The Journey of Telenor My Health in Pakistan PDF
The Journey of Telenor My Health in Pakistan PDF
The Journey of Telenor My Health in Pakistan PDF
DECEMBER 2016
GSMA
mHealth
The GSMA represents the interests of mobile By forging stronger connections between the
operators worldwide, uniting nearly 800 operators mobile and healthcare industries, the GSMA mHealth
with almost 300 companies in the broader mobile Programme is supporting commercially sustainable
ecosystem, including handset and device makers, health services that transform the lives of people
software companies, equipment providers and in need and promote the wellbeing of mothers and
internet companies, as well as organisations in families in developing countries. Mobile can increase
adjacent industry sectors. The GSMA also produces the quality, reduce the cost and extend the reach
industry-leading events such as Mobile World of healthcare to benefit millions. mHealth services
Congress, Mobile World Congress Shanghai, Mobile have the potential to generate significant impact by
World Congress Americas and the Mobile 360 reaching women and children who lack access to
Series of conferences. essential healthcare and nutritional information.
For more information, please visit the GSMA For more information about GSMA mHealth
corporate website at www.gsma.com Programme visit our website at: www.gsma.com/
mobilefordevelopment/programmes/mhealth
Follow the GSMA on Twitter: @GSMA
Follow us on twitter @GSMAm4d
Published
2
THE JOURNEY OF TELENOR MY HEALTH IN PAKISTAN
KEY INSIGHTS 5
COUNTRY CONTEXT 7
Health indicators 7
Competitive environment 8
SERVICE DESIGN 9
CONTENT 14
Content streams 14
MARKETING 16
LOOKING AHEAD 18
Monetising content 18
Mobile financial services 18
Evolution to data 18
Contents | 3
GSMA
Executive Summary
Telenor My Health is a mobile health (mHealth) service PKR 0.585 tax (USD 0.03) to receive daily health alerts
launched by Telenor Pakistan—the second largest via SMS, and PKR 0.10 (USD 0.00096) per minute to
mobile network operator (MNO) in Pakistan with access additional content via interactive voice response
more than 39 million subscribers. A health portal with (IVR). Telenor’s value-added services (VAS) vendor,
information on general, maternal and child health, as Planet Beyond, is responsible for content creation,
well as wellness and lifestyle topics, the service aims aggregation, and marketing of the service. Launched in
to build customer loyalty for the MNO. Telenor charges February 2015, by August 2016 the service had over half
users a weekly rate of 3 Pakistani rupees (PKR) plus a million active subscribers.
Service design Subscription-based push text content and pull IVR content
4 | Executive Summary
THE JOURNEY OF TELENOR MY HEALTH IN PAKISTAN
Key insights
This case study outlines the key benefits for MNOs a daily SMS health alert on seasonal, medical, dental
to engage in mHealth projects and highlights key and everyday hygiene topics, with an option to receive
considerations for the implementation of mHealth stage-based pregnancy information. An additional
services at scale: option to access content through the IVR channel is
also available, enabling those with lower literacy levels
Health VAS increased network loyalty for the MNO. to benefit from the service.
Telenor’s mHealth service has fostered high levels of
customer loyalty. The average monthly churn1 rate for The case of Pakistan illustrates the importance of
the service between January and July 2016 was 8.2%, having an enabling environment to iterate services
compared to 20% of all value-added services in the and improve content. In Pakistan, mHealth content
Telenor portfolio. Fifty percent of users have stayed must be validated by a registered health professional,
with the service for longer than eight months, with 34% but does not require approval from a government
subscribing for more than a year. body such as the Ministry of Health. The possibility
to speed up the validation process has allowed
Customer willingness to pay has created a viable Telenor’s VAS partner Planet Beyond to continuously
commercial model for mHealth services. By create new content and update product offerings
offering a low price point, the service has proven to for its users.
be commercially viable as it appeals to customers
at all average revenue per user (ARPU) levels. This, “Live shows” and high levels of responsiveness
combined with different content streams, has enabled to user feedback are key to creating a “sticky”
the service to reach a larger addressable market. service. Every week, Telenor’s mHealth service hosts
an interactive live show which users can listen to by
A mix of pull and push content provides value to dialling into an IVR line. These shows, in conjunction
the user and appeals to a wider audience. Providing with promotional SMS text messages requesting
content on both SMS and IVR channels has allowed feedback, have been a successful way to collect user
Telenor to reach users at all literacy levels. Users receive feedback and tailor the service to user needs.
1. Churn = total gross disconnections per month as a percentage of average total connections at the end of the period
Key insights | 5
GSMA
Introducing Telenor
My Health
Telenor My Health was launched nationally at the One of Telenor’s main incentives for launching the
beginning of 2015 to provide Telenor users with service was to increase network usage, which has been
affordable, localised health information on an array of an important strategic priority since the passage of
health-related topics. In addition to delivering health more stringent know-your-customer (KYC) regulations
content via SMS and IVR, the IVR channel hosts a in Pakistan. One of these regulations is a limit on the
search tool allowing users to learn more about diseases number of SIM cards owned by an individual, limiting
and locate healthcare providers. The service meets the the revenue opportunities earned from the sale of SIM
Telenor group’s mandate to help countries reach their cards. By introducing new services such as Telenor My
health targets through mHealth information services.2 It Health, Telenor has been able to drive more traffic to its
has also become an alternative revenue channel for the network and build customer loyalty, which in turn has
MNO. Reaching both urban and rural users with diverse had an impact on its market share in Pakistan.
health content, there were 516,704 active subscribers
as of August 2016.
2. https://www.telenor.com/wp-content/uploads/2012/05/BCG-Telenor-Mobile-Health-Report-May-20121.pdf
Country context
2010 2016
Health indicators
High out-of-pocket health expenditures are still This is due in part to a high proportion of doctors
one of the biggest economic shocks to low-income leaving the country. Seventy-five percent of qualified,
families relying on daily wages from agricultural licensed female doctors in Pakistan are also excluded
and blue collar jobs, and those living in rural areas from the workforce due to socio-cultural barriers,
(61.2% of Pakistan’s total population) are impacted exacerbating this shortage.13 The presence of Lady
the most. However, access to information can lessen Health Workers14 in communities has been found to
this financial burden. Studies have shown that 40% have a positive impact on education about maternal
of income in rural households is spent on treating and child health, however there are still shortages
preventable diseases from contaminated water and of nurses and midwives, particularly in remote areas
unsanitary living conditions.12 where the resource burden is even higher.
Pakistan is experiencing a drop in the number of The ubiquity of mobile in Pakistan (71% GSM
physicians working in the health system, which has penetration as of October 2016)15 provides an
created a shortage of doctors in a growing population. important opportunity to reach large segments of
Country context | 7
GSMA
the population to improve health indicators. the delivery of health services. GSM penetration is
By providing content on healthy behaviours, forecasted to reach 78.65% of the population by the
telemedicine to reach resource-scarce areas, or year 2020, creating an even stronger case for mobile
health financial services, mobile can be leveraged in health interventions to reach the underserved.
Competitive environment
In Pakistan, Telenor has the second largest market rate after being the first MNO to introduce 4G in
share with 38.5 million connections representing 27.7% Pakistan. In a highly competitive mobile market, social
of total connections, whilst Mobilink , after a recent business models like Telenor My Health are becoming
merge with Warid Telecoms, are the market leaders increasingly important to achieving core business
with 51.1 million connections, equivalent to 37.0%. targets and contributing to key business objectives,
New entrant Zong is also growing at an aggressive such as driving network usage and customer loyalty.
8 | Country context
THE JOURNEY OF TELENOR MY HEALTH IN PAKISTAN
Service design
Users can register for Telenor My Health by dialling the language option. There have been no reported issues
IVR code *345*7764# or by sending a message with with registration, as the dual channel caters to users at
the text ‘SUB’ to 7764. When users register through all literacy levels.
IVR, they receive a welcome message prompting them
to select their preferred language: Urdu or Punjabi. Once they are subscribed, users receive a daily SMS
Users are then taken directly to the IVR menu. ‘health alert’ with information ranging from seasonal,
medical, and dental health to everyday hygiene. Users
If users opt to register via SMS, they receive a welcome can also access additional content through the IVR
message and the option to change the IVR menu to line (7764). Once they dial in, users are presented with
Punjabi (by sending an SMS with the word ‘HELP’ to the option to access two content streams: Family First
7764). For the SMS channel, Roman Urdu is the default and Healthy Lifestyle.
HEALTH ARTICLES
Audio articles on a variety of family health topics. There is an option to skip
and replay the articles.
FAMILY FIRST
HEALTH ASSISTANT
HEALTHY LIFESTYLE
Audio articles on wellness topics, such as weight loss and healthy eating.
As with the health articles in Family First, users can skip and replay articles.
EAT WELL
Information on the caloric value of foods are sent via SMS. Users send an SMS
to 7764 with the word ‘EAT’ and the name of the food (e.g. bread) and then
receive information on that food.
Service design | 9
GSMA
After users subscribe, promotional text messages are sent notifying them of the additional content available
through the IVR channel:
LIVE SHOWS
ADDITIONAL CONTENT
A weekly live radio show on a variety of health topics, accessed through the
main IVR line ( 7764)
10 | Service design
THE JOURNEY OF TELENOR MY HEALTH IN PAKISTAN
16. Commercially sustainable services that target a social need or have a social responsibility angle.
17. http://tribune.com.pk/story/1126706/40-pakistanis-live-poverty/
FIGURE 1
SAHIWAL MUZAFFARGARH
SWAT
SHEIKHUPURA
LAHORE
URBAN
GUJRAT RURAL
ISLAMABAD
OKARA
SEMI-
SARGODHA URBAN
RAWALPINDI
GUJRANWALA FAISALABAD
SIALKOT
Partnership model
Telenor is responsible for the overall product strategy Planet Beyond creates all the marketing material
of Telenor My Health and provides strategic direction for the service. It has invested in its own recording
and marketing channels (SMS and IVR), with final studios, recording artists, and radio jockeys who
approval on all service and marketing content. The provide voice-overs for IVR content, live shows and
service is supported by VAS vendor Planet Beyond, marketing outbound calls. Planet Beyond bears all
which has a revenue share agreement with Telenor. the costs for content development as this allows it to
Planet Beyond has a dedicated content team and differentiate its products and have a competitive edge
manages, creates, and produces all SMS and IVR over other vendors. Additionally, content created by
content for the service. By regulation, Pakistan’s Planet Beyond is not exclusive to Telenor My Health
Ministry of Health mandates that all health content after a certain time period, allowing the VAS vendor
must be vetted by registered professionals, thus Planet to provide similar health content to other interested
Beyond has established relationships with certified MNOs in the future.
medical professionals who validate all of its content.
BOX 1
Health TV is owned by Ziaudin Group, which controls a large network of clinics and hospitals. Through this
partnership, Planet Beyond was able to validate all the content for Telenor My Health and leverage Health
TV’s database for the ‘’Nearest Doctor’’ feature.
Feedback from user surveys conducted through outbound calls and Telenor call centres revealed that whilst
SMS content was generally accepted, IVR content clips based directly on segments from a TV show did not
resonate with users. This ultimately led to the end of the partnership between Planet Beyond and Health TV,
and Planet Beyond assumed full responsibility for content creation thereafter.
18. http://htv.com.pk/about
Content
During the service inception phase, Telenor gathered To ensure Telenor My Health appealed to a large
feedback on health content preferences by surveying addressable market with different literacy levels,
existing users of the mEducation service ‘Telenor Telenor opted to use both SMS and IVR as content
Taleem’ and ‘Ask-Telenor’, a service that allows users to delivery channels. SMS health alerts are sent daily in
ask questions and receive a response. This was done Roman Urdu, a language understood by the majority
based on the assumption that users who subscribe of the population.19 IVR targets users with lower
to these services might also be the initial target literacy levels20 and serves as an infotainment channel
market. Feedback from users in urban areas revealed for those interested in any of the content streams
an interest in general wellness, while users in rural (e.g. live shows), creating additional value for these
areas were more interested in prophetic medicine, users. IVR content is available in both Urdu and
herbal nutrition, and health information on illness and Punjabi, the language spoken in the most populous
maternal and child health. region of Pakistan.21
Content streams
Content for My Telenor Health can be classified into four and easy to understand. There are two categories of
categories: SMS, static IVR, dynamic IVR, and live IVR. SMS content ( see Figure 2). The first category are
the daily health alerts with information on seasonal
SMS content medical, dental and everyday hygiene. The second
category are the maternal alerts which provide
Localised SMSs are sent to all users. To reach users additional customised information on pregnancy and
more effectively, Planet Beyond’s content team child health topics (based on user profiles).
creates content in the local vernacular that is simple
19. One survey showed that 37% sent SMS’s in Roman Urdu, 17% wrote in English and 15% wrote in Urdu script. http://www.alnap.org/pool/files/pepl-guide-to-sms-engagement-in-pakistan.pdf
20. The literacy rate in Pakistan is currently 58 percent.
21. Urdu is the national language of Pakistan and 48% of the population are native Punjabi speakers.
14 | Content
THE JOURNEY OF TELENOR MY HEALTH IN PAKISTAN
FIGURE 2
Static IVR content have attracted the largest number of callers. Once
every quarter, Planet Beyond hosts a health specialist
Through the IVR menu, users can access content clips on the show to discuss topics of a more clinical nature,
from the TV broadcaster Health TV, as well as recorded such as pregnancy or non-communicable diseases.
content clips from Planet Beyond. The information is The live shows have proven to be successful in creating
localised and presented in Urdu and Punjabi. Content “stickiness” for the service, transforming health content
clips are approximately two minutes long and recorded into infotainment. Live shows have also been added
with voice-overs designed to be engaging for users. to other Telenor services, such as the mAgri service
Content offered via static IVR includes Family First Kushal Zamindar.
(information about family health) and Healthy Lifestyle
(wellness and lifestyle information). Dynamic IVR content
Live IVR content On the IVR channel users can listen to a 24-episode
serial drama that addresses a variety of health topics.
Live content is available to users through live weekly Each 15-minute episode is in Urdu and based on the
shows. Users dial into the IVR line and have the option fictional character of an unemployed doctor from a
to join the live show. The show is curated and run by small village who fails to find a job and becomes a
Planet Beyond, which has its own studios and radio taxi driver. Each week the doctor has a new client who
jockeys. Each week, a new health topic is discussed and faces a particular health issue, and during the course of
users are given the option to ask questions live on air. the taxi ride he provides the passenger with guidance
Topics such as ‘quit smoking’ and prophetic medicine22 and information.
22. Prophetic medicine: A genre of medical writing advocating traditional medical practices.
Content | 15
GSMA
Marketing
Telenor My Health is promoted solely through below- currently conducted in Urdu. Telenor also introduced
the line (BTL) marketing activities carried out by Planet loyalty incentives, giving all users who activated the
Beyond through SMS and outbound calls (OBD).23 service through the Telenor website a 50% discount.
Telenor provides data on user trends (e.g. previous
VAS subscriptions) to target potential subscribers. To Telenor and Planet Beyond continuously measure
drive uptake of the service, promotion is segmented by the success of its marketing activities and uses this
rural and urban users. SMS is used to target the urban data to refine their approach to target customers
segment whilst OBD reaches rural users. more effectively. For the SMS marketing channel, user
queries (which allow users to request health content
This segmentation is based on network intelligence for the service free of charge) have proven to be the
that allows Telenor to capture potential and current best way to drive uptake, and live shows have also
subscribers based on the most-used cell phone proven effective in increasing up subscriptions. Telenor
tower.24 Although promotional activities were initially and Planet Beyond have learned that continuous two-
conducted in different regional languages, conversion way communication through marketing channels helps
rates were highest with Urdu, so all marketing is to keep users engaged and interested in the service.
Similarly, OBD calls revealed the most popular message, and although this could indicate a general
features driving activation were live shows and user preference for a female voice, it may also be a sign
queries. Family First topics such as maternal alerts of a larger female user base as, culturally, women are
have also yielded higher numbers of subscriptions. It more comfortable discussing sensitive issues such as
was found that female voice-overs had a 50% higher health with other women.
activation rate than male voice-overs for a similar
23. Outbound calls are pre-recorded voice messages that inform a user about the benefits of a service.
24. Telenor Pakistan uses Data Science and Analytics to boost mAgri uptake: http://www.gsma.com/mobilefordevelopment/programme/magri/telenor-pakistan-uses-data-science-and-analytics-to-boost-magri-uptake
16 | Marketing
THE JOURNEY OF TELENOR MY HEALTH IN PAKISTAN
80%Female
40% Male
To retain users, BTL marketing is conducted using Live shows and user queries have played a dual function
SMS for urban areas and OBD for rural areas. These as Telenor regularly draws on them to collect insights
activities mainly inform users of new content available on users’ content preferences and refine content to
on the platform, a new episode of the drama serial, meet user needs. Content is created on the topics that
and the next live show and health topic that will be generate the highest number of callers for live shows, as
discussed. The service regularly offers cash prizes to well as the most requested subjects from user queries.
users for answering health questions and calling in
to health shows.
BOX 2
b. Agar ap TAMBAKU NOSHI se Nijaat Pana chahte hain tau suniye, My health per LIVE SHOW or Saath hi
Saath Rs.100 FREE Balance Jeetne ka moqa bhi payein! Abhi 7764 milaein. Sirf Rs.3+t haftawar aur Rs.
0.10+t/Min. (If you want to get rid of your tobacco habit, then listen to My Health LIVE SHOW and you
can also win PKR 100 FREE balance! Dial 7764 now. Only PKR 3 + tax per week and PKR 0.10+t/ Min)
c. Telenor My Health kay zariye pocheye sehat kay mutalik tamam sawalaat! Tou abhi HELP likh kar reply
karain wo bhi MUFT! (Through Telenor My Health, ask any question related to your health! Reply with
the word HELP now— for FREE)
Marketing | 17
GSMA
Looking ahead
Monetising content
To drive revenue growth, besides generating revenue directly from users, Telenor could also form partnerships
with interested health organisations to leverage their platform for data collection or with organisations that want
to disseminate health content that aligns with their service. These would from an additional B2B revenue stream
for the service itself whilst concurrently enriching content offering for the user base.
Evolution to data
The evolution to rich media is a key strategic priority for Telenor Pakistan. As smartphone penetration increases,
Telenor is aiming to increase data usage on the network. A mobile app for Telenor My Health could be created
to target urban and semi-urban users and capture the market with the highest smartphone penetration. The
service could deliver additional health and lifestyle information, which are the most requested topics from
urban and semi-urban users.
25. MicroEnsure is a company that aims to provide microinsurance to the mass market. Its business model typically involves partnering with a mobile network operator to use mobile channels to register users and
process and send claims.
18 | Looking ahead
For more information on the Mobile for
Development mHealth programme visit:
www.gsma.com/mobilefordevelopment