How a chatbot is disrupting stigma around sexual health

In 2018, Kenyan entrepreneur Nick Oketch started a Facebook chatbot called LucyBot, with the goal of revolutionizing young people’s access to accurate information about sexual and reproductive health.

We recently spoke with Nick about how he came up with the idea for LucyBot, and how he hopes this technology and others like it can make an impact.

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What led you to start Lucybot?

In Siaya county, where I come from, cultural practices such as forced marriages, wife battering, and polygamy are still practiced. My own two sisters were married off when they were just 12 and 14 years old, respectively. I have always dreamt of a world where each and every person has the freedom to exercise their reproductive health rights without discrimination or stigmatization. To help tackle some of these pressing reproductive health challenges, we developed LucyBot, a Facebook messenger chatbot that uses artificial intelligence to help disseminate accurate and instant information on sexual and reproductive health information to young people in Kenya.

LucyBot is a project of the organization you founded when you were just a senior in high school: Paradigm Youth Network Organization, a nonprofit dedicated to breaking the culture of silence around sex among Kenyan youth. What drove you to want to create change in this area?

I live in a very conservative society where matters of sexual and reproductive health are discussed in low tones, and only by adults. Young people’s peers become their main source of information about sex, and misinformation ends up getting spread, like the idea that washing with soap and water after sex can prevent pregnancy. Without access to reliable channels providing high-quality, accurate information on sex and sexual health, youth are prone to making ill-informed choices.

The consequences of these information gaps are a huge public health burden to Kenyan society and the people of Siaya: early and unplanned pregnancies, unsafe abortions, a high prevalence of HIV/AIDS, the spread of STIs, and incorrect usage of emergency contraceptives among young women. I believed strongly that technological innovations could fill these information gaps and increase access to reliable and confidential sexual and reproductive health resources in Kenya. That’s why I created the chatbot—to provide young people with a safe online space where they can access information without censorship or discrimination.

Can you say more about why you chose chatbot technology as the way to achieve your goals?

Data collected from our community outreach and focus group discussions with young people from Siaya and Kisumu Counties, revealed that young people feel more comfortable asking questions about their sexual and reproductive health through the approachable and popular medium of Facebook Messenger.

With LucyBot, users are able to message in Facebook Messenger 24 hours a day with questions about sexual and reproductive health, and receive answers within seconds, making it the best way to deliver personalized, immediate, non-judgmental, and accurate sexual health information to young people.

LucyBot shares information with its users through conversations driven by instant messaging and can also direct users to additional resources, including the locations of existing health care facilities and live educators. The bot is greatly helping to relieve the awkwardness surrounding discussions about sexual and reproductive health, particularly in conservative African settings. It offers a safe space for young people to ask questions around the subject in private without fear of censorship and stigmatization.

What is something you learned from creating LucyBot that could help others designing technology meant to help young people?

It’s important to design programs that reach young people where they already are (in our case, Facebook Messenger), rather than asking them to install new apps or other technology. It’s also important to engage your end users in the design and implementation process, to increase the chances that what you’re creating will meet their needs.

Tell us about the impact of LucyBot. What is your most important measure of success, and why?

Since its launch in 2018, LucyBot has reached more than 10,000 young people with information about sexual and reproductive health. In addition, the three health facilities we work with have recorded a nearly 10 percent increase, on average, in the number of adolescents visiting them and getting sexual and reproductive health services. It is my hope that LucyBot will encourage more adolescents to speak up and demand the sexual and reproductive health rights they deserve.

Do you have any stories about the ways LucyBot has changed the conversation or changed minds around sex and reproductive health in Kenya?

One of the most notable stories about how this innovation has helped young people is Jane’s story. Jane is a teenager who had just had unprotected sex. After consulting with her partner, she went to the hospital the next morning to get emergency pills. On reaching the hospital, she found out that the nurse in charge was her aunt, who Jane feared would tell her mother. So Jane turned to LucyBot. The chatbot gave Jane advice, recommended resources, and provided her with a chance to talk to a doctor discreetly without going to the hospital. Stories like Jane's give me hope that LucyBot is actually giving young people a voice and options to choose from when faced with sensitive sexual and reproductive health decisions.