Every entrepreneur knows the fulfilment of seeing their idea come alive, and the reality of realising it may not work as expected. But sometimes, that’s where true innovation happens. It’s also where qualities like resilience, adaptability, and creativity are tested, where dedication to the solution is pushed to its limits, and where belief in the vision is truly measured.
As we celebrate both Entrepreneurship Month and Children’s Month this November, we’re honouring the entrepreneurs we’ve walked alongside. Those who continuously test, refine, and adapt their ideas in response to unexpected challenges, driven by a commitment to solving early childhood challenges in South Africa.
We’re shining a spotlight on our partner, the Perinatal Mental Health Project (PMHP) at the University of Cape Town (UCT), as our investment partnership comes to a close.
When we met the team in 2022, they shared a compelling vision to improve the mental well-being of mothers during and after pregnancy and, in doing so, positively influence children’s own well-being. They proposed to work with UCT’s Computer Science Department to develop an app called Secret History Mobile Application (SHiMA) to strengthen maternity healthcare providers’ skills in respectful maternity care, empathic engagement and self-care. Their thinking was that when healthcare workers are equipped with the knowledge and tools to care for themselves, they’re better able to offer compassionate, stigma-free support to mothers, creating safer, more nurturing experiences that ultimately benefit both mothers and children.
This vision was grounded in the realities faced by many women in South Africa’s low-resourced communities, where psychological stress during and after pregnancy is alarmingly common. Factors such as poverty, young maternal age, intimate partner violence and limited social support often heighten this stress, affecting both mothers and their babies. Added to this is the distress caused by disrespectful or abusive treatment in healthcare settings, which discourages women from seeking care and can have lasting effects on their health and their children’s early development.
Instilling Empathy, Care and Compassion in Healthcare
Rooted in the in-person Secret History Training Method, SHiMA transforms the experience into a digital, interactive one. The original method uses group role-play to help healthcare providers develop empathy, care, and compassion, qualities often overshadowed by the technical side of nursing. Conventional nursing training, by contrast, has long focused on medical conditions, with manuals and guidelines designed to ensure nurses can identify, diagnose, treat, and monitor patients effectively. Yet, this approach leaves little room for the emotional and human realities of caregiving, where understanding and connection are as crucial as technical skills.
SHiMA bridges that gap by enabling healthcare providers to learn through interactive digital scenarios focused on empathy, communication, and stress management. It helps nurses understand and respond to the feelings, concerns and fears of patients in their care. Drawing on storytelling and role-play principles, it guides users to recognise subtle emotional cues, understand potential sources of trauma, and respond in ways that are both supportive and respectful, fostering a sense of trust and safety.
When using SHiMA, healthcare providers navigate clinical narratives simulating real-life interactions between healthcare workers and patients. They are prompted to select responses based on each scenario, with every choice shaping how the story unfolds and how the patient’s experience evolves. For example, users begin by choosing a story that resonates with them, then continue making decisions that strengthen their ability to engage compassionately and thoughtfully and respectfully with both colleagues and mothers of young children, building their confidence and emotional awareness along the way.
Testing, Learning, and Growing Through Practice
When PMHP first developed the SHiMA mobile app, the vision was to create a structured platform where healthcare workers could meaningfully engage with training modules through interactive stories, reflection exercises, and practical skills development tools. The app featured multimedia content such as PDFs and videos, designed to reinforce and supplement in-person training in Respectful Maternity Care (RMC) and maternal mental health.
However, during the user testing phase with 18 nurses from Mowbray Maternity Hospital, a few practical challenges emerged. The navigation on the app wasn’t always easy to use. Certain features demanded a level of digital skill that many users hadn’t yet developed, which sometimes caused hesitation. Despite the app using no data once downloaded, users still did not trust that they wouldn’t incur data charges.
Amid these challenges, the content resonated deeply with nurses and midwives, and they recognised their own experiences in the stories. Many appreciated the app’s focus on self-care, a crucial addition given the demanding and often under-resourced conditions in which many public health workers operate.
This phase revealed an important lesson, which is that testing is just as critical as development. It is not enough to have a promising idea, because user feedback and real-world trials shape a solution into something that truly meets people’s needs and supports them effectively.
Adapting SHiMA to the Real Needs of Healthcare Workers
Recognising the limitations of the app, PMHP and the Computer Science Department brought on a partner, Reach Digital Health (the architects of MomConnect) and pivoted to WhatsApp. In South Africa, about 96% of people with smartphones use WhatsApp, making it an intuitive, low-cost, and familiar channel for training. The WhatsApp-based SHiMA prototype was built using Turn.io, a platform for creating chatbots. It retained all the core components of the original app and added additional self-care content through the “StressLess” challenge, previously developed by PMHP for Health Worker Connect during the COVID-19 period. Simple user feedback mechanisms were added, as well as prompts to facilitate navigation.
The WhatsApp prototype was tested with 10 nurses and midwives at Mowbray Maternity Hospital who had previously engaged with the first app version of SHiMA. The feedback was overwhelmingly positive.
Participants found it convenient, easy to navigate, and relatable to their daily experiences. They appreciated that it could be integrated seamlessly into their routines, working around demanding schedules while still offering practical guidance on both empathic care and self-care.
Key Lessons and Insights from Developing and Testing SHiMA
The journey of developing SHiMA offered far more than a new training tool; it revealed insights about the process of innovation, the realities of healthcare environments, and the importance of listening attentively to users. Every challenge highlighted an opportunity to learn, adapt, and refine the approach with careful thought and consideration. It demonstrated that innovation is as much about flexibility, responsiveness and perseverance as it is about the original idea.
Several lessons emerged from this journey:
Flexibility is essential
Moving from an app to WhatsApp was not a failure, but a strategic pivot informed by user needs and realities.
User-centred design drives engagement
Health workers appreciated content that reflected their realities and offered practical, relatable guidance. The addition of the StressLess self-care modules was especially valued, reinforcing the importance of addressing caregiver well-being.
Testing and iteration are non-negotiable
Even small adjustments, such as clarifying instructions or modifying menus, produced immediate improvements in usability.
Technology must meet users where they are
WhatsApp’s familiarity, low data requirements, and reliability made it the most feasible channel for reaching healthcare workers, demonstrating that sometimes simpler solutions can outperform technically sophisticated ones.
Partnerships amplify impact
Collaborating with technology experts, research institutions, and funders like Innovation Edge ensures that solutions are robust, scalable, and grounded in evidence.
“It is so exciting to see how digital storytelling can bring meaningful learning into the hands of busy maternity healthcare workers. The stories of impact on behavioural change – both in terms of self-care and compassionate care for women in labour – were extraordinary! Now, we need a home for SHiMA so that more health workers can have access.” – Associate Professor Simone Honikman, PMHP Director
The SHiMA journey reminds us that entrepreneurship is rarely linear. Innovations don’t always succeed at the first attempt, and some don’t succeed at all, but each phase offers lessons that bring us closer to effective, meaningful solutions and a deeper understanding of what works in practice. Innovation Edge values these journeys as much as the outcomes, and we continue to support entrepreneurs and social innovators in developing solutions that create lasting impact for young children and their caregivers.
Read more stories here.
Author: Dimpho Lephaila – Communications Associate at Innovation Edge