Rwanda: How Rwandan Doctor Started Telehealth Platform to Tackle Teen Pregnancy, SRH

23 October 2023

In 2020, Following a Covid-19 lockdown, Dr Jerome Nshimiyimana encountered a young girl who was pregnant. Notably, she was both deaf and visually impaired.

The encounter took place in Kimisagara, Nyarugenge District, where the medical doctor resided while conducting his clinical rotation at the University Teaching Hospital of Kigali (CHUK).

"That touched me to the extent I started asking myself many questions. I realised that the girl had gotten pregnant mainly due to a lack of information about sexual and reproductive health," he said.

During the same period, there seemed to be a surge in teenage pregnancies, according to Nshimiyimana.

"In my clinical rotations, I saw many young girls come to us, searching for safe abortion services. During the lockdown, many people were staying at home, getting together, which may have been the cause of the increase in teenage pregnancies," he explained.

There was a growing demand for information regarding sexual and reproductive health. According to Nshimiyimana, the demand may have been fuelled by the belief that discussing sex was considered taboo in Rwandan culture, or by religious doctrines that discouraged such discussions.

Currently working at Rwamagana Teaching Hospital, Nshimiyimana decided to initiate a platform called 'JoCare', with 'Jo' representing his first name, Jerome.

"I was trying to address the issue I had seen in my community. I put a team together, and we started using social media to disseminate information about teenage pregnancy and increased maternal deaths," he said.

Nshimiyimana mentioned that as people began to interact with them, their platforms gained attention, leading them to create the web application for their telehealth solution 'jocare.org' for more extensive dissemination of information.

"At JoCare, we deliver information innovatively by ensuring the inclusion of persons with disabilities. We make and share video content that includes sign language so that the Deaf community can understand. We want everyone in East Africa or Africa in general to be informed because we believe that in being informed, the community becomes healthier," said Nshimiyimana who is currently the CEO of JoCare Group Ltd, which owns JoCare.

JoCare has expanded to a mobile application now accessible on the Google Play Store. Additionally, the digital health startup maintains a physical office at Norrsken Kigali House.

Nshimiyimana mentioned that they are presently collaborating with five secondary schools across various districts in Rwanda, primarily focusing on teenagers as their target demographic.

"So far, we have witnessed a decrease in teenage pregnancy among the students. People are giving us feedback that we helped them. Many young girls and students here in Rwanda don't know how to calculate their menstruation cycle. But through JoCare they were able to learn that, which helps in preventing teenage pregnancies. Currently, we have enrolled more than 500 people for learning," he said.

JoCare envisions a community in which every pregnancy is wanted. While their platform initially launched online in response to the pandemic, Nshimiyimana said the team soon recognised that the primary challenge of teenage pregnancy resided in rural areas, where most young girls lacked access to smartphones.

"We decided to produce offline materials by making hard copies of our online materials. We currently have physical games that we offer to schools and families so that they can learn about sexual and reproductive health. When they have a question, they contact us. We also have games in alphabet and braille, which are helpful for blind people. They play our games not only for fun but also for learning," he said.

Discussing the challenges, Nshimiyimana emphasised the issue of inadequate funding, citing that the current revenue falls short of meeting the financial needs of JoCare, considering its status as a startup and social enterprise.

To address the challenge, the company is actively pursuing additional partnerships with big institutions and non-governmental organisations (NGOs). Presently, JoCare collaborates with Immortal Foundation, UNFPA, and Save the Children, all of which utilise the platform to carry out their outreach programmes and workshops.

The startup also won USD 10,000 during iAccelerator phase 4 organised by Imbuto Foundation in collaboration with the Ministry of Youth and Culture, KOICA, and UNFPA. It aimed to explore new and engaging ways to respond to and prevent teenage pregnancies while promoting social entrepreneurship among young people aged between 18-30.

In terms of their five-year targets, Nshimiyimana stated that the platform aims to boost productivity and revenue while simultaneously making a more significant impact on the community.

"We are expanding through the African continent because we have seen that many people in Africa are not informed," he said. "We are also increasing partnerships. Some bring grants to support our projects so that we can scale and sustain," he said.

Nshimiyimana also highlighted the commitment to conducting additional research in order to embrace evidence-based interventions. He noted that there is still a gap in research, and it's essential to have data-driven insights since these numbers represent people.

"It will help us to make the right decision for what we can do for the future and help the government and other stakeholders to support what we are doing," he added.

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