One-line solution summary:
Health credit coupled to matched tontines members’ contributions to registered savings can provide social benefits to informal workers
Pitch your solution.
African Tontines have been a prevalent saving formula in West Africa for vulnerable informal workers, providing safety nets and emergency funds for healthcare access. In Cameroon, using a collateral-free cashless digital health credit we serve the health needs of cash constraint informal workers who are tontines' members. Now we are proposing that coupling our digital health credit to matched tontine members’ savings contributions can address the lack of reliable social protection for informal workers. Matching cash contributions are dictated by tontine members’ individual contributions to the tontine’s fund deposited at NaYa. While the health credit acts as a safety net to ensure affordable access to care regardless of economic means, the cash matched contribution serves as an incentive for the workers to maintain participation. Accumulated members' savings and matched contributions serve as a basis for universal basic social benefits for informal workers during prolonged period of lack of revenues.
Film your elevator pitch.
What specific problem are you solving?
1 in 2 people in Cameroon are tontines members, close to 80% of the Cameroonian population works in the informal sector. While periodic contributions to tontines' savings funds are a popular way by which informal workers build safety nets, tontines' funds are typically underfunded to offer adequate emergency funds to all members. Hence, informal workers do not have access to a guaranteed minimal revenue through their tontines. We propose a solution to extend tontines' abilities to provide a guaranteed minimum revenue to their members. In our solution, savings for economically challenging times are no longer limited to individual members contributions, but rather are amplified with matched contributions from an external sponsor. Creating a significant volume of savings over time to ensure a guaranteed minimum revenue during loss of revenue period. Access to this registered saving scheme is coupled to a health digital credit.
Who does your solution serve, and in what ways will the solution impact their lives?
Informal workers members of tontines constitute our end-customers. Learning from our pilot phase providing digital health credit to uninsured people in Cameroon, we established that over 70% of our clientele comes from the informal sector with the two third being African women market, familiar with mobile (money) banking as they use it nearly every day for their job as a buyer and seller. They don't have medical insurance. They look to informal loans from peers and tontines to cover for unexpected medical expenses and loss of revenues. As micro-business owners, they have some financial knowledge necessary to understand the benefit of growing capital which is a key feature of the matched saving contribution program that we are proposing. Where the sponsor cash match constitutes the interest one can gain on the contributed regular savings contributions collected into the Tontine’s social benefit fund managed by NaYa. As Tontines' members they are familiar with saving routine. Our solution of digital health credit coupled to matched tontines members’ savings contributions provides to cash constraint uninsured informal workers an affordable access to health care and a flexible way to contribute to guaranteed minimum revenue schemes for economic hardships.
Which dimension of the Challenge does your solution most closely address?
Explain how the problem, your solution, and your solution’s target population relate to the Mission Billion Challenge WURI West Africa Prize and your selected dimension.
The WURI prize is looking for solutions which incentivize informal sector workers to contribute to social protection programs. A core feature of this objective it’s the need for sustainable social protection programs designed for informal workers. The current problem we are addressing, lack of sustainable guaranteed minimum revenue, aligns with the prize’s core feature providing social protection to informal workers. The solution we are proposing, a matched registered savings account for informal workers, members of tontines coupled to a digital health credit, would guarantee to informal workers access to a basic revenue during economic hardship and a safety net for medical crisis.
Where is your solution team headquartered?Yaounde, Cameroun
What is your solution’s stage of development?
Who is the primary delegate for your solution?
Dr. Marthe-Sandrine Eiymo Mwa Mpollo
Which of the following categories best describes your solution?
Describe what makes your solution innovative.
Our solution is innovative because it uniquely leverages culturally accepted savings mechanisms across West Africa (tontines), reverse engineered medical insurance scheme and widespread low-cost mobile technology to make social protection and health benefits accessible to a historically underserved new user group: the informal workers.
Beyond the lack of funds, the adoption of traditional insurance schemes among African populations has been hindered by a lack of trust, in part driven by the requirement to make upfront payments for an event that had not happened. To build trust with the communities of informal workers members of tontines, we reversed engineered insurance schemes for a high-demand essential service: healthcare access. Offering to tontines a discounted premium-free access to health care with our portable health credit. With their group membership, tontines’ members receive care at any NaYa affiliates medical providers nationally and across borders and pay later using widespread mobile money. By using post payments of a health event that has happened and is no longer a hypothesis like in risk insurance, we dispel skepticism related to insurance like mechanisms. Our digital health credit is a key driver of trust and a differentiating factor from traditional insurances.
Moreover, targeting tontines' members allow us to leverage on the established saving habit and numeracy acumen of tontines’ members to extend their savings capabilities and reach many informal workers regardless of their literacy skills. Using the mobile money payment feature on NaYa application, informal workers can conveniently contribute to their savings in Cameroon and West Africa.
Provide evidence that your solution works.
Our solution to the lack of guaranteed minimum revenue for informal workers comes in two parts: a matched savings plan and a portable health credit.
Similar to our proposed matched registered savings account for tontines' members, in Canada employers matched contributions to employees registered retirement savings accounts drive people participation to pension savings plan https://quickbooks.intuit.com/ca/resources/finance-accounting/how-to-match-employee-retirement-contributions/. In a similar fashion, Canada government's matching contributions to a child's registered education education savings plan has been shown to incentivize parents to save towards their children’s post-secondary education. In this two examples matching contributions allows participants to grow their savings and thus is a powerful incentive to participate. In both programs participants can contribute any time during the year. The sponsor or matching entity tops up the participant annual contribution by a set percentage, up to a maximum cash amount each year for each beneficiary .
As for the health credit part of our solution, it has been used as a financially inclusive tool to address health needs of vulnerable people and economically challenged women. At NaYa we digitalized the process, allowing in app- approved users to access care at NaYa affiliated medical providers and differed payment.
Similar to NaYa, for over 15 years in India Credit AccessGrameen has been delivering health loans to cash constraint women to cover their medical expenses. Moreover, In 2006, Freedom from Hunger, a U.S.-based international development organization, in partnership with microfinance launched a four-year program to offer integrated financial and health-related services in five countries, two of which were West African countries. The initiative known as the Microfinance and Health Protection (MAHP) initiative, was funded by the Bill & Melinda Gates Foundation. The initiative revealed that 84 % of health loans beneficiaries in India were satisfied to have access to funds to cover health expenses, and 81 % felt the interest rate was low enough to be affordable.
Please select the technologies currently used in your solution:
What is your theory of change?
Strengthening the economic power of financially challenged people has shown benefits in building resilient communities. At NaYa we believe that the lack of universal access to health and lack of protected loss of revenue impact not only vulnerable people at the individual level but also the entire economic ecosystem in which economically vulnerable people live in. Economically vulnerable people have a reduced to null power of consumption, limited capability to generate value either with human capital or intellectual contribution as they routine is focused on surviving the day. However, consumption of goods produced in a given economy drives the country growth, stimulates business growth. By strengthening the economic power of the most vulnerable people with social protection mechanisms and/or health benefit we believe local economic ecosystems thrive. The World bank’s cash transfer program illustrates very well this theory of change; where money is provided to a vulnerable target population to address healthcare access or cover basic expenses such as food. Money received not only allow to cover the essential needs of the targeted vulnerable population, help them free up some resources to invest themselves in value-creation activities but more broadly circulates in the local community creating more economic growth for the overall community economic ecosystem. Similarly, in Canada cash payments made by the government to self-employed individuals who found themselves, experiencing loss of revenues during COVID-related lockdowns, helped individuals receiving the money to survive the crisis but also helped the local economy to thrive.
Describe how 'user friendly' your solution is to incorporate into social protection programs and delivery systems in West Africa.
There are three aspects to our solution of digital health credit matched to tontine’s members contribution to registered savings plan that is: the mobile application and its mobile money payment feature, and the saving scheme.
Our saving scheme builds on established cultural savings mechanism with which informal workers are very familiar with the tontines. Because informal workers are already familiar with savings mechanisms through their tontines’ affiliation, they are already primed to participate to member led contribution-social protection programs. In addition, as they are largely unbanked, they leverage mobile money service on their phones to send and receive money for their business and personal activity. Our proprietary data show that more that the third of the informal workers we serve with our digital health credit receive or send money via mobile money; while all have a mobile money account. To increase comfort and experience with the in-App transactions and our business model we have been using on site NaYa agents and tablets to deliver education to Tontines and assist informal workers with the use of our services. Those agents can be deployed throughout medical facilities to train personnel or tontine members on the NaYa App.
Lastly, because part of our solution, the health credit is already 1) serving and reaching informal workers members of tontines, and 2) incorporated in the existing care delivery systems including pharmacies the solution is well adapted to the realities of the target population and delivery systems across West Africa.
Explain how your solution is interoperable with existing technologies and open standards.
Our solution of digital health credit coupled to matched to tontine’s members contribution to registered savings plan is primarily powered by an application and mobile money API. While we developed the app the mobile money API is provided by the telecommunication operators operating in markets across Africa. Integration of the mobile money API into our application allows informal workers to contribute to their NaYa registered accounts from anywhere in West Africa and Cameroon. Furthermore, because NaYa health credit is cashless and digital, informal workers could access care from any region in West Africa through NaYa affiliates medical service providers. The mobile App and the openly mobile money API make our solution truly portable across West Africa and Cameroon.
How does your solution account for low connectivity environments and for users with low literacy and numeracy levels?
People in low connectivity environments have several choices to access our proposed solution:
- Provide their identification details during the enrollment of their tontine to NaYa health credit service. Tontines are offered discounted service fees and longer repayment period during group enrollment and should provide the list of their eligible members.
- Visit a NaYa agent at any affiliated medical facilities in their regions. On site NaYa agents have access to internet and can help members to register and make their contributions.
- Have a NaYa agent attend a Tontine gathering to register members on the App
At any time, registered informal workers can also make their contributions off application, from their mobile phones using generic mobile money transfer mode to designated NaYa mobile money account. This transaction does not require internet and is strictly powered through the local Telecommunication operator network.
Currently we have NaYa agents doing communities outreach for our digital health credit service. Users with low literacy and numeracy skills can access our solution through the informational session delivered by NaYa agents at Tontines gatherings. Individual assistance is available at affiliated medical facilities via NaYa agent. Train-the trainer programs can also be initiated to train Tontines’ leaders and informal workers associations on the solution
Select the key characteristics of your target population.
Do you already operate in one or several countries in West Africa? If so, which ones?
In which countries will you be operating within the next year?
How many people does your solution currently serve? How many will it serve in one year? In five years?
During our pilot phase of providing bridge health credit, we directly offer a safety net to more than uninsured 200 informal workers, with 65% of the beneficiaries being women with low income. In addition, we helped two local businesses such as individually owned pharmacy to thrive as we guaranteed providers payments. Allowing them to not miss a sale and maintain their business even during economically challenged times.
Considering that 2/3 of our customers for health credit are informal workers and that each of our medical partner serve in average 18 000 people annually, we assume we will capture about 20% of that population. Hence, we forecast that in one year with an extended network of six (06) medical providers we would be able to serve about 7280 informal workers members of tontines with our combined health credit service and matched tontine member contribution to a savings account. This estimate takes in that 1 in 2 people in Cameroon are tontine members.
Collectively the estimated population of ECOWAS countries is 349 million. In five years with distribution in Cameroon and tree countries in the ECOWAS region West Africa countries we anticipate to reach 10 millions with our Digital health credit coupled to matched tontines members’ contributions to social benefit programs .
What are your goals within the next year and within the next five years?
While during our pilot, we’ve shown that health credit is an attractive and affordable safety net for informal workers to access health in economically challenged time. Over the next year we plan to extend our partnership with an additional 6 medical providers in order to capture 50-60% of the population of informal workers in Yaounde and Douala, the main cities in Cameroon.
Having capture we anticipate that a third of this population will adhere to the matched tontine contribution savings mechanism.
In the next five years our main goal is to entrench contributions to social protection to in the habits of 10 millions informal workers people across West Africa.
This would be achieved through the use of 1) our health digital financing platform, 2) the partnership with existing female- Tontines groups and 3) agreement with existing local medical service providers in the public and private sectors in the three countries. Incentive schemes involving the sharing of a percentage of the flat health credit service fee with informal Tontines will help us secure partnerships with those groups 4) assistance from the world bank in the form of matched cash contributions.
What barriers currently exist for you to accomplish your goals in the next year and in the next five years?
We have already established proof-of-concept of health financing as a culturally acceptable solution to address the healthcare needs of Cameroonian informal workers. To encourage participation to the proposed matched contributions registered savings program we need to get financial support from a trusted sponsor institution which will guarantee the matched contributions. In parallel, we would need to increase awareness among tontines's members with awareness campaigns. In addition, we need to complete the development of a robust and secure offline application app for individuals in area without internet connectivity to access our services. Securing partnerships with telecommunication companies with operations across West Africa will be crucial to achieve full inter-regional integration of mobile money payments in the App; allowing migrants informal workers to maintain participation anywhere they found themselves in West Africa. Added to these barriers we would need to partner with sponsor institutions and local social protection plans with extensive knowledge on how to manage social benefit.
How do you plan to overcome these barriers?
To gain financial support from the sponsor institutions we plan to communicate on impact and metrics of our current health benefit program, where we provide vulnerable people access to free medicines using donors funds.
To increase awareness, we plan to seek partnerships with publicly trusted local enterprises as well as working with locals in-network brand ambassadors. Particularly leveraging current users of NaYa health credit who are already tontines' members. In addition, we plan to further promote our commercial partnerships with local respected partners: established medical service providers.
To build a robust and secure cross-border application we will look to partners with established organization such as Google which have developed knowledge and expertise developing complex user-friendly applications.
Raising capital to fund the development of an improved app and securing matching contributions will be done through a combination of grants and a development impact bond.
What type of organization is your solution team?
How many people work on your solution team?
Our personnel is composed of the founders acting as managing directors, the local field staff and the remoly based technical staff and the marketing contractor.
- Co-founders/Managing director : n=2
- Advisor: n=1
- Field local staff and local in-country manager: 3 (full-time)
- Developer team (contractors): n=4
- Local business developer: n=1
- Marketing agency (contractor): n=1
How long have you been working on your solution?
Three years. The two co-founders partnered to found NaYa in 2017 and launched operations in 2019.
Why are you and your team well-positioned to deliver this solution?
Derived from our pilot phase on health credit, our team has the field experience of working and gaining adoption of informal workers for insurance like social benefits.
Moreover, NaYa managing team has complementary expertise in financial/investment services, team building, stakeholders management and administration of health benefit program .
Dr. Marthe-Sandrine Mpollo a trained scientist and healthcare consulting professional has extensive experience in implementing and managing health benefit programs sponsored with donor funds and building strategic partnerships. During COVID outbreak, Marthe-Sandrine successfully designed a medicine access program at NaYa, allowing donors to contribute to medicine costs of COVID vulnerable patients. The ongoing program administered through NaYa provides three-month access to life saving medicines to pregnant women and chronically ill children.
As a former principal in an established private equity firms, NaYa’s co-founder Yannick has over 10 years of experience managing investment funds and corporate finance advisory. Under his leadership, the team succeeded in investing in excess of US$ 70 million in sub-Saharan Africa over the last few years.
The managing team is advised Mr. Stean Mpolo, former bank officer at the reserve bank of Cameroon (BEAC), founder of Cameroon finance advisory and SME funding firm Marabout Finance and the current Regional Coordinator for Central Africa of the African Business Roundtable.
Lastly, the established relationships of our operating field team with the target population of informal workers favorably position us to rapidly implement tactics to drive adoption of the social protection mechanism by the targeted population.
What organizations do you currently partner with, if any? How are you working with them?
We've partnered with individually owned local pharmacies to attract and distribute our solution to informal workers. Pharmacies provide medicines to NaYa registered users (informal workers) when they are short in cash and we pay the pharmacies. Pharmacies also act as NaYa branches, as users with low connectivity can access NaYa app from tablets and with NaYa agents' assistance present in the affiliated pharmacies
In addition we partnered with patient associations whose members are informal workers and tontines members. Patients whose care access was facilitated by NaYa health credit act as NaYa ambassadors in their tontines.
What is your business model?
Our operating model provides value to informal workers with tontine membership and is based on a service fees collection. Our business model is composed of four main actors: the users, the medical services providers (labs, clinics, and pharmacies), NaYa App and the matching institutions (the World bank). Basically, through our application we allow informal workers members of NaYa registered tontines to benefit from a flexible post paid payment structure when they face a health expenses. Coupled to this health benefit, tontines' members can make part of their regular tontine contribution to a registered NaYa savings account to which a matching institution contribute to up to a percentage of the initial member's contribution. NaYa's revenues is a percentage applied both to repayments collected and aggregate members' and World bank's matched contributions contributions to savings accounts.
During challenging economic times, this model allows uninsured informal workers to have access to 1) a affordable medical coverage with no up-front payments and 2) access to a guaranteed minimal revenue.
Access to cashless collateral-free health credit is currently done through our App at point of care. Beneficiaries of the digital credit get care from any affiliated NaYa medical service providers without paying up front.
Importantly, through our App and medical service providers network we allow users to contribute to their savings anywhere in West Africa. Because the saving scheme involves a matched contribution from a donating institution like World Bank, contributing members have an incentive to maintain contributions and expand their saving capital.
Do you primarily provide products or services directly to individuals, or to other organizations?
What is your path to financial sustainability?
Providing a safety net to vulnerable people is central to our non-for profit business model. Partnering with two local pharmacies and communities , we are already reaching out to the target population of informal workers with our collateral-free cashless digital health credit. We propose to act as a contribution collector of We plan to fund our operations with a combination of grants and service fees. In our current model, a service fee tontine dependent variable service fees (8-12%) is applied to the repayment of the health credit, and we thus forecast that expansion of the service distribution would increase the profitability and delivery of our business model making it self sustainable. More importantly, because we will be acting as a clearinghouse to attract and collect individual contributions to registered savings account, the services fees applied for the collection of those contributions will become a significant revenue stream in the long-term.
In the near term, we will need to raise capital through grants to expand our end-customer reach and service distribution through the existing care delivery system: pharmacies and hospitals. In the immediate term- grants and donations would be need as a seed capital to our cash matched tontine saving scheme.
If you have raised funds for your solution or are generating revenue, please provide details.
Our bridge health benefit program is self-funded by its two co-founders with a combination of debt and equity. The amount invested by the two co-founders averages $US 25 000, of which 90% of this amount is in equity.
Added to this is the amount of$US 1190 crowdfundraised from our GoFundMe platform to provide free-of-charge financial assistance for medicines expenses to economically vulnerable patients during COVID outbreak (https://ca.gofundme.com/f/help-protect-patients-at-highest-risk-from-covid).
If you seek to raise funds for your solution, please provide details.
Our current funding goals are to raise a total of US$ 200 000 for the two years. Funds raised would be a combination of debt, grants and equity.
Debt would be raised by proposing savings contribution as an investment vehicle to informal workers. As their periodic savings could act as a revolving capital for NaYa health credit facility needed to expand the distribution of the proposed solution. Service fees collected on the deferred payment of health credits would then be shared with informal workers members of tontines with NaYa registered savings account.
In addition, we are awaiting decisions from several grant competitions by mid October 2020:
Influsive Fintech : Prize of $US 25 000
What are your estimated expenses for 2020?
Why are you applying to the Mission Billion Challenge WURI West Africa Prize?
We are applying to the WURI WEST Africa prize because we believe we can gain exposure to and financing from funding organisations with an interest in providing sustainable access to health for economically vulnerable people. In addition, being selected as winner for this challenge will give us access to tech resources from Google tech developers which will enable to develop a robust and secure our cross- border application.
In which of the following areas do you most need partners or support?
Please explain in more detail here.
As we develop our application, Our team will need in-house expertise in cross borders solutions development and data organisation. Having guidance on data architecture as it relates to the App development for cross borders services would be crucial to our success
Data privacy and regulations on digital value-added services would vary across geographies, while we have a local counsel with Cameroonian expertise, having a counsel with a broad knowledge on related ECOWAS regulations will help plan the App development, service distribution accordingly.
Our team as relied on remote professionals for the marketing. However, our experience so far suggest that having mentorship from or access to marketing savings local professionals who live in markets and who have launched blockbuster social services in those African markets is critical to get an impactful messaging campaign and exposure.
As we implement our solution, we must ensure profitability of our services. Having access to mentorship on our pricing assumptions would help us maintained affordable pricing across markets.
What organizations would you like to partner with, and how would you like to partner with them?
We would like to partner with the World Bank as they have expertise with funding and monitoring social protection programs for economically vulnerable people and in Africa (cash transfers).
Partnerships with telecommunication operators (Orange, MTN) to provide internet custom access to informal workers who use our application. In addition, partnering with telecommunication companies will enable us streamline integration with mobile money finction in our application for cross border use.
We like to partner with pharmaceutical manufacturers, as the partnership may allow us to provide access to care at further reduced costs for the end users. Particularly since sourcing medicines directly from the manufacturer can offer the benefits of lower pricing pf products currently sold by our partnered pharmacies.
Partnerships with local governments will help us raise awareness and trust towards the program.
Partner with an organization such as TNH which offers chat bots- enabled medical assistance to patients with specific conditions. We hope to offer patients support programs to help informal workers manage their and reduce related- expenses, making room for more savings.
Dr. Marthe-Sandrine Mpollo NaYa Co-founder and Executive director , NaYa Limited