Inclusion & Impact (i&i)

The quality of services, and especially on healthcare services, has substantially received little consideration in many African countries (Adindu, 2010). Access to quality and affordable healthcare in Guinea for women and girls 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 daily, 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, hospitals, laboratory services, and pharmacies). Below are processes used: Mobile Phone Operators: Provide seamless platforms such as USSD to enrol local community members on the “i&i” program; Provide off-line payment options such as mobile money to collect premiums. 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 women and girls 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. Macro market research with favourable 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 private hospital to use their database to develop and test the product, using their employees as initial clients. This ecosystem platform would ensure that the targeted population are able to access healthcare services without having a bank account. Other burdensome administrative and payment processes would be omitted. Furthermore, this application 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.

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.

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' 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 competitors 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 2022 Challenges to improve the lives of women and girls of Guinea first, then the Sub-Sahara Africa region.

“i&i” is an ecosystem application and web platform which enables subscribers to have easy access to and pay for affordable and quality healthcare services as and when they require it within their environment to improve lives.

With “i&i”, they do not need to have a bank account. The payment to “i&i” platform will be done daily through Mobile Money according to their daily, weekly, or monthly earnings. Subscribers can save money to help cover their future healthcare needs, receive, and pay at minimal cost.

The system links them directly to healthcare service providers so both treatment and payment are fast, efficient, and transparent. When someone needs treatment, this person dials into / log in the “i&i” platform with a mobile phone, selects the appropriate healthcare service provider and location and thereby initiates the process. The healthcare service provider then proceeds with diagnosis, laboratory analysis, treatment, medication, and finally submits the claim. The information is then digitally sent to the “i&i” platform, who reviews and authorises payment. With total transparency at every stage of the process, if the claim is approved promptly, payment can be made under 24 hours. 

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. 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. 

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 accessibility to 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 women and girls with access to affordable and quality healthcare services.

•Increased coverage of essential health services (defined as the average coverage of essential services based on tracer interventions that include reproductive, maternal, new-born and child health, infectious diseases, non-communicable diseases and service capacity and access, among the general and the most disadvantaged population)

•Increased proportion of population with large household expenditures on health as a share of total household expenditure or income

•Invested fund into research and development projects pertaining to the derivation of more refine micro-insurance products based on the data collected and tailor-made to the need of the customer.

•Increased proportion of medium and high-tech industry value added in total value added.

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 and healthcare professionals (hospitals, labs, and pharmacies) to provide services to women and girls 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 women and girls will increase with a healthcare products/service, 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 women and girls from low and middle-income groups in Guinea and in Africa in general.

The “i&i” platform leverages mobile network micro-payment technology to expand easy access to affordable healthcare for the hard to reach (unbanked and uninsured) low and middle-income population in Guinea, and within the West African region. “i&i” 's core technology is based on the unstructured supplementary service data (USSD) protocol. It taps into the existing micro-payment infrastructure deployed by mobile network operators across Africa.

Our primary user-facing application is a USSD application although we also offer web and native mobile applications. “i&i” enables users to use their “feature” mobile phones as a ‘cash’ account to pay for micro-insurance services without having to open a bank account.

We employ artificial intelligence to detect and prevent fraudulent transactions. We also use big data techniques to support the large datasets we manage and extract meaningful information to support health policy development.

The technology stack of the "i&i" platform comprises mostly open-source software. We use a LEPP (Linux, Nginx, Postgres, PHP) stack in our backend systems. Our external APIs are RESTful, which ensures interoperability and integration with other systems. 

From its foundation, “i&i” leadership is a diverse team from different countries and professional background. This strength will be complimented by 60% of girls and women composing its second layer of leaders. Same principle would be applied to our brokers from unemployed graduate and postgraduate students, which will be essentially composed with at least 60% girls and women.  

”i&i”’s culture and reason for existence see it engrave the following Core Principles in its Business Model: 

• Ability.
• Integrity.
• Dependability.
• Purpose.

To support the above, our Core Values include: 

• Teamwork.
• Customer Service.
• Excellence. 
• Employee Development. 
• Passion.
• Diversity.
• Honesty and Trustworthiness.

“i&i” enables easy access to affordable and quality healthcare services to women and girls from low and middle-income groups at their chosen moment and within their environment to improve lives. They will access services using their mobile phone to access and pay for healthcare insurance, which increases their financial inclusion. With this product, they don’t need to have a bank account as payment will be done daily through mobile money as they earn, which removes all administrative burden of traditional insurance companies and upfront cash payments at hospitals, labs and pharmacies.

It has been assumed that a donation 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 50:50. "i&i"’s total funding requirement amounts to US$860,000. 

So far we have spent US$30,000 to perform market research using triangulation of interviews, field visits to stakeholders, observation of a sampled population, develop a business plan.

For the financial projections model, we have prepared the projected financial performance over a five-year, sixty-month period. With sales and cost of sales projection, 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 are 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.