Asia’s femtech revolution: the hunt for higher girls’s well being

Worldwide Ladies’s Day marks 67 days for the reason that starting of 2022. That’s seven days greater than the common variety of college days a lady in Laos misses yearly resulting from interval poverty.

Interval poverty — insufficient entry to menstrual hygiene instruments and training — is estimated to have an effect on as many as 1 in 10 menstruating women and girls worldwide, in keeping with a report by the United Nations.

The difficulty is especially rife in patriarchal societies resembling Laos, the place intervals are thought-about a taboo topic. Something regarding the feminine reproductive system is mentioned solely in hush-hush tones, and details about menstruation is usually restricted to previous wives’ tales, resembling the assumption that ladies should not eat spiced mango whereas on their interval.

A 2016 survey by Lotus Instructional Fund, a world NGO that helps the education of women in southern Laos’ rural Champhone district, revealed that 70 per cent of ladies and ladies within the district’s poorest villages didn’t know why they bled each month.

Many women additionally admitted to skipping work or college when menstruating resulting from an absence of sanitary sources or data of methods to take care of themselves.

“Women instructed us that they had been too embarrassed to attend college once they had been menstruating as a result of that they had no sanitary pads,” Lotus co-founder Dianne Gamage instructed Nikkei Asia. “One woman even instructed me that she wore two sinhs (conventional Lao feminine gown) on the times of her interval, for concern of bleeding by means of the material.”

70% of girls in rural Laos did not know why they menstruated

However regardless of the prevalence of interval poverty, and its potential influence on ladies’ training, bettering menstrual well being isn’t on the high of governments’ to-do lists, stated Trine Angeline Sig, managing director of RealRelief, a Danish-based firm that has been designing sustainable assist merchandise for growing nations since 2013.

“I’ve so many tales from coming into high-level places of work and assembly ministers,” Sig instructed Nikkei Asia. “And while you discuss to them about combating malaria, or distributing mosquito nets, and so on, they are going to hear they usually assume it’s unbelievable. However the minute you carry up sanitary merchandise, the assembly is all of the sudden over they usually don’t have time. Menstruation is so stigmatised in so many nations, and males don’t need to be concerned.”

Girls in Laos’ Champhone district learn about contraception
Women in Laos’ Champhone district find out about contraception in one in all Lotus Instructional Fund’s intercourse training workshops © Courtesy of Lotus Instructional Fund

Yan Li, a professor of digital transformation at ESSEC Asia-Pacific in Singapore, instructed Nikkei that girls’s well being has traditionally been sidelined not solely by governments however by the medical trade itself. “Ladies’s healthcare is handled as area of interest,” Li stated, “despite the fact that we make up half of the inhabitants. Many drug trials don’t even take a look at on feminine topics, so girls can simply be overdosed by chance.”

In accordance with an often-quoted research printed within the British Journal of Scientific Pharmacology in 2018, solely 22 per cent of topics in Section 1 drug trials are feminine.

Out with the previous, in with the tech

Within the absence of ample illustration in mainstream healthcare, entrepreneurs throughout Asia are turning to a brand new power to deal with girls’s well being considerations: femtech.

Coined within the US in 2016, “femtech” refers to any software program, product or service that makes use of know-how to enhance girls’s well being.

Early femtech got here within the type of sustainable sanitary merchandise for tackling interval poverty, resembling the three,200 sanitary kits produced and distributed in Laos by Lotus in 2016. The kits contained reusable pads, underwear and detergent, and had been produced by ladies enrolled in Lotus’ training programme.

Lotus Educational Fund sanitary containing reusable pads and underwear
To assist fight interval poverty in rural Laos, Lotus Instructional Fund supplied 3,000 sanitary kits in 2016, containing reusable pads and underwear © Courtesy of Lotus Instructional Fund

As know-how has developed, so has femtech. In 2018, RealRelief received the Danish Design Award for its Safepad, a reusable sanitary towel made with a singular antimicrobial cloth that kills any micro organism inside 30 seconds.

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RealRelief’s Sig defined that antimicrobial know-how is critical as a result of many women in Asia’s poorest areas would not have entry to scrub water. “With Safepad,” Sig stated, “even if you happen to wash it in a contaminated lake or river, the material kills any dangerous micro organism, so that you don’t have to fret about infections.”

Safepad is at present distributed in 10 nations throughout Africa and Asia, together with Laos and Bangladesh. RealRelief’s newest problem has been getting the product to women in Afghanistan, which has been experiencing a humanitarian disaster following the withdrawal of US troops final 12 months, and the place the UNHCR estimates that 80 per cent of the 700,000 folks displaced by battle in 2021 are girls and youngsters.

When the Taliban took over the nation in August, Safepad’s manufacturing centre in Kabul was instantly pressured to close down.

SafePad is a reusable sanitary towel made with antimicrobial fabric to fight bacterial infection
SafePad is a reusable sanitary towel made with antimicrobial cloth to combat bacterial an infection. Its manufacturing centre in Kabul has been given permission by the Taliban to reopen © Courtesy of RealRelief

However after a number of months of cautious talks with the Taliban, Safepad was given permission to renew manufacturing, supplied the 12 native girls employed to assemble the pads are accompanied to and from work by male guardians.

“I’ve to say,” Sig stated, “I didn’t anticipate them to allow us to proceed, however I used to be so glad for the ladies as a result of they actually look ahead to coming to work day-after-day . . . For them, it’s freedom.”

Asia’s femtech increase

The final couple of years have seen a increase in funding in femtech worldwide. Analytical data company FemTech Analytics counted 1,323 femtech firms globally final 12 months, 41 of which had been in south-east Asia, with 1,292 buyers.

“The huge digitisation of healthcare, partially pushed by the Covid-19 pandemic, has given a much-needed enhance to the femtech trade. Increasingly more applied sciences aimed toward bettering girls’s well being are being designed,” stated Kate Batz, director of FemTech Analytics, in an interview with Nikkei.

Asia is dwelling to only 14 per cent of the world’s femtech firms, however is ready to take advantage of the increase. FemTech Analytics predicts that by 2026 the Asia-Pacific area will probably be seeing the world’s quickest development in girls’s well being apps.

This development will probably be fuelled by “higher consciousness and openness about feminine well being matters, altering perceptions about girls’s well being points and extra capital accessibility for feminine founders” within the area, Batz stated.

Femtech companies by region

One such app is Oky, launched in 2019 by Unicef, that was designed in collaboration with ladies in Indonesia and Mongolia. It helps train ladies aged 10 to 19 about menstruation, with a cycle tracker and diary operate, and lists native sources for reproductive well being and sexual violence help.

Oky, now accessible globally, additionally has readout performance for customers with low literacy or visible impairments. Unicef plans to increase the app’s localised language content material to eight nations this 12 months, based mostly on a franchise mannequin.

However Gerda Binder, who leads the Oky group at Unicef’s East Asia and Pacific regional workplace, stated there’s a want for extra curiosity and funding from massive companies if enlargement objectives are to be achieved. “There’s an enormous untapped [well of] company contribution,” she stated.

Covid’s influence on feminine well being

Asia’s want for extra femtech innovation has been highlighted by the Covid-19 pandemic; menstrual well being is the tip of the iceberg.

Sarah Knibbs, the officer-in-charge of UN Ladies Asia and the Pacific, instructed Nikkei the pandemic had disproportionately affected the area’s girls.

“Even earlier than the pandemic, girls on common had been doing thrice as a lot unpaid care work as males,” Knibbs stated. “Through the pandemic, there was an enormous improve within the burden of care work, resulting from closures of kid care, aged care and faculties.”

The elevated pressure on girls has affected their capability to deal with pre-existing well being considerations. “For those who’re tied down with baby care or social norms that make it tough to depart the house,” Knibbs stated, “you might not be capable of entry the healthcare, together with vaccines, you want for your self.”

A woman receives a shot of Covid-19 vaccine during a special mass vaccination drive for women in Mumbai
A girl receives a shot of Covid-19 vaccine throughout a particular mass vaccination drive for ladies in Mumbai, India. The burden of care work from home has made it tough for a lot of Indian girls to find time for their very own well being appointments © EPA-EFE

MyAva, an Indian femtech start-up, hopes know-how is the important thing to getting girls the healthcare they want beneath pandemic situations.

The MyAva app streamlines the monitoring and therapy of polycystic ovary syndrome (PCOS) by giving girls entry to centres that make use of gynaecologists, nutritionists and health coaches, multi functional place.

Amongst girls aged 15 to 44 world wide, 1 in 10 is believed to endure from PCOS, a hormonal situation whereby small follicles type on the within of the ovaries. Signs embody weight acquire, irregular intervals and facial hair.

Analysis means that PCOS disproportionately impacts Asian girls. In accordance with a nationwide survey performed in 2021 by OZiva, a plant-based diet and wellness model, the syndrome impacts 1 in 5 Indian girls.

One in 10 women suffer from PCOS

Divya (a pseudonym) lives in New Delhi. The 17-year-old suffers from PCOS. “Her situation has worsened” through the pandemic, Divya’s mom instructed Nikkei Asia. “As a consequence of concern of catching Covid-19, I haven’t been taking my daughter to the gynaecologist often,” stated the mom, visibly fearful. “Earlier than the pandemic, I by no means missed an appointment.”

Even earlier than Covid hit, getting handled for PCOS in India was a problem. Like menstruation, the situation is historically seen as taboo and never talked about with male members of the family, the choice makers in most households.

Regardless of the syndrome’s prevalence in India, OZiva’s survey revealed that 25 per cent of India’s feminine inhabitants didn’t know something about PCOS, whereas 65 per cent had been unaware of the signs.

Smartphone images of the MyAva app alongside founder Evelyn Immanuel
MyAva, based by Evelyn Immanuel, proper, is an app that gives easy-to-access data and help for victims of PCOS in India © Courtesy of Evelyn Immanuel

Evelyn Immanuel, a biomedical engineer who has PCOS herself, based MyAva in 2020 to “present a holistic method to the administration of PCOS”.

The app has about 50 docs, 25 nutritionists and 12 health coaches on board as consultants. Its subscription plans, which vary from a length of three to 12 months, price wherever from 2,500 to 18,000 rupees ($33 to $239).

UN Ladies’s Knibbs thinks technological approaches resembling MyAva maintain nice potential for advancing girls’s well being. “One of many advantages of [femtech] is it might create an setting the place girls can search assistance on a problem that they’ve problem speaking about, or in conditions the place it’s tough for them to depart the home,” she instructed Nikkei.

Accessibility doubts

However there are considerations concerning the viability of femtech in societies the place girls have restricted entry to know-how, or lack the monetary means to pay for subscriptions. Neither Divya nor her mom had ever heard of femtech as a PCOS therapy possibility.

“In south Asia, the digital gender hole is gigantic,” Knibbs stated, explaining that “58 per cent fewer girls than males have entry to cellular web providers, and 28 per cent fewer girls than males personal cellphones” within the area.

The state of affairs considerations Pushpendra Singh, a professor on the Indraprastha Institute of Info Expertise Delhi. Singh is concerned in a mission that makes use of cellular studying platforms to coach girls in rural India about healthcare.

“The best way many femtech apps have been developed means they’re concentrating on themselves at girls in city areas,” Singh instructed Nikkei. “If [an app] requires customers to pay, that consumer must be from the next financial background. If we need to attain rural girls, we’ve got to essentially change the best way apps are being developed.”

The mission Singh works on makes use of WhatsApp to supply free or low-cost medical consultations to girls in India’s poorest areas, specializing in female-specific well being considerations resembling being pregnant and post-partum. His hope is to supply “informational help” to girls, growing consciousness of feminine well being points and mobilising communities in the direction of higher well being planning.

Femtech’s function in household planning

Demand for motherhood- and fertility-related femtech, which contains 38 per cent of the world’s femtech market, shot up through the pandemic.

Femtech companies by sector

Maternal care and household planning had been the primary providers to be scaled again or axed when hospitals had been pressured to redirect sources to the Covid response. A current UN report discovered that 1 in 3 girls in Pakistan have been unable to entry the antenatal or postnatal care they wanted through the pandemic.

Within the Philippines, group well being centres paused sexual and reproductive well being programmes to concentrate on Covid, in keeping with the College of the Philippines Middle for Ladies’s and Gender Research.

Jessica de Mesa, a registered nurse, noticed a “massive first-mover benefit” in offering Filipino girls with well being providers and medical contraception, bought on-line and delivered discreetly. The Philippines already has well being tech firms and specialised girls’s clinics, so de Mesa and co-founder Abetina Valenzuela began Kindred to mix the 2.

Kindred’s 12 workers and 21 docs have served round 900 sufferers of their first 5 months. As quickly as a brand new buyer indicators on, the corporate foresees lifetime demand, from menarche (a lady’s first interval) to motherhood to menopause.

A Filipino health worker holds birth control pills at a women’s health clinic in Manila
Contraception tablets turned laborious to pay money for for a lot of Filipino girls through the pandemic, as sexual well being and household planning providers shut down © EPA=時事

Anna, Kindred’s contraception arm, sells six totally different medication for medical contraception, in addition to emergency contraception. Month-to-month packages vary from 500 to 1,000 pesos ($9.75 to $19.50). Digital consultations with docs on Kindred begin at 850 pesos, with further packages for fertility and sexual healthcare.

Instagram has been the primary gross sales channel for Anna. Kindred clients, which de Mesa describes as upper-middle-income girls within the city workforce, want to have interaction with Anna by way of direct messages on the platform.

The beginning-up plans to open its first bodily clinic this 12 months and preserve elevating funds; it has already received an preliminary funding from Pulse 63, a enterprise capital specializing in healthcare.

“Kindred’s success will set the stage for different femtech start-ups,” de Mesa believes.

Femtech for males?

The urge for food for femtech is rising in Vietnam, too. The capitalist class is taking cues from the ruling Communist social gathering, which talks up equality throughout courses and amongst genders. Its efforts embody requiring menstruation breaks at work and female-friendly labour legal guidelines.

Ngoc Nguyen, a coder from the Mekong Delta, can hint her life as a start-up CEO again to a bit of black dot on an ultrasound that appeared when she was pregnant in 2016. That dot turned out to be no trigger for concern, however the early scare launched her on an obsessive bid to scour the online, books and her community to be taught extra about being pregnant.

Ngoc Nguyen, founder of motherhood app Momby
Ngoc Nguyen based her motherhood app, Momby, to make being pregnant and baby care extra collaborative between moms and dads © Lien Hoang

Her analysis gave beginning to Momby, a parenthood app. On Momby, customers press one button to make an obstetrician appointment, one other to ask inquiries to a chatbot and one more for tips about breastfeeding.

“Dad and mom have instructed us that once they don’t know who to ask [about pregnancy-related concerns] they’ll come to us,” Nguyen instructed Nikkei. Working with seven docs, Momby combats “data overload” by giving mother and father verifiable info in Vietnamese.

Vietnam takes a progressive line on reproductive rights, from abortion entry to parental go away. The nation of 99mn outperforms the area on maternal mortality, with 43 deaths per 100,000 reside births, in comparison with 69 on common in Asia, in keeping with the World Financial institution.

85,000 women in the Asia-Pacific die related to pregnancy or childbirth every year

However as is the case in a lot of the area, strains on the household unit have a tendency to return from society, together with a desire for sons, an ageing inhabitants and the normal perception that baby care is a girl’s duty.

Momby’s purpose is to enchantment to fathers in addition to moms, to make being pregnant and parenthood extra collaborative. The app features a diary of what to anticipate at every stage of being pregnant and childhood growth, a function widespread with each moms and dads.

Momby accommodates particular content material directed at fathers, resembling details about morning illness and perinatal melancholy that their companions might encounter — and the way they may also help.

“I felt actually glad after we obtained suggestions like that,” the founder stated, noting that 20 per cent of customers are males.

The menace that’s menopause

As Asia slowly emerges from the pandemic, an unlikely new child on the femtech block is gaining consideration: menopause care.

Menopause — the interval throughout which a girl’s ovaries cease producing eggs, often between the ages of 45 and 60 — impacts 100 per cent of menstruating girls and brings with it signs resembling sizzling flushes, night time sweats and complications.

1.1bn women will be experiencing menopause by 2025

As lifespans get longer, the North American Menopause Society estimates that 1.1bn girls — 12 per cent of the world’s inhabitants — will probably be experiencing menopause by 2025. This determine is turning into more and more laborious to disregard in Asia, dwelling to a few of the world’s most quickly ageing populations. In Japan, for example, over 29 per cent of the inhabitants is over 65.

However Susan Davis, director of the Ladies’s Well being Analysis Program at Monash College’s Faculty of Public Well being and Preventive Medication, Australia, instructed Nikkei that analysis into the influence of menopause on girls’s well being is gradual and underfunded.

“There’s a lot we don’t know,” Davis stated. “Nobody is concerned about investing cash in mid-life girls’s healthcare. Youthful girls’s well being is much extra enticing as a result of they’ll have kids, so individuals are extra emotionally invested in that.”

What little analysis has been achieved suggests menopause could possibly be severely affecting girls’s psychological wellbeing. “Our research discovered that the influence [of menopause] on girls’s psychological wellbeing is equal to the influence of getting persistent again ache,” Davis instructed Nikkei.

And “it’s not nearly sizzling flushes”, Davis went on. “Menopause additionally impacts your bone well being and cardio-metabolic well being. When oestrogen ranges drop, bone mass drops, which is why so many ladies get osteoporosis after menopause.” There’s additionally analysis to recommend menopause will increase girls’s danger of contracting diabetes, coronary heart illness and most cancers.

Women can lose up to 20% of their bone mass during menopause

Remedy choices for menopause are restricted. Hormone alternative remedy (HRT), which replenishes a few of the hormones a girl’s physique loses throughout menopause, is the most typical method, however “we nonetheless have docs everywhere in the world who don’t know methods to prescribe HRT”, Davis stated. “And what works for one lady, won’t work for an additional. We’d like extra data.”

Menopause femtech in Japan

In Japan, feminine entrepreneurs uninterested in ready for advances in menopause care are turning to femtech.

Akiyo Takamoto, founding father of femtech start-up Yorisol, determined it was time to take issues into her personal palms after struggling to seek out data and help when she began experiencing menopausal signs a couple of years in the past.

“Earlier generations used to only put up with the burden of issues like menstruation and menopause,” Takamoto stated, “and there are nonetheless quite a lot of girls in Japan who assume that gaman (perseverance) is the precise strategy to take care of these points.”

Akiyo Takamoto, founder of Yorisol
Akiyo Takamoto based Yorisol, an AI-powered chat bot, final 12 months to assist facilitate communication between menopausal girls and their companions © Courtesy of Yorisol

Launched in April 2020, Yorisol makes use of synthetic intelligence to facilitate communication between feminine customers experiencing menopause and their male companions. “I usually obtained into fights with my husband as a result of I felt he didn’t perceive my signs or thought I used to be complaining an excessive amount of,” Takamoto stated. “There’s a giant hole in communication between women and men relating to menopause.”

By including Yorisol as a contact on the favored messaging app Line, feminine customers can log their every day signs and emotions, prompted by questions from an AI-powered bot. The bot then forwards these responses to the consumer’s associate, with options of how they could relieve their spouse’s or girlfriend’s signs that day.

“My purpose,” Takamoto stated, “is to create a brand new tradition the place women and men can navigate menopause collectively.” She added: “Japan nonetheless views menopause as a girls’s drawback above all else. However it impacts males’s lives, too.”

Takamoto instructed Nikkei that the lack of know-how about menopause in Japan, amongst each women and men, is resulting in communication issues and even divorce for a lot of {couples}. On high of the chat operate, Yorisol offers a month-to-month couple’s counselling service.

Streamlining menopause care

However the societal influence of menopause extends exterior of the house. Analysis means that untreated menopause signs negatively influence girls’s efficiency at work.

A survey performed in January by the Japan Society of Endometriosis discovered that 66.3 per cent of Japanese girls going by means of menopause felt their productiveness at work drop by at the least 30 per cent on days once they had been experiencing signs.

Davis, the Monash College professor, instructed Nikkei that firms have a duty to assist their feminine staff discover applicable menopause therapy.

“Workplaces needs to be offering particular go away for ladies who want to go to the physician and get menopause care,” Davis stated. “Turning up the aircon within the workplace as a result of some girls are having sizzling flushes is just not sufficient.” Menopause go away is just not at present a authorized requirement in any nation.

Menopause impact on work performace

EloCare, a Singapore-based wearable know-how start-up, believes the important thing to decreasing menopause’s influence on girls’s productiveness is to streamline their entry to efficient therapy.

“Menopause impacts each lady in a different way,” Mabel Yen Ngoc Nguyen, the start-up’s CEO, instructed Nikkei. “Many ladies don’t perceive their very own signs, so it might take a number of journeys to the physician to even get recognized with menopause, not to mention be prescribed applicable therapy.”

Mabel, who holds a doctorate in biomedical engineering, co-founded EloCare with Fandi Peng in 2020 after noticing a spot in Singapore’s femtech market. “I’ve at all times been concerned about femtech and realised that nobody [in the industry] was speaking about menopause,” Mabel stated. In accordance with FemTech Analytics, solely 6 per cent of the world’s femtech firms specialize in menopause.

EloCare is growing a wearable product that screens a girl’s physique temperature, blood strain and different variables to supply “personalised information therapy for menopause”, Mabel stated. The purpose is that customers will be capable of monitor their sizzling flushes and different signs, then see a physician armed with information about their situation, within the hope of receiving a extra correct prognosis and applicable therapy.

By EloCare, Mabel hopes to assist girls higher perceive their very own signs and supply worthwhile information to researchers and docs within the menopause area — information that was not accessible when EloCare began out. “The explanation our prototype is taking so lengthy is that there was no analysis to base it on,” Mabel stated. “We needed to do all of it from scratch.”

Mabel sees Asia’s feminine healthcare panorama evolving. “Increasingly more girls are demanding options to menopause signs,” she stated. “And buyers are getting increasingly more concerned about femtech. Male buyers won’t perceive why it’s vital, however they’ll see femtech is fashionable, so I believe funding will solely improve.”

Dylan Loh in Singapore and Gwen Robinson in Bangkok additionally contributed to this story

A model of this text was first printed by Nikkei Asia on March 2 2022. ©2022 Nikkei Inc. All rights reserved

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