plans to deploy it in additional locations, with enhanced features through machine learning and data analytics. Ultimately, the team hopes to share key findings from its growing vaccination database with India’s government to improve public health care.

The potential to transform lives through health-care tech advancements has energized the team. As the FollowApp database continues to expand, the team is gaining insight into what factors affect vaccination compliance. “Is it the income level, education level or the gender of the child that matters most? Can we help the government formulate policies and have a targeted outreach by predicting the likelihood of a child getting vaccinated? These are important questions for the future,” Pai says.

Meanwhile, FollowApp could be expanding to Bengaluru, in the Indian state of Karnataka, where a local nonprofit wants to leverage it to help monitor and treat underprivileged families for anemia, which, if untreated, can endanger their health. “It’s exciting to try it in another city and to see if we can adapt it to cover more than vaccines,” says Pai.