Kendeya

In Guinea, West African countries, and most of sub-Saharan Africa people in the informal sector, low to middle income don’t have access to healthcare insurance. This means they struggle to pay and afford quality health care.

They have no way of saving for medical emergencies or contribute to a health plan. This results in increases of diseases spreading like malaria, cholera and killing people as they don’t get treatment fast enough yet if they could afford medical attention the spread and death tolls caused by such disease would be greatly reduced.

Yet on a daily basis they find themselves spending little money on luxury consumption such as, soft drinks, alcohol, calling airtime for social calls. If they had a platform or health plan they can pay on a daily or weekly basis a portion of these funds they could have health savings plan they can use to access quality healthcare. This will also introduce increased revenue pool for health service provider boosting the industry to have more service providers as well improving the quality of service to meet the demand.

From an estimated 228 million global cases of malaria in 2018, 19 sub-Saharan Africa countries carried almost 85% of the burden, with 50% within the West African region. 

Malaria, without health insurance, is one of the deadliest diseases in West Africa. For example, Guinea has only 5% of 12.4 million covered by public health insurance.

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 healthcare services and products daily, and/or via mobile money channels.

“Kendeya” is an application that will give users ability so save or have an automatic debit for a minimal amount on daily or weekly basis or have a monthly contribution form a relative in the disapora. These savings can only be used to access quality and affordable healthcare services from partner health care service providers for the user and any added dpendents. Through Kendeya informal sector and low-income population groups will have health savings plan that they can access for any medical emergency. Kendeya will partner with related services providers to create an ecosystem platform that enables collaboration between beneficiaries and service providers (mobile phone operators, hospitals, laboratory services, and pharmacies). 

"Kendeya" insure adequate and sustainable healthcare services to improve lives of local community members in an accessible and affordable manner. 

"Kendeya" would foster collaboration between mobile phone operators and healthcare professionals to enable access to quality and affordable healthcare services for the region’s low and middle-income population. 

This would enhance their financial inclusion and improve livelihoods.

Technologies used are mobile network payments, machine learning for predictive analytics, big data and a modern mobile and web technology stack.

1. Users can use a USSD platform and purchase phone airtime, and they can transfer part of the airtime to their Kendeya health savings account. Loading airtime for calling is something most people do on a daily/weekly basis.
2. A family member in the diaspora can also create an account add dependents and make a monthly contribution to a savings using a credit card.
3. Users can use the app or USSD to book for a medical attention and pre-pay for the service. The health care service provider will have a Kendeya profile which they can use to accept bookings or request payment upfront for treatment for walk-in patients.
4. The treatment data can be used to detect any outbreaks and help authorities respond faster and prevent serious implications
5. Mobile phone operators provide seamless platforms such as USSD to enrol local community members on the “Kendeya” program; provide off-line payment options such as mobile money to collect premiums. 
6. "Kendeya" platform enrol members, collect premium and pays same day all service providers. 
7. Healthcare service facilities provide medical treatments, laboratory services, and medications based on “Kendeya” program and submit their invoices onto "Kendeya" platform for payment.

Rollout Plan
From next year, “Kendeya” would be implemented in Conakry and by the end of the fifth year it would have been replicated across all provinces. From the sixth year and from profit generated from Guinea, “Kendeya” would be replicated in other West Africa countries.

“Kendeya” targets informal sector as well as low and middle-income population within the age range of 15-54 years within the West African region. 

In African, 74% of females are informal workers (UN Women, 2016). The World Bank (2019) indicates that 51.7% of Guinea’s population are females, 51.2 for Senegal, and 49.3% for both Ghana and Nigeria (World Bank, 2019). 

Macro market research in Guinea with favourable feasibility was conducted using triangulation of interviews, field visits to stakeholders, and observation of a sampled population. 

This population groups can easily access and pay for luxury consumption items such as soft drinks, alcohol and snaks and these are sold in marketplaces. This shows that there spending income available and if some of that income can be diverted towards a medical savings it will go a long way improving their access to quality healthcare.

This ecosystem platform would ensure that the targeted population are able to access and pay for healthcare services and products without having access to a bank account. Other burdensome administrative and payment processes would be omitted. 

Furthermore, this ecosystem 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 relatives. 

Subsequently, this would curb stigmatization within communities as activities would be performed in healthcare facilities, hence, ensuring confidentiality, and thereby promoting the well-being of beneficiaries. 

The team is drawn 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. 

With 20 years’ work experience in complex humanitarian and development environments all over Africa and Asia, the Team Lead have a successful track record of accomplishment in fighting epidemies.

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 could 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.

Below are the links to the prototype design. 

Agent: Because of the literacy level of the low and middle-income population, Kendeya will engage as broker unemployed graduate and postgraduate students, essentially composed with at least 60% girls and women, to do door-to-door campaigns in the local dialect to enrol customers possessing basic phone with USSD.

Patient: Any individual using smartphone or computer (including diaspora population caring for their relatives back home) without a need of assistance to enrol.

Health Service Providers (HSP): Hospitals, Labs and Pharmacies signing-in on the platform.

Agent Web: https://xd.adobe.com/view/422a...

Agent Mobile: https://xd.adobe.com/view/a2ee...

Patient Web: https://xd.adobe.com/view/6943...

Patient Mobile: https://xd.adobe.com/view/4f5f...

HSP Web: https://xd.adobe.com/view/ecdf...

HSP Mobile: https://xd.adobe.com/view/3c66...

Development platform / Details
Platform: Web Progressive Application and Graphic Designing

• Programming Language & Web Framework: Python & Django
• Front-End Technology: Vue Js
• API Development: Django Rest Framework
• Graphics/UI Designing: Adobe XD

1. Business Analyst
2. Front-end Engineer
3. Back-end Engineer
4. Graphics/UI Designer
5. Project Manager / Lead
6. Database Expert
7. Technical Architect
8. Quality Engineer

• Google Chrome:- 88.0.4324 to 106.0.5249.119
• Mozilla Firefox:-78.6 to 105.0.3
• Safari:- 13.1.2 to 16

• Android: OnePlus Nord CE2, Moto E7/G/Nexus 6, Huawei P20 Lite, Samsung M30s, Samsung Galaxy J7/S4, Nokia 6.2 with OS version 12.0
• iPhone: iPhone 12/ Mini, iPhone 11, iPhone XR, iPhone 7, iPhone 6s plus with iOS v 13.x to 16.x

1. Online & Offline Mode Support: A data storage and synchronisation mechanism will not be available offline for this solution as of now. It will only work online.
2. Language Consideration: This solution will only be available in English and French as of now.  
3. Database: We are using Postgress database for this solution. Regarding the relevant information, we will enter pertinent information about the product via backend or admin panel.
4. Responsive Website: By default, we will consider all the developing web panels as responsive but the admin panel will be responsive till some extent.
5. Application For Smartphone Only: At this stage, the application will only be available for the smartphones. We will extend the development for Android tablets or iPads.
6. Orientation: We are considering developing mobile application with fixed portrait mode. As of now the landscape mode would not be supported in the proposed applications.

Non-functional assumptions

1. 3rd Party Licensing, SDK & Hosting a/c Purchase: In order to meet this solution development need, we will purchase third-party licensing, SDKs, hosting services and other certain requirements. The development team will just use those credentials to integrate into the solution to achieve certain functionalities.
2. Premium Plugins: We will purchase all required premium plugins that are essentially required for the implementation.
3. Content / Data Setup: Up to 5 dummy data uploads is set up. Furthermore, we will upload the images, setup the content and enter the basic need as per preference in order to make a demo and feasibility review.

The solution is for the patients who can subscribe and book appointment for  specific services and can also add the dependents according to their package, who can also book the appointment under specific patient. 

Patients will be added by the agents and agents will get the commission based on the patients subscribed package. 

HSPs can add the services for the patients and can also book the appointments for them.

Within the first year, “Kendeya” would serve about 525,000 people of Conakry. “Kendeya” would be then replicated to the suburbs of Guinea’s capital city to serve an additional 525,000 people from the second year. During the third year, there would be an expansion to other country provinces. By the fifth year of implementation, “Kendeya” would be serving a minimum of 2,625,000 low and middle-income population in Guinea.  

Furthermore, a minimum of 15% of the West African low and middle-income population within each targeted country (notably Liberia, Mali, and Sierra Leone) should have a considerable access to affordable and available healthcare services using the “Kendeya” ecosystem platform from the sixth year.

We are applying to Solve to receive mentorship from Solve Experts and be invited to a high-level event to present our solutions, when successful. We greatly value the supportive community of peers, funders, and experts we will gain access to, to help advance our innovative work. Solve Experts 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. 

Additionally, to enable us to have a competitive advantage over similar digital solutions, among others, we would receive mentorship and strategic advice from Solve Experts’ networks. 

Furthermore, the team is applying to Solve to have access to prize funding for 2023 Challenges to improve the lives of low and middle-income population within the West African region.

“Kendeya” 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 “Kendeya”, they do not need to have a bank account. The payment to “Kendeya” platform will be done daily through airtime or 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. 

No Need for bank Account.

Ability to make small daily contributions allows for them to use a portion of the money the would have spent on luxury items such as alcohol, soft drinks, airtime on social calls.

Booking and payment system for treatments is easy.

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 “Kendeya” 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 “Kendeya” 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.

Within the next year, “Kendeya” would initiate the implementation of the app in Guinea which would have insured the 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). 

By the third year, “Kendeya” would have been expanded to integrate a savings (sussu) and pension funds while Guinean citizens living out of their countries (diaspora) would be able to pay for their relative’s healthcare services back home. 

Within the fifth year, and in collaboration with national authorities, data collected and analysed would facilitate adjustment of healthcare management policies and facilitate access to a national ID for customers and their dependents. 

In 2014, the World Bank 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 “Kendeya” in Africa to meet the needs of the uninsured. 

As an ecosystem application and web platform, “Kendeya” would have been replicated across West African countries from the sixth year to increase the financial inclusion of low and middle-income population, and proportion of population with large household expenditures on health as a share of total household expenditure or income.

• Reduced maternal mortality ratio from 576 over 100,000 live births (WHO. 2017)
• Increased proportion of births attended by skilled health personnel, currently at 55.3% (Worldometers. 2021)
• Reduced under-five mortality rate from 70.2 per 1,000 live births (Worldometers. 2021)
• Reduced neonatal mortality rate from 44.9 infant deaths per 1,000 live births (Worldometers. 2021)
• Reduced mortality rate attributed to cardiovascular disease, cancer, diabetes, or chronic respiratory disease from 22% for population between 30-70 years (WHO. 2016)
• 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 the World Population Prospects (2019), West Africa is home to 39% of the Sub-Saharan African population of 1.04 billion people in 2018. Averagely, life expectancy at birth for males/females is 48/51 (WHO, 2016). West Africa has 0.12 doctors per 1,000 inhabitants on average, and the probability of dying under five in Sierra Leone is 150 and Guinea is 101 per 1,000 live births (Garenne & Gakusi, 2006). For an example, Guinea’s 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 the low and middle-income population within the West African region, “Kendeya” will enable easy access to and pay for affordable and quality healthcare services for them. 

Research in 2012, and 2015 indicates that only 5% of Guinea’s population in 2008 were covered by public health insurance (Spaan et al., 2012). 
Through effective use of the “Kendeya”, the financial inclusion of low and middle-income population in Guinea will increase with a healthcare 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). “Kendeya” is aiming to reduce the impact of catastrophic epidemics like Ebola or Covid-19 on the West African low and middle-income population specifically. 

The “Kendeya” 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. “Kendeya” '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. “Kendeya” 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 "Kendeya" 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, “Kendeya” leadership is a diverse team from different African 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.  

”Kendeya”’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.

“Kendeya” is an ecosystem application and web platform. It enables low and middle-income population especially, and individuals living in their communities to access affordable and quality healthcare services from their own environment thereby enhancing their financial inclusion and improving their lives.

With “Kendeya”, they will use their mobile phone to register, pay for through Mobile Money according to their daily, weekly, or monthly earnings, locate and visit providers to receive services.

We aim to significantly reduce administrative burden of traditional banks, insurance companies and upfront cash payments at hospitals, labs, and pharmacies.
Profit generated will allow expanding the service to other provinces in Guinea and countries within West Africa region, starting by countries hit by Ebola in 2014/2015.

After five-year of operation in Guinea, “Kendeya” will be used by subscribers as "saving pocket (sussu)" from which a pension scheme will be set aside. 

It has been assumed that a donation and/or grants of 30% of the total funding requirement will be applied for by “Kendeya” 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. "Kendeya"’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 that 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 “Kendeya” 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 $2,413 and the net profit after taxation to US $99,884. 

For year-one, the total premiums collected (sales) will be US $89,1M and the premiums paid over (cost of sales) will be US $88,2M with a premium collection fee retained (gross profit) of US $891,050. The company is projecting an Internal Rate of Return of 182%. 

As a start-up, we have not yet received grants or investment fund, nor generated revenue. The Team Lead and team members invested their own funds to get to this stage of the solution.