'Roshni Bajis': Promoting Resilience & Continuity-of-Care

Climate-change-induced flash flooding has ravaged South Asia (Pakistan, Bangladesh and parts of India) over the past 12 years, devastating arable land in rural areas and leading to mosquito-infested swamps in areas accompanied by week-long ‘black-outs’ as heavily flooded areas are disconnected from the grid to prevent live electrocution, etc. Consequently, much of the target population is deprived of access to energy for periods stretching between weeks to several months to 6 weeks. 

Environmental, health and physical safety (especially of women) are threatened during extreme weather events such as flash floods (humanitarian disasters)

Our solution anticipates the shutdown of the electric grid in specific target areas/neighbourhoods, which are severely affected by flash floods. Our solution enables both personal safety, health & well-being and environmental safety through (i) the provision of self-defence training (especially for women who are often victims/survivors of gender-based violence (GBV) during humanitarian emergencies); (ii) prevention of water-borne and/or infectious diseases (e.g. dengue) during ‘flood swamps’ which can persist for several weeks post flood.  In addition, the resilience of target communities to cope with these emergencies is enhanced in advance of the event through the provision of Roshni-Baji-assisted teletherapy that focuses on enhancing the mental health and well-being of community members.  The therapy is delivered by remotely located practitioners (therapists) and leverages mobile technology.

The solution targets marginalized communities that live in low-income ‘urban slum’ areas. These communities are susceptible to ‘brown-outs’ or ‘black-outs’, especially during climate-change induced flash flooding which is occurring with greater intensity and frequency each monsoon season (between July and September of each year).

The doctHERs' team leadership all speak the local dialect. They are from the same country (Pakistan), and have lived in the same environment as the community-based beneficiaries for the previous 13 years. Several team members are from the same ethnic groups as the beneficiaries, which helps establish rapport with the target population.  

The doctHERs team has familiarised itself with the unmet needs of the target population by immersing itself in the target population as part of a  Human-Centred Design (HCD) process. 

The target communities have been frequently surveyed for unmet needs - in a sample community, access to mental health services was assessed to be a major unmet need during COVID-19 and community beneficiaries requiring support were offered 12 weekly sessions of trauma-informed therapy and cognitive behavioural therapy (CBT).

To catch a glimpse of one of our HCD journeys in the field, please watch the following video:

https://www.facebook.com/watch...

75000+ . Over 3 Million lives have previously been impacted by the doctHERs digital health & wellbeing plan, with over 75,000 active members enrolled.

One of the major barriers to working in a frontier market (Pakistan) is access to growth capital. We're hoping that if this solution is chosen to be an MIT SOLVER, it will help shed some light on our inclusive business model and help it to raise sufficient growth capital to meet its immense potential. 

In addition, several of our mid-level managers require capacity-building and mentorship, and we're hopeful that this is something that can be achieved by joining the SOLVE community. 

As a 'kaizen' organization that practices 'continuous learning and improvement,' we seek to share insights and key learnings with a network of like-minded entrepreneurs to benefit from one another. A true 'win-win.' 

The kaizen philosophy also helps promote network effects enabling doctHERs to leverage an emerging corporate-social enterprise ecosystem. By proactively seeking partnerships with corporations, doctHERs is positioning itself as an integral part of this ecosystem.  

We are innovative in that we use mobile technology to facilitate access to:  (i) mental health & well-being for the target population, (ii) digital financial services – humanitarian savings accounts, (iii) Digital Payments – pay for access to clean solar energy during grid shut-downs (black-outs/brown-outs) in target areas. We also provide women in these communities with access to self-defence training which is particularly popular and useful based on previous cohorts/sessions we have run with similar target populations.

1-Year Impact Goals:

• Continuity-of-Care Plan: 150,000 low-income beneficiaries enrolled in a health & well-being plan that coordinates care (output)
• Inclusive Employment: jobs created for 100 remotely-located female healthcare providers (HCPs) 
• Women's Entrepreneurship: 20% relative increase in monthly income levels of female frontline health workers

5-Year Impact Goals:

• Continuity-of-Care Plan: 1.5 Million low-income beneficiaries enrolled in a health & well-being plan that coordinates care (output)
• Inclusive Employment: jobs created for 1000 remotely-located female healthcare providers (HCPs) 
• Women's Entrepreneurship: 50% relative increase in monthly income levels of female frontline health workers 
• Positive Health Outcomes: 70% relative reduction in community members with mental health disorders (anxiety, depression, PTSD, etc.)

Key Performance Indicators (KPIs):

• Continuity-of-Care Plan: number of low-income beneficiaries enrolled in a health & well-being plan that coordinates care (output)
• Inclusive Employment: number of jobs created for remotely-located female healthcare providers (HCPs) 
• Women's Entrepreneurship: % change in monthly income levels of female frontline health workers 
• Positive Health Outcomes: % change in community members with mental health disorders (anxiety, depression, PTSD, etc.)

Human, technological and financial resources (collectively the 'inputs') are combined to generate enrolment in digital health and solar energy plans (collectively the 'Outputs'). These outputs are generated via enrolment drives ('activities') and sharing of relevant data between the end-user and the (female) frontline health worker. The outputs lead to improved outcomes, e.g. 70% reduction in anxiety/depression and/or a 30% increase in monthly income for frontline workers, ultimately leading to the (social) impact we seek (i.e. increased resilience of communities in fragile contexts). 

The first of our technologies consists of a proprietary digital health platform that includes the following components: 

• Automated Claims Management System
• Telemedicine/Videconsultation system
• Electronic Health Records (EHR) system
• Member Access Portal

The 2nd technology we use is solar energy - the frontline workers offer communities solar lamps to address their energy poverty

doctHERs' core team is a multidisciplinary group of entrepreneurs, doctors, MBAs, design thinkers and UX experts who represent the wide diversity of ethnic groups that comprise its target population. 

Sixty percent of doctHERs' Senior Management Team (SUMMIT) is women, while Fifty Percent of the board is women. In addition, 80% of doctHERs' extended workforce (contract workers) are also women. 

In terms of equity, women receive a special car allowance to enable them to come to work (culturally speaking, very few women ride motorcycles in Pakistan).

Approximately 60% of every $1 received from customers underwrites the cost of the digital health services that are offered by doctHERs to its target market. Twenty percent (20%) covers the overall operating costs of the venture, yielding a net surplus of 20% which is re-invested to help scale the business. 

Regarding market opportunity, doctHERs has just skimmed the top of a very large iceberg – over 90 Million low-income beneficiaries suffer from energy poverty (frequent black-outs and brown-outs - especially in response to humanitarian crises).  

In the short term, doctHERs plans to become financially sustainable through a combination of donations and grants, selling products or services, service contracts to governments and raising investment capital. 

In the long term, doctHERs' earned income model should have scaled up and be sufficient to cover its operating expenses (i.e. it would be profitable and sustainable). 

Over the past 8 years, doctHERs has raised over $2.5 Million in capital ($125,000 in seed equity while the rest is in the form of R&D innovation grants), including notable grants from (i) USAID, (ii) Grand Challenges Canada, (iii) Philips Foundation, (iv) Levi Strauss Foundation, (v) Tommy Hilfiger (v) Punjab Population Innovation Fund and (vi) UKAID-Unilever (Transform). 

doctHERs is currently generating about $0.85 Million USD in annual revenue and is now well positioned for exponential growth as it has established the market trust necessary for the hockey-stick-like growth of an emerging healhtech.