How ImpulsoGov increased preventive screening completion 269% in Brazil's public health system using WhatsApp
Transforming data into effective care: the digital public health strategy reaching 3 million users across more than 300 Brazilian municipalities.
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- 3.6xMore screenings completed
- 300+Municipalities served
- 3MSUS users reached
- 16xBetter cost-effectiveness
Discover how ImpulsoGov uses Turn.io's and WhatsApp to transform millions of health records into concrete preventive care actions—doubling screening completion rates whilst being 16 times more cost-effective than traditional methods.
The reality that drove ImpulsoGov
When data doesn't become care
Brazil has one of the most comprehensive public health systems in the world. With 90% of primary healthcare units already digitised and more than 170 million citizen records, the SUS (Sistema Único de Saúde) generates an impressive volume of information daily
But a paradox exists: despite this wealth of data, it doesn't always translate into effective care for the population.
But a paradox exists: despite this wealth of data, it doesn't always translate into effective care for the population.
Brazil has one of the largest and richest health datasets in the world. Every day, thousands of healthcare professionals record consultations and feed into a unique database. Yet little of this effort converts into practical information capable of guiding decisions, supporting management, and improving people's lives.
Gabrielle Arruda
Product Manager, ImpulsoGov
Challenges in Brazil's Public Health System
Before implementing the Turn.io solution, communication with SUS users faced significant barriers:
Manual, in-person processes: Community health workers had to travel kilometres to reach each patient.
Limited reach: Professionals naturally served people near central units, leaving remote areas underserved.
Enormous physical barriers: In a continental-sized country like Brazil, territorial extent made in-person work unviable at scale.
Underutilised data: Valuable information about pending screenings, chronic conditions, and follow-up needs remained trapped in systems.
Lack of intelligent prioritisation: Without analytical tools, identifying who most urgently needed attention was difficult.
But how do you scale this essencial human-centered model to effectively reach millions of people?
The solution:
WhatsApp
as the cornerstone of patient communication
as the cornerstone of patient communication
Founded in 2019 with a mission to strengthen primary care through technology and data, ImpulsoGov identified WhatsApp as a unique opportunity to democratise access to health information at national scale.
Why WhatsApp and Turn.io?
he choice wasn't arbitrary. It was based on four fundamental pillars:
📱
Universal Accessibility
99% of smartphones in Brazil have WhatsApp installed—a penetration no other application achieves.
🎯
Message Comprehension
The population already knows how to use WhatsApp for communication, eliminating technological adoption barriers.
🎬
Media
Richness
Riqueza de Mídia
Sending videos, audio, and images facilitates communication across different cultural contexts and literacy levels.
🤝
Values
Alignment
A partnership between two organisations focused on maximum social impact and bringing better health to the Brazilian population.
Choosing WhatsApp as our communication channel was largely based on our belief that this platform offers far greater accessibility and has true permeability within Brazilian society. We knew most phones already have this app installed, and people already know how to use it for communication. So when we talk about accessibility, one of the important things isn't just reaching many people—it's ensuring they can actually understand the message we're delivering.
— Gabrielle, Product Manager at ImpulsoGov
How the implementation works
ImpulsoGov's strategy with Turn.io goes far beyond simply sending messages. It's an integrated ecosystem connecting data, healthcare professionals, and the population:
1. Data untelligence and prioritisation
ImpulsoGov developed a proprietary platform that analyses millions of SUS records and automatically identifies:- Patients with pending screenings (cervical cytology, mammography, glycated haemoglobin)
- People with chronic conditions requiring follow-up (hypertension, diabetes)
- Urgent needs based on multiple health indicators
2. Healthcare professional training via WhatsApp
urses, doctors, and community health workers receive periodic WhatsApp communications with:- Invitations to bi-monthly training sessions on best practices
- Guidance on reinforcing the messages sent to citizens
3. Personalised mass communication
Citizens receive automated, personalised messages based on their specific health conditions:4. Multi-channel approach to overcome distrust
One of the biggest initial challenges was fear of fraud and scams. To overcome this, ImpulsoGov implemented a multi-channel strategy:- Printed materials distributed at health units
- Promotion on official municipal health department social media channels
- Communication in local newspapers about WhatsApp usage
- Validation by community health workers themselves, who share the official WhatsApp number during visits
"When we presented to the municipality, we also sent materials that could be printed and shared on other social media platforms, and we communicated in local newspapers about the WhatsApp service, informing people it was an official number. We noticed we stopped receiving fraud reports after that"
— Gabrielle, Product Manager at ImpulsoGov
Cultural and Regional Adaptation
In a country as diverse as Brazil, ImpulsoGov understood that generic messages don't work.
That's why they invest heavily in adaptations:
That's why they invest heavily in adaptations:
- Local qualitative interviews to understand how each region communicates about health
- Use of culturally appropriate terms for each health condition.
- Consideration of specific contexts — what works in the South may not work in the North.
The results:
Measurable impact on public health
The success of the partnership between ImpulsoGov and Turn.io isn't based on assumptions, it's backed by rigorous scientific evidence. In collaboration with Johns Hopkins University, a randomised controlled trial was conducted over eighteen months, evaluating 28 municipalities across all regions of Brazil.
Results achieved with WhatsApp and Turn.io
Cervical Cytology Screening*
With WhatsApp
More screenings completedDiabetes Patient
Follow-upWith WhatsApp
Mais pacientes em acompanhamentoProgramme Cost-Effectiveness*
With WhatsApp
More effective*16x more cost-effective than the CONITEC (Ministry of Health) cost-effectiveness threshold
WhatsApp Penetration in Brazil
Universal penetration across Brazil
*Preliminary data verified by randomised controlled study in partnership with Johns Hopkins, conducted across 28 Brazilian municipalities over 1.5 years.
"We conducted a study with Johns Hopkins featuring three evaluation rounds over eighteen months. Twenty-eight municipalities across all regions of Brazil were evaluated through a randomised controlled trial." — Gabrielle
The essential role of community health workers
One of the most powerful insights from this implementation is how WhatsApp amplifies the work of community health workers erather than replacing them. The technology functions as a digital extension of these essential professionals.
The primary health unit is the heart, and community health workers are the veins distributing care throughout the entire social body. With WhatsApp, we can reduce physical barriers—which still exist, but now have far less impact within Brazilian reality.
— Gabrielle, Product Manager na ImpulsoGov
How Community Health Workers integrate with the digital strategy
- Message validation: They inform families that the WhatsApp number is official and safe
- Contextual interpretation: They help citizens with technological difficulties understand the messages
- In-person reinforcement: They conduct complementary home visits when needed, especially for elderly and more vulnerable populations
- Valuable feedback: They communicate each territory's particularities to ImpulsoGov to improve messaging
IA
The future:
Artificial intelligence and personalisation at scale
ImpulsoGov is already exploring the next frontier in health communication: using artificial intelligence to make interactions even more effective and bidirectional.
AI for Bidirectional Engagement
Recent studies show that bidirectional chatbots, where patients can ask questions and receive automated responses, generate superior outcomes:
Next Steps in the AI Journey
Next steps in the AI journey — ImpulsoGov is working on multiple AI innovation fronts:
- Intelligent prioritisation: More sophisticated algorithms to automatically identify highest-risk patients
- Error identification: Automatic detection of inconsistencies in health records
- List optimisation: Facilitating work for professionals managing extensive patient lists
- Contextual automated responses: Chatbots that understand each citizen's context and respond in a personalised manner
We have one of the health systems with the most data and most registered people in the world. Not just registered, but with high quality data as well. These professionals spend significant time every day recording and sending information to the government. But this information isn't processed and actioned at the same speed professionals record it.
Gabrielle Arruda
Product Manager, ImpulsoGov
What we learnt
Lessons for the healthcare sector in Brazil and Latin America
WhatsApp as a product, not only a channel
One of the most important conclusions from ImpulsoGov's experience is that WhatsApp has been a highly effective channel and a fundamental component of the digital health product.
Why SMS and email aren't viable alternatives
Although SMS and email are established channels, they don't work in the Brazilian context:
SMS: Culturally, the Brazilian population doesn't tend to check their SMS messages- E-mail: A large portion of the vulnerable population doesn't have or regularly access email
- Proprietary apps: Require downloads, consume phone storage, and face low adoption rates
"Using WhatsApp enabled us to reach citizens at scale with high engagement levels—essential aspects for generating measurable public health impact." — Gabrielle.
Recomendation for other health leaders
Successful implementation requires:
- Start simple: Begin with basic use cases and evolve gradually
- Invest in trust: Multi-channel strategy to overcome fear of fraud
- Adapt culturally: Generic messages don't work— regional personalisation is essential
- Integrate professionals: Train and engage healthcare teams from the start
- Medir resultados: Establish clear KPIs and track impact
"If you're considering integrating WhatsApp into your health strategy, you should do it. And my advice is to start. WhatsApp will give you a way to integrate into your patient's journey, whether in the public or private sector, that provides access to that person far more easily than if you tried through other processes"
— Gabrielle, Product Manager, ImpulsoGov
