Adolescent girls all over the world have questions about growing up, puberty and relationships. But in India, girls are often not allowed to discuss sexual health and contraception, are shamed for their curiosity, or given unhelpful answers. This puts a girl’s health at risk, leaving her vulnerable to exploitative and abusive relationships, unplanned pregnancy, and STIs.
Billions have been spent on essential health services that girls need in recent years but these go underutilised. Why? Often girls don’t see these services as “for them”. They feel unwelcome, unsure or only seek help in a medical emergency. 70% of 15-19 year old adolescent girls in India report at least one big problem accessing medical advice or treatment when they are sick (Guttmacher Institute).
“Bol Behen” is Girl Effect's sex and relationships chatbot in India. She is a digital big sister to provide girls with a private, online space where they can access trusted, non-judgmental advice about sex, STIs, contraception and relationships. Bol Behen - colloquial Hindi for ‘Speak, Sister’ - is designed to boost girls’ confidence to speak up about health concerns, improve her experience through increased knowledge and to direct girls to access services.
In our successful pilot launch on Facebook Messenger in 2020 over 240,000 conversations were started by girls, with 2.7 million sent. This year (2022) we launched Bol Behen on WhatsApp to allow us to reach more girls than ever before. Our goal is for Bol Behen to be the entry point for girls in India to health services.
From our research we know that the barriers to girls accessing a health service go beyond affordability or knowing where a clinic is located. With our chatbot, we are able to take a girl on an entire journey from arming her with information, building her intention to access a service, nudging her and connecting her to a clinic when she is ready.
Bol Behen is designed with a girl-centered approach and speaks girl-talk in “Hinglish” (Hindi-English). Unlike other helplines, she is available 24/7 on-demand and designed for low-end smartphones, limited data packs or shared devices. Available on the social media platforms where girls already are, Bol Behen tackles doubts and misconceptions around love and sex through a fun conversation. Girls can test their knowledge via fun ‘Quizzes’ that help us measure the impact of our content.
We started by creating a minimum viable product replicated from our sex and relationships chatbot in South Africa. We piloted it on Facebook Messenger in 2020 to test how girls in India would respond. In just 4 weeks 27000+ conversations were started on Bol Behen. Through in-bot quizzes, we have been able to show that Bol Behen positively shifts knowledge and attitudes around key sexual and reproductive health topics.
Building our product for WhatsApp
This year we launched Bol Behen on WhatsApp. With 400+ million users it is the most commonly-used messaging app in India. 87% of our target audience use it daily and it is their preferred chat channel - even those hardest to reach across urban and rural areas.
Our main challenge to date was that while we knew from our pilot that Bol Behen could shift attitudes and build intention to access a service, the user journey needed improvement. By directing girls out of the bot to a vetted service directory on our website we were seeing high drop off rates. To achieve our goal we needed to build a seamless user experience to connect girls to health services - building her awareness and knowledge, to intention to talk to a doctor, to actually booking an appointment - all within the chatbot.
A seamless user experience
Girl Effect was one of 120 organizations selected for WhatsApp’s Incubator Program. We launched a 5 week campaign from August - September 2022 to test Bol Behen’s ability to link girls directly to services within WhatsApp. Our vetted service directory - including a telemedicine website, clinic information, helpline numbers, counselors and emergency helpline - was integrated within the chatbot. During the campaign Bol Behen’s chat flows were built to address the needs of girls at different stages - whether they are just looking for information, or urgently need to access a service. The results proved that bringing together information, tools and access to vetted health services in one place does increase girls’ intention to take action.
Within a 45 day campaign window we saw:
19,000+ girls initiating a conversation with Bol Behen
Onboarding rate (Number of users who accept our terms and conditions/Number of users who initiated conversation) improved from 63% to 67.6%
Our conversion rate that measures girls' intention to access services, improved from 0.6% (towards the website) to 8.4% (from within the chatbot)
1,600+ girls connected to service information
India’s booming population shows the scale of opportunity to use the power of chat to achieve more equitable access to healthcare for adolescent girls.
We have proven that Bol Behen can create demand for sexual health services and our users are primed to act to protect their health. Now we are ready to scale by enhancing our artificial intelligence (AI) to become more conversational and explore more service connections.
Through a new triaging framework, we will be able to better understand the sentiment of girls’ messages to help us to deliver more seamless, personalized healthcare journeys from booking appointments, getting reminders and sharing feedback all within Bol Behen.
Over the next 4 years we want to connect 1 million girls to Bol Behen and focus our efficiencies on enhancing service connections, enabling us to connect a girl in need to health service.