Leveraging text messages and influencers, Suvita is tackling childhood vaccination rates in India.
Almost 6 million children in India go under-vaccinated each year. That stark statistic moved Varsha Venugopal and Fiona Conlon to establish Suvita, a non-profit organisation that’s using a creative approach to boost childhood immunization rates.
Suvita uses a combination of text reminders and local influencers to inform parents and caregivers of the importance of getting their children immunized on time. Inspired by Nobel Prize-winning research, Suvita’s interventions have reached more than 3 million children in the Indian states of Bihar and Maharashtra.
The paths of founders Venugopal and Conlon’s first crossed in 2019, at an incubation programme run by Charity Entrepreneurship, a London-based non-profit that helps launch high-impact charities. The intensive two-month programme provided training, mentorship, and a platform for the duo to develop their vision.
With Venugopal’s expertise in global development from stints at the World Bank and Open Society Foundation, and Conlon’s background in public health at the World Health Organization, they zeroed in on a puzzling issue: India’s low childhood vaccination coverage despite being a major vaccine producer. The problem, they realized, wasn’t supply, but demand – parents, especially those with low means, often lacked information about the free, government-run universal immunization programme that protects against measles, hepatitis B, and 9 other deadly diseases. This information gap often led to a drop-off after the first few vaccine doses.
A large-scale randomized controlled trial conducted by the MIT Poverty Action Lab (J-PAL) in Haryana, India, gave them an idea. The study, led by MIT economists and Nobel laureates Abhijit Banerjee and Esther Duflo, tested the effectiveness of 75 different interventions to boost immunization rates. The results were striking: a combination of SMS reminders and “immunization ambassadors” — trusted community members who encourage vaccination — increased the number of fully immunized children by 20%.
“I found that really compelling,” Venugopal recalls.
Armed with this evidence, Venugopal and Conlon launched Suvita in 2019, establishing offices in Pune, Maharashtra and Patna, Bihar – two states with significant gaps in childhood immunization coverage. Today, Suvita’s team of 42 dedicated staff across these two locations work to translate the insights from rigorous research into tangible, real-world impact.
A two-pronged approach
In collaboration with state governments in Maharashtra and Bihar, Suvita obtains contact information for new and expectant mothers from the state’s Reproductive Child Health database. The non-profit then sends personalized text reminders to parents or caregivers about their children’s upcoming immunization appointments. These reminders, sent on behalf of the state government and Suvita, are tailored to each child’s specific vaccination schedule and written in the local language. Parents can opt out of the messaging at any time, but most choose to stay opted in. The reminders are sent one week before and again one day prior to each scheduled vaccine dose, providing timely nudges adapted to individual schedules. By leveraging existing health databases and telecom networks, Suvita’s SMS program has modestly boosted immunization rates in these states, while being cheap to run and scalable.
Alongside the SMS reminders programme, the Suvita team is also building a network of trusted “immunization ambassadors” in local communities, identified through a simple survey asking residents whom they’d most like to hear important information from. These ambassador volunteers regularly share vaccination updates and help to address any concerns or misconceptions in order to foster trust in the community. Early data suggest that they are having a meaningful impact on local vaccination rates, which is no surprise to Venugopal. “As a parent, I can vouch for the fact that folks in my network telling me about something registers differently in my head than an SMS text.”
By combining targeted SMS reminders with the power of trusted local voices, Suvita has mobilized parents to get their children vaccinated while keeping its operating costs low.
Scaling up to save lives
Suvita’s efforts are paying off. The organization has successfully scaled its SMS programme to reach more than 3 million children and pregnant women and has recruited a network of more than 7,000 volunteer ambassadors in Bihar and Maharashtra.
This early success has caught the attention of GiveWell, an influential San Francisco-based nonprofit that evaluates effective charitable giving opportunities. In 2023, GiveWell awarded Suvita a US$3.3 million grant to expand its SMS programme in all administrative districts in the state of Maharashtra and scale up the ambassador program. GiveWell’s analysis suggests that Suvita’s programme could be up to 23 times more cost-effective than unconditional cash transfers – direct cash given without any strings attached. This remarkably high level of cost-effectiveness, even compared to simply providing money, underscores Suvita’s significant potential to drive increased childhood vaccination coverage across India.
With less than five years under its belt, Suvita is still a relatively young organization. The team is now looking at ways to improve what it does and is hoping to expand into Uttar Pradesh, Gujarat, and other Indian states. The long-term goal, Venugopal says, is to build a model that can scale sustainably and even be part of the country’s public health infrastructure. “We’ll have to work out a way to transfer this to government entities,” she says.
Story by Pratik Pawar