createhealth

6 months back my accountant, Mr Shabbir reached out to me and told me "umar my mother is very sick and i need help", I asked him, "what's wrong? how much money do you need? does zakat (form of islamic charity) apply?" Shabbir confirmed that zakat applies, so i reached out to my friends in Pakistan and outside Pakistan, who told me Umar we don't know shabbir, but we trust you, we will give you our money. I received that money into my account and transferred it to Ziauddin hospital (a well known local hospital) and thats how we saved Shabbir's mother.... but its not only about Shabbir, 95% of Pakistan is un-insured and dependent on informal means to save their life. 

95% of Pakistan has to let go off all the privacy and have their pictures posted across online and offline channels to raise money when their loved ones fall sick - they are dependent on what's referred to as Informal health safety-net. Less than 5% of the 250mn population have health insurance. Inspite of this loss of privacy they are mostly not able to generate funds at the right time.

This informal health safety-net is made up of (1) loans (2) sadqa/Zakat - these are forms of islamic charity (3) charity

Its important to note that just the global Zakat fund is >$600Bn annually. 

CreateHealth has digitized this existing Informal health safety-Net. One platform which brings together 3 key stakeholders: (1) citizens/patients, (2) donors and (3) health centers, optimizing the flow of information and flow of monies, bringing more trust, speed, authentic data and as a result massive access, across the chain.  

A mobile enabled tech which allows every citizen to join easily (only with their cell number) so that they can highlight when they face health related challenge (emergency, chronic or any other) easily and quickly without giving away their personal information. the donors get notified about the needs only once the health center (a hospital) has vetted the patient/citizen, hence the donor can trust the information and then the donation goes directly to the health center (no middle men, the patient never gets money directly) and the health center provides authentic and relevant data confirming treatment completion and cost receipts closing the loop on a treatment. Currently php but intention is to improve post MVP. 

Patient registration and donor collection is an always-on process. Every donor finds out exactly where their money has been used and the impact. 

Donors will also get the ability to pledge to any specific therapy area or cause like oncology or Neo-natal etc. 

The existing fund raisers like NGOs will be given the option to also use CreateHealth to get better fund utilization data and impact analysis for their donors. 

There are three key stakeholders:

1) Citizen/Patients: 

Most of the urban and rural population in Pakistan (>95%) does not have health insurance. The government hospitals are very few, under-staffed and marred with inefficiency and bureaucracy. Similarly government health insurance initiatives have extremely limited impact and beyond poor execution. The insurance companies have not been able to make any low cost insurance product which works for SMEs or middle class of Pakistan. they have also not been able to provide any awareness or compelling enough reason/tech to bring about a behavior change amongst the target audience...all in all leaving 200 million citizens (patient and caregivers) completely under-served.  

Value proposition: (1) Get the funds when they need them, timely availability to save lives. (2) De-identified data, for both fund collection and later reporting allows for normal people to safeguard their self respect and respect in their own families and communities. 

2) Donors: 

Professionals, corporates, business owners, stay at home moms, students, children, elderly, citizens living inside Pakistan, those who live outside the country - these are people with disposable income and they want to play an active role in building their communities in their home country. In addition, Zakat is mandatory in the muslim religion and this audience actively seeks opportunities to fulfill this obligation. In most cases these people struggle to find trust worthy ways to contribute. 

Value proposition: (1) hospitals and other health centers are vetting the patients, thats why the donors can now trust and feel confident that their charity and zakat is being used in the right way. (2) They transfer their monies directly to the health center hence no middle men and again massive trust. (3) The data they receive is not only good to look at pictures, rather confirmation from hospitals on treatment completion, even therapy level or gender level reports which helps donor see the bigger impact their contribution is able to make in the country/community. 

3) Health centers: 

These are hospitals, clinics, labs and other such facilities where caregivers and patients go for treatment and advise. Currently most hospitals are small (less than fifty beds) and struggle to manage footfall and they struggle with ROI across their different services. The most interesting thing is that these hospitals and health centers already get Zakat patients and know the entire process to manage them, its just that this process currently is on paper rather than automation hence is not scalable. 

Value proposition: (1) Higher footfall (2) Higher ROI across services (3) Very limited behavior change as the process remains the same, the effort remains the same, it only gets digitized, most of the workforce is literate hence understand how to use technology. 

Five key inputs to consider: 

1) CreateHealth has been operating as a health care consultancy and service provider to pharmacy: This team has been engaged with health care and communities for over multiple years - before working on this technology, createhealth has been working with almost all Pharmaceuticals (GSK, Bayer, ICI, Novartis, Getz to name a few). Team got the opportunity to engage with patients and health care professionals in communities as multiple projects for Pharmaceuticals have been in such communities. 

2) we are currently doing a pilot - this pilot is currently being done in a 50 bed hospital in North Nazimabad area in karachi. This is a small, primarily paper based hospital which serves the nazimambad community. by working with this hospital we are getting the opportunity to directly work with caregivers and patients from our target communities. 

3) createhealth has already gone through an incubation by the Agha Khan Development Network - this is called the NHI (national health incubator). Not only has createhealth worked and demonstrated ability to bring the product to life with the communities, but we did it in a manner that the NHI has already given us the top prize, selected us for funding and gave us the opportunity to participate in their regional event where tech startups from Pakistan, Tajikistan, Kyrghistan, Azerbaijan, Afghanistan presented and Createhealth again has gotten shortlisted amongst the top 8 - we are presenting on the 4th April and very confident of winning. this experience and time spent during incubation allowed us structured opportunities to engage with communities. 

4) Our Cofounder and CEO Moomal effendi has over a decade of experience of leading business for GSK in Pakistan and then for the Gulf and Near East markets. This experience gave Moomal immense opportunities to engage with communities and build models which ensure product reflects the needs and behavior understanding of the communities. Furthermore Ali (our cofounder) has also worked for Bill and Melinda Gates foundation in the Lady health workers program, which is the biggest community program in the country. 

5) our third cofounder umar comes from a consumer goods background and brings in immense understanding of the low income consumer - the consumer goods industry has proven to be the most effective one at unlocking behavior change and consumption in this target audience via implementing proven behavior change models. umar has been a regional and global director and brings experience of not only pakistan but also africa hence passionate about low income Target audience and considered an expert in this area. 

The problem that we are trying to solve is massive, we have increased probability of success by choosing an approach that digitizes an existing behavior - but the only way this can work if we get the support of the entire ecosystem. Our primary focus would be to get legal, financial and technical help. 

We need legal help: We have already started preliminary work with legal and tax consultants. Formation and structuring the organization to be able to work with three stakeholders, collect charity/cloud funding would require different legal compliance across our selected markets (Pakistan for execution and UAE, Saudi Arabia, UK, USA for charity collection). 

financial help: one element is the financial funding need to manage company formation, human resource, growth/CAC, product development and scale up post pilot. we also feel there is a strong fintech play involved in our approach and we would need financial technical assistance to unlock that as we progress. 

technical product: in order to de-identify data and build trust amongst the donors we want to explore blockchain technology and would need assistance in doing that. 

95% of Pakistan does not have health insurance. They do not have health insurance because of three key reasons, (1) it currently costs too much (2) they do not believe that anything bad can happen to them and don't want to pay substantial money in advance  (3) its too complex to get insurance and majority of this population is not educated. 

CreateHealth addresses this problem by: 

1) Only $1 for joining Createhealth

2) the user only needs to provide their cell number to join, they get an OTP sent to their phone and they are in the system

3) there is zero behavior change - hospitals get to vet the patients and the patients are ok to provide more information to hospitals, they trust hospitals.   there is no extra effort or new behavior needed

Further more its critical to understand that the health market size or TAM in Pakistan or any developed market seems far smaller than it actually is - the unconstraint pakistan health market size is $79Bn (WHO advisory), while the constraint size is $11Bn. which means a portion of the global annual zakat (>$600Bn) can completely change the landscape of the health industry and bring in enormous growth to the health centers, medicine and access for patients. 

1) Increase in average health care expenditure per person

2) Optimal utilization of zakat as a percentage of global zakat: 

3) Growth in partner health centers in terms of ability to serve patients 

4) reduction in deaths in child birth

5) reduction in deaths in chronic diseases due to lack of medical care

6) reduction in deaths in emergencies

7) increase health care spend in specific therapy areas for example oncology

8) early identification and move from primary to tertiary care between partner health centers 

9) Increase the number of hospitals with more than 100 beds

10) Increase the number of patient support centers and groups

No Poverty: 10% of the world is pushed into poverty every year because their health expenditure goes beyond their household income. Createhealth will cover such expenditure and reduce the need for people to compromise on basic life needs. we will use the current poverty percentage and ppl being pushed into poverty every year in Pakistan as a starting point.

Good Health and wellbeing: Createhealth's core mission is enabling more people to get health access when they need it. 

Gender equality: in a developing country like Pakistan, women do not get the same access as men, the health investment on women is lower - createhealth will increase focus on such areas as neo natal to enable more investment, better life, few deaths amongst women. 

There are two core challenges we are addressing: (1) Health infrastructure is poor, expensive and insufficient. (2) Per person health expenditure is extremely low and does not provide enough resources to deliver quality health services. 

Createhealth will increase overall investment in the health sector in Pakistan by increasing the flow off charity specially zakat in the country by providing better quality, authentic and trust worthy data to donors. 

WHO advisory confirms that the unconstrained health market size in Pakistan is 7 times more than the current market size. Createhealth will enable growth towards the optimal market size.

1) web, and sms technology - these are being used

2) Apps - this is what we are working towards

3) blockchain - this is what we aspire to incorporate post MIT solve

Diversity and inclusion is part of our DNA. Our cofounder and team leader is a proven women leader in the country and community.

By design we are choosing women to work with communities - this is a proven model in pakistan (its called the lady health workers) and it is linked to the fact that families are conservative and feel more secure if a women comes to them or their house to engage with them. 

our recruitment policy involves and encourages work from home as well enabling more women to work with us

Revenue model:

14% per transaction per health center

3% donation processing fees

$1 nominal charge at patient registration

Services for Patients, health centers and donors has been explained in the value proposition section. 

as per our business plan we will become self sustainable in our 5th year - this is based on our revenue model. 

we are currently at pre seed and will be raising funding via venture capital 

only at pilot stage till now