Inclusion & Impact (i&i)

Like every Sub-Saharan country, malaria is one of the deadliest diseases in Guinea. This situation makes a large part of the population vulnerable while the protection against disease risk is 5%. In 2008, only 5% of a population of 12.6 million were covered by public health insurance. "i&i" would foster collaboration between mobile phone operators, insurance companies, and healthcare professionals to enable easy access to affordable and quality healthcare services to pregnant women, new mothers and newborns. Their financial inclusion will increase, and their livelihoods would improve greatly. Within the next year, “i&i” would be implemented in Guinea and by the end of the fifth year it would have been replicated across Sub-Saharan Africa countries. Grants for 60% of the total funding requirement would be applied for to get MVP. The remaining 40% would be sourced via Equity Funding. Profit would then be generated to replicate “i&i” in other countries.

The quality of services, and especially on health services, has substantially received little consideration in many African countries (Adindu, 2010). Access to quality and affordable healthcare in Guinea for pregnant women, new mothers, and newborns from low and middle-income groups is quite limited. This inadequacy creates dependency on their male relatives, and often increases stigmatization within their communities. Sadly, in Guinea access to public and private health insurance is not widely available. Only 5% of its 12.4 million population (51.8 % women – World Bank 2018) had public health insurance in 2008. Private insurance companies could only cover another 0.4% (Camara et al., 2015). Insurance companies offer an average amount of $388 USD annually for a family of 3, or an average of $32 USD per month while the total annual health expenditure represented 4.12% of GDP. This represents an expenditure of $89.17 USD per capita for a population which earns on average $2 USD per day per capita (World Bank, 2017). Additionally, while the World Health Organization (WHO) recommended spending allocation to healthcare is 10%, the national annual budget of Guinea approximately allocates a measly 3.5% on healthcare spending (Pacific Prime).

As a cash-based society, it would become a revolution should Guinea be able to provide its citizenry with the opportunity of having multiple options to choose from and pay for health insurance on a daily basis, and/or via mobile money channels. “i&i” is an application that will give users such easier access to quality and affordable healthcare services. The ecosystem platform enables a collaboration between beneficiaries and service providers (mobile phone operators, insurance companies, hospitals, laboratory services, and pharmacies). Below are processes used: Mobile Phone Operators: Provide seamless platforms such as USSD to enroll local community members on the “i&i” program; Provide off-line payment options such as mobile money to collect premiums. Insurance Companies: Assist in product design of the “i&i” program; Underwrite and manage risks for the program; Provide insurance coverage for the risk pool. Healthcare service providers: Provide medical treatments, laboratory services, and medications based on “i&i” program; Ensure adequate and sustainable healthcare services to improve lives of local community members in an accessible and affordable manner. Technologies used are mobile network payments, machine learning for predictive analytics, and a modern mobile and web technology stack.

“i&i” targets pregnant women, new mothers, and newborns from low and middle-income communities within the age range of 15-54 years in Guinea. According to the World Bank (2018), 6.4 million (51.5%) of the Guinean population are female. A macro market research with favorable feasibility was conducted using triangulation of interviews, field visits to stakeholders, and observation of a sampled population. Thereafter, an agreement was made with a local insurance company and private hospital to use their database to develop and test the product, using their staff as initial clients. This ecosystem platform would ensure that the targeted population are able to access health insurance without having access to a bank account. Other burdensome administrative and payment processes would be omitted. Furthermore, this insurance cover will enable beneficiaries to have access to all preferred medical facilities and specialists for safe and quality medical and laboratory services, and medications at their own discretion without relying on their male relatives. Subsequently, this would curb stigmatization within communities as activities would be performed in a healthcare facility, hence, ensuring confidentiality, and thereby promoting the well-being of beneficiaries.

Access to quality and affordable healthcare in Guinea is quite limited. Access to public and private health insurance is not widely available. Only 5% of its population had public health insurance in 2008. Private insurance companies could only cover another 0.4%. “i&i” is an application that enables a collaboration between beneficiaries and service providers and give users such access to quality and affordable healthcare services. The target population is pregnant women, new mothers, and newborns from low and middle-income groups. “i&i” will enable access to health insurance, improve healthcare outcomes, and improved livelihood.

Although BIMA (https://bimamobile.com/about-us) - an “insurance company” uses similar products, it operates essentially in English-speaking African countries such as Ghana, Gambia, Tanzania and Kenya. Our solution significantly stands out in focusing on un-tapped and unreached populations. Also, as an ecosystem platform ensuring stakeholder collaborations, we are not mandated to have a fund management license. Additionally, our targeted market will focus on Guinea initially, then the French-speaking West Africa region before covering the Central Africa region. Similarly, although CAREPAY (https://www.carepay.com/), a Kenya-based company uses products akin to that of “i&i”, our solutions are greatly different from theirs especially as they use a Free-For-Service funded by national and international humanitarian and charity donors. Like BIMA, CAREPAY operates only in Kenya with plans to expand to two other English-speaking countries of Tanzania and Nigeria. “i&i” is a uniquely offering targeting beneficiaries within an under-served segment at the bottom of the social pyramid with long lasting effects, when implemented in a successful manner. 

The “i&i” platform uses mobile network micro-payment technology to expand easy access to affordable healthcare for the unbanked and uninsured population in Guinea.

Mobile network micro-payment technology (mobile money) is mature and has high penetration in Africa. Mobile money transactions in Sub-Saharan Africa were an estimated $26.8 billion in 2018. Safaricom’s M-Pesa and MTN Group’s Mobile Money (MoMo) are two of the largest examples of a very vibrant mobile money sector. Using a conventional or feature phone, consumers can conveniently and instantly transfer money to pay for goods and services. Link: https://qz.com/africa/1721818/africa-mobile-money-industry-is-entering-its-next-stage-of-growth

Run by technology, the world we live in today has the potential to ensure that individuals will one way or the other encounter the use of ICTs. The health sector not being an exception, is one of the fastest growing and needed sectors in the world (Kwesiga & Mukonyezi, 2017). Because mobile phones have become an essential item in our lives today, there is the need for quick, accurate, affordable, and accessible health solutions in the Africa Continent. Mobile applications developed by young African programmers therefore have the potential of meeting these needs (Kwesiga & Mukonyezi, 2017). According to WHO, Guinea has a population of 12.4 million, out of which 52% are female (2016). Life expectancy at birth (year, 2016) male/female is 58/60. Probability of dying under five (per 1 000 live births, 2018) is 101. Probability of dying between 15- and 60-years m/f (per 1 000 population, 2016), 273/251. Total expenditure on health per capita (Intl $,2014): $ 68; Total expenditure on health as % of GDP (2015): 5.6 (UN-DESA, 2019). As an ecosystem application and web platform enabling collaboration between mobile phone operators, insurance companies and healthcare professionals (hospitals, labs, and pharmacies) to provide services to pregnant women, new mothers, and newborns from low and middle-income groups, “i&i” will enable easy access to affordable and quality healthcare services for them. Research has shown that in 2008, only 5% of the population were covered by public health insurance; the social security office 0.4% or other health insurance offices and 0.4% were covered by private health insurance (Camara et al., 2015). Through effective use of the “i&i”, the financial inclusion of pregnant women, new mothers, and newborns will increase with a health insurance products/services, and their livelihoods also will improve. According to Global Findex data, financial exclusion affects a particularly high proportion of women, young people and people living in rural areas (World Bank, 2014). “i&i” is aiming to reduce the impact of catastrophic epidemics like Ebola or Covid-19 on pregnant women, new mothers, and newborns from low and middle-income groups in Guinea and in Africa in general.

Within the first year, we would serve 750,000 people mainly from Conakry. “i&i” would be then replicated to the mining city’s countryside to serve 1,150,000 from the second year. By the fifth year of implementation, “i&i” would be serving 2,875,000 people countrywide, representing 45% of Guinea female population (World Bank, 2018).

Within the next year, “i&i” would initiate the implementation of the app in Guinea which would have been successfully achieved nation-wide by the second year. By the third year, “i&i” would have been expanded to integrate a savings (susu) and pension funds. Within the fifth year, and in collaboration with national authorities, data collected would facilitate accessible national ID for customers and their dependents. In 2014, it was reported that Sub-Saharan Africa, with about 350 million unbanked adults, accounts for 17% of the global unbanked population (World Bank, 2015). There is a huge potential for “i&i” in Africa to meet the needs of the uninsured. As an ecosystem application and web platform, “i&i” by the end of the fifth year would have been replicated across Sub-Saharan Africa countries to increase the financial inclusion of pregnant women and new mothers with access to health insurance services, and subsequently access to affordable and quality healthcare services.

• Negative reaction from conventional insurance companies.

• Other entities duplicating our idea, becoming competitors.

• Clients’ inability to adapt to latest technology.

• Insurers becoming direct competitors with similar digital solutions.

• Newcomers looking to quickly cash-in on the opportunities.

• Through meetings and workshops, we will bring insurance companies to better understand the win-win concept behind the ecosystem platform offered by i&i and collaborate with us.

• Our creative ideas translate to better marketing strategy and continued innovation will allow us to lead on the market.

•  Door-to-door campaigns in the local dialect by our brokers from unemployed graduate and postgraduate students, and essentially composed with at least 80% girls and women

• Aggressive marketing and consumers’ incentives will help us as first comer in the market to conquer new and maintain already enrolled subscribers.

• Analyzed data by some of our partners will allow us to influence decision makers and the market on the best pricing by healthcare services providers.

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1 full-time staff and 3 part-time staff.

Our team is drawing from the best and brightest of Africa's new professional generation combining thirty-years of experience with a proven leadership and experience in bringing advanced technologies and innovation in an economically sustainable manner from laboratory to market. Outside of risk reduction, the team has experience for large-scale disasters allowing it to understand structure and positioning of mitigation from its response experience. Credited with operational management, program and project management, financial and administration management, the team members are multidisciplinary and multicultural and has the ability to lead similar teams in strategy development and implementation with a track record in ICT spanning Information Systems Audit, Cyber Security, IT Governance, IT Training, Scientific Computing, Data Networks, Cloud Computing, and Web Application Development.

“i&i” currently has groups of partners for application and ecosystem platform development and initial piloting: WIREDIN, a Rwanda-based leading IT development company as technology partner. SOGAM, a private insurance company in Guinea. CLINQUE MAHAWA, a private medical clinic located in Conakry. CELLCOM Guinea, a mobile phone operator is ready to participate in the project with a preferential price on transactions from consumers to insurance companies. This will be extended during the rollout phase to ORANGE Guinea and AREBA (MTN Guinea). To reach the goals mentioned above, “i&i” seeks partnerships to: Mentor and advice to strategic planning and products development. Support marketing and communications that clearly distribute data. Build connections to investors and grantors to progress our fundraising strategy. Additionally, the African Institute for Mathematical Sciences (AIMS), partnering with the Mathematics Department of the University of Liverpool, will be engaged to analyze data collected after year one, to do the modeling and come out with pricing solution to be implemented by all service providers to the benefit of the pregnant women, new mothers and newborns. With a well-regarded artificial intelligence/machine learning program, the partnership with AIMS will allow us to integrate artificial intelligence into the “i&i” platform to improve product pricing, claims management (e.g. optical character recognition to handle handwritten documents), and fraud detection. We expect information synthesized from the “i&i” platform will be used to inform Guinea's leadership decisions and be used to adapt current healthcare laws accordingly.

“i&i” is an application and web platform which enables, pregnant women, new mothers and newborns from low and middle-income groups, easy access to affordable and quality healthcare services as and when they require it within their environment to improve lives. They will access healthcare services using their mobile phone to pay for healthcare insurance, which increases their financial inclusion. With i&i, they do not need to have a bank account. The payment for i&i will be done daily through Mobile Money according to their daily, weekly, or monthly earnings. We aim to significantly reduce administrative burden of traditional insurance companies and upfront cash payments at hospitals, labs, and pharmacies.

It has been assumed that a donations and/or grants of 30% of the total funding requirement will be applied for by “i&i” to get to the Minimum Viable Product. The balance of 70% will be sourced from the financial market with a ratio Business Loan / Equity Funding of 60:40. "i&i"’s total funding requirement amounts to US$860,000. For the financial projections model, we have prepared the projected financial performance over a five-year, sixty-month period. With below projection sales and cost of sales, enough cash (gross profit) will be annually generated to a worst-case scenario of 15%. In fact, a formal “what-if” (sensitivity) analysis for year-one clearly shows that “i&i” will have enough cash available even in the worst-case scenario in which the expected sales is 75% lower than projected and the operating expenses 25% higher than projected. In this unlikely scenario, the closing cash balance will amount to US$758,000 and the net profit after taxation to US$137,000. For year-one, the total premiums collected (sales) will be US$391,5M and the premiums paid over (cost of sales) will be US$387,6M with a premium collection fee retained (gross profit) of US$3,9M. The company is projecting an Internal Rate of Return of 467%.

We are applying to Solve to become a Solver, if successful. We greatly value the supportive community of peers, funders, and experts we will gain access to through Solve's nine-month support program, to help advance our innovative work. Solve community's support will help us navigate potential negative reactions from conventional insurance companies, which are one of our key partners in this project, and better understand our targeted clients' ability to adapt to latest technology. Also, mentorship and strategic advice we will receive from Solve and MIT networks will give us a better competitive advantage vis-à-vis insurers becoming direct competitors with similar digital solutions, and newcomers looking to quickly cash-in on the opportunities. Finally, but not the least, we are applying to Solve to have access to prize funding for 2020 Challenges to improve the lives of pregnant women, new mothers, and newborns of Guinea first, then the Sub-Sahara Africa region.

First, we need advice and support in terms of best solution technology to develop and implement “i&i”. Second, mentorship in fine-tuning our funding strategy and the revenue model will assist us mobilize partners to work with and take the project to the next level. And finally, expanding our partnership portfolio to benefit from experience of companies in marketing, media and exposure will assist us better position our impact solution in the local, regional, and continental market.

We would like to partner with MIT faculty or initiatives in terms of solution technology for our impact solution to be internationally recognize by its standard while in terms of funding, revenue model, marketing, media and exposure, Solve’s Network of cross-sector community will assist us build the partnerships needed to accelerate our work, validate our impact and business model, and scale our solution.

“i&i” is an innovative technology that improves quality of life for women and girls by putting insurance power and control in their hands. As a technology-focused product, “i&i” provides simple, convenient, hassle free insurance so women and girls can manage their changing insurance needs on the go without relying on their male relatives and curb stigmatization within communities. Using a conventional mobile phone to access and pay for healthcare insurance increases their financial inclusion, “i&i” improves lives of pregnant women, new mothers, and their newborn babies from low and middle-income groups by enabling the provision of affordable, quality, and accessible healthcare services.

Research shows 95% of the population in Guinea did not have access to health insurance (WHO, 2008). In a best-case scenario, claims processing in Guinea takes at least 9 business days. The administrative burden and cost of processing health insurance claims is also quite high due to manual procedures and processes. Healthcare service providers (hospitals, pharmacies, and diagnostic laboratories) often delay treatment until a manual verification of insured patients’ coverage is confirmed. Insurance companies also manually review claims, which leads to long lead times before reimbursement of healthcare service providers. This reduces willingness of healthcare service providers to accept insured patients, often preferring patients who pay cash. Insured patients often pay the full cost upfront at healthcare service providers and seek reimbursement from insurance companies. “i&i” will process and manage large amounts of health insurance data. This data will help train our artificial intelligence models to reduce patient wait times and claims processing times. AI-assisted engines will automate the claims review process, using OCR to process hand-written documents. Our AI model will also provide efficient fraud detection. With predictive analytics from our platform, our product pricing will be continually adjusted to provide the best possible value-for-money for patients and other stakeholders. We will partner with the African Institute for Mathematical Sciences (AIMS), and the Mathematics Department of the University of Liverpool, to integrate artificial intelligence and machine learning into the “i&i” models. With a well-regarded artificial intelligence/machine learning Master’s program, the partnership with AIMS will allow us to deliver across-board improvements to “i&i”’s mandate to improve health outcomes for pregnant women, new mothers and newborn babies. We expect information synthesized from the “i&i” platform will be used to inform Government of Guinea decisions and be used to adapt current healthcare policies accordingly.

Research shows 95% of the population in Guinea did not have access to health insurance (WHO, 2008). In a best-case scenario, claims processing in Guinea takes at least 9 business days. The administrative burden and cost of processing health insurance claims is also quite high due to manual procedures and processes. Healthcare service providers (hospitals, pharmacies, and diagnostic laboratories) often delay treatment until a manual verification of insured patients’ coverage is confirmed. Insurance companies also manually review claims, which leads to long lead times before reimbursement of healthcare service providers. This reduces willingness of healthcare service providers to accept insured patients, often preferring patients who pay cash. Insured patients often pay the full cost upfront at healthcare service providers and seek reimbursement from insurance companies. “i&i” will process and manage large amounts of health insurance data. This data will help train our artificial intelligence models to reduce patient wait times and claims processing times. AI-assisted engines will automate the claims review process, using OCR to process hand-written documents. Our AI model will also provide efficient, fraud detection. With predictive analytics from our platform, our product pricing will be continually adjusted to provide the best possible value-for-money for patients and other stakeholders. We will partner with the African Institute for Mathematical Sciences (AIMS), and the Mathematics Department of the University of Liverpool, to integrate artificial intelligence and machine learning into the “i&i” models. With a well-regarded artificial intelligence/machine learning Master’s program, the partnership with AIMS will allow us to deliver across-board improvements to “i&i”’s mandate to improve health outcomes for pregnant women, new mothers and newborn babies. We expect information synthesized from the “i&i” platform will be used to inform Guinea's leadership decisions and be used to adapt current healthcare laws accordingly.