Jamii Life

Zeenith is the founder & CEO of Jamii Life - a social enterprise aims to redesign home-care increase accessibility, transparency, quality care and peace of mind in South Africa, and eventually across Africa.  Zeenith's grandmother, who was bedridden for 16 years, inspired Jamii Life.  Zeenith aims to improve the lives of low-income communities like the one she grew up in and to make an impact at scale by contributing to transforming the care system and infrastructure across Africa for people as they age.

Before this, Zeenith led GE Healthcare's Affordable Care, and Indirect Channel Partners across Africa focused on enabling access to medical equipment across Africa.  Zeenith spent a decade in rail infrastructure, leveraging infrastructure projects to create jobs and transfer skills. She led the team that created thousands of jobs and transferred critical manufacturing skills in South Africa as the GM & CEO of GE South Africa Technologies.

Across SSA, 66 million (5 million in SA) elderly will need help by 2050. Today, approximately 60% of the two million South Africans that need care have no way to access it. As a result, family members (often women) stay home as caregivers further decreasing the family’s household income.  

We connect vetted carers to people that can’t care for themselves and families that need help. We leverage quality standards and technology to make quality care and health tracking accessible. On-demand training for health workers and families make learning available to those that may not otherwise have had access.  

Jamii Life aims to transform care and social infrastructure for elderly by: 

• Directly providing care at a price that allows them to pay from their state-pension, giving them independence and paying health workers double what they would earn as a community health worker,

• Extending operational benefits to community health worker NGO’s.

The number of elderly South Africans that need some level of assisted living will more than double to five million by 2050. Of the two million South Africans that need help, community health workers meet 33% of this need but are limited in coverage, capacity and expertise.  Their low wages ($200 per month) limit their ability to provide for their own families.  A further 7% of people (often the wealthiest) can afford private care.  The remaining 60% of people have no solution because private care is too expensive and free NGO carers are stretched too thin.  They rely on untrained, unregulated informal and family care (usually women); further limiting household income and keeping families in a cycle of poverty.

Furthermore, lifestyle diseases are at least three times -in poor communities, like the Cape Flats, resulting in more disability from strokes; heart attacks; etc.  Increased lifestyle diseases exacerbate the need for long-term care in an environment where post-acute support is minimal.

Jamii Life connects vetted health workers with people that cant care for themselves and families that need help. Health workers record tasks performed based on standard protocols; enter health readings, and records emotional state. With the consent of the care receiver, families can view progress and share with doctors.

Jamii Life allows us to take vetted care and technology to all communities by using a platform that:

• Standardises care protocols

• Provides on-demand training for health workers and families that may lack resources and 

• Tracks health progress over time, allowing for better health decisions.

We’re starting with providing care directly to the customer, targeting a price point of approximately $3 per hour. This critical price point enables those on a state-pension to pay for care themselves, assuming families cover living and food costs. 

80% Of the revenue from patients go to the health worker allowing them to earn double the community health worker wage.

Our platform to minimises administration costs, for ourselves and NGO’s proving the service for free, allowing them to serve 25% more patients. 

The operational benefits will also benefit traditional home care agencies, allowing them to focus on providing care and helping them to decrease operational costs.

Jamii Life serves the increasing number of African elders that need care.  Our model is scalable across SSA to help the estimated 66 million older people expected to need care by 2050.

It is an honour for African families to collaborate on care and that older persons often live with their family.  We deliver care in hourly increments hour (to bring expertise and medical devices to track health progress) complemented with collaborative tools for care to handover over to family and neighbours.

Our services free up family caregivers to pursue careers.  We provide resources for families to help them supplement care.  Visualisation of tasks performed and health data supports collaboration, eases family tensions and provides peace of mind.

We conducted focus groups with 103 family caregivers to assess and understand the pain points care provision for a loved one that cant care for themselves.  We spent time with more than 200 health workers to understand their challenges and to facilitate technology adaption.  

Extending the platform to minimise the administrative burden for community health workers allows them to serve 25% more patients increase health outcomes and presents a case for improved community health worker wages.

Jamii Life provides a better quality of life for elderly Africans, allowing them to live more productive, independent lives while remaining rooted in African traditions and within our culture of community care.

Jamii Life frees up family members who would otherwise be family caregivers to pursue education and careers to better their lives and increase household income.  Women are often unpaid caregivers and are limited in terms of education and career opportunities.

Jamii Life pays health workers 80% of revenue from caregiving, at least double minimum wage allowing them to provide for their families and improving their quality of life.

Jamii Life is inspired by my grandmother and our family’s struggle to care for her during the 16 years she was bedridden.  I wish we were able to afford expertly trained home-based care and that we could better care for her ourselves, i.e. by knowing better hygiene techniques for bedridden people.  Writing this, and recalling how her emotional well-being deteriorated over time, and how she often commented that she felt like a burden breaks my heart.

I came up with the idea two years ago.  After that, I set out to understand if and how big a challenge this was for communities like the one I grew up.  We spoke to more than 100 family members that were also caregivers and went door to door to talk with 30 care receivers.  Talking to approximately 203 CHW’s allowed us to understand their current practices and challenges.  And to create trust with them to facilitate technology adaption.  Focus groups with about 50 unemployed community members interested in becoming health workers helped us understand their barriers to training and what it will take to ensure that they can develop the skills they need to earn a livable wage.

My grandmother inspired the creation of Jamii Life.  She was bedridden for 16 years.  My cousin, who is three years older than me stayed home to take care of her for years while I pursued my academic and professional career.  My cousin is unemployed today.  The cost of expertly trained home-based caregiving is prohibitive for most South Africans.  Our family, live thousands of others, could not afford home caregiving.  Our entire team have experience with this challenge of how to care for a loved one far away.

Jamii Life is the service that I wish we had when my grandmother was still alive.  It’s the service that I wish I had so that I could better see and understand her health progress and caregiving when I moved to another city for work.  Its the platform that I wish we had to ease family tensions when it was not clear who administered her medication that day.  

Jamii Life’s focus on skills development for health workers and providing access to training is the kind of organisation that I wish my cousin had access to make sure that her skills we recognised, developed and transferable.

Over the last 15 years, I focused on delivering skills development, creating employment and understanding affordable healthcare with the long-term objective of providing a solution that both creates employment and delivers better healthcare outcomes.  The community that I seek to serve is my own, and others like it.  Communities like where I grew up often have 40 - 50% unemployment.  Conditions are getting worse.  I am compelled to use the skills I've developed professionally and academically to make positive change.

 People: I am proudest of the teams that I built during my career.  My team continued to excel when I left is my legacy at GE.  For Jamii Life I've assembled an exceptional team that includes an experienced health care executive, a registered nurse for clinical oversight, a UX product designer and four interns to capture data.

 Technology: Leading a multi-investor, digital start-up at GE, gave me invaluable skills on how to build a case for investment and helped me develop strong relationships with technology development teams to adopt the technology platform for this venture.

 Money: So far, I've been able to attract approximately $60,000 in grant funding from Harvard Social Innovation and Change Initiative and from winning the Skoll Venture Award.

 Institutional Support: My time at GE helped me build credibility with multiple government stakeholders by focusing on job creation and skills development. I've been able to leverage these skills to work with NGOs, local universities and public officials.

I am the first in my family to go to university and was the only person from my primary school to go to university.  On average, 12 of 12,000 people from my community finish university.  During this time, my mom took on additional work to clean houses.  

I knew then I needed to be financially self-sufficient and that I needed to take care of my family – my mother, grandmother and younger sister if the need arose.  As a result, I worked in the private sector for 14 years.

I come from a coloured township in Cape Town, South Africa with 50% unemployment. Conditions are worsening.  I moved back home to live with my mom because I believe that proximity is vital in social impact work.  We seldom leave the house because it's become so violent. The longer there is no work in my community and others like it, the worse it gets.  I am committed to playing a role to elevate communities like mine.             

In 2015, I was appointed as the General Manager and CEO of GE South Africa Technologies responsible for the locomotive manufacturing and for delivering on GE's $750 million localisation commitment to the Government, including creating 14,000 jobs and building hundreds of locomotives.  My transition to lead this manufacturing localisation programme was one of the most challenging experiences of my career.  

With limited supply-chain experience, I initially struggled to lead a team measured on delivering products on time, at the lowest cost and highest quality especially when local suppliers needed additional financial and manufacturing support.    

I knew that we needed to be creative in how we supported local suppliers to realise the goal of becoming globally competitive.  I also knew that I needed help leading the team.  I reached out to GE's Global Supply Chain leader for guidance, support and mentorship.  With his support, I drove three interventions to reach the required cost, quality and schedule commitments.  We built the most localised locomotive ever made on the African continent and facilitated thousands of skilled jobs.  This is one of my proudest achievements.

Not applicable

• Our team is from the communities that we serve. Therefore, we understand the challenges health workers face (i.e. safety). This is a unique differentiator of our team.

• We are building our solution with health workers who provide services in challenging communities. Our participatory approach to product design is unique and allows us to design a solution for their challenging environment better.

• We are committed to system change. By providing the platform to community health worker NGOs and supporting them to increase capacity, we are scaling the platform. We believe that the more people that use the system, the more sticky it becomes, and the more we learn about how to make it better.

• Our platform taps into the desire for family members, even those far away to feel like they are contributing and connected to the care of their loved ones. A unique insight for African communities is that it is an honour to care for our elders.

• We plan to leverage South Africa’s unique context, like the alarm systems in many homes vs installing sensors as part of longer-term product development.

• Our objective is to impact employment, training and health outcomes and therefore, it is critical that we partner to leverage existing resources.           

STAKEHOLDER: PATIENT

Value: Healthcare assistance and care after an acute health event

ACTIVITY

- Receives post-acute & rehab care

- Can monitor health data and rehab progress

OUTCOME

- Improved patient health outcomes across different metrics after an acute health event

IMPACT

- Improved health outcomes, quality of life

STAKEHOLDER: PATIENT'S FAMILY

Value:

- Quality, affordable home care service

- Monitoring family member’s condition/ rehab progress

- Peace of mind

ACTIVITY

-Track care services provided

-Track health data and progress

OUTCOME

- Peace of mind that family member is cared for

- Reduced time managing care logistics

IMPACT

- Improved health outcomes, quality of life

-Peace of mind knowing a loved one is taken care of

STAKEHOLDER: HEALTH WORKERS

Enablers/ Value

-Documentation of services provided

-Track patient’s health and progress over time

ACTIVITY

-Provide post-acute and rehab care according to Jamii protocols

-Add patient medical data to app each visit

OUTCOME

- Higher quality home care

IMPACT

- Jamii carers will earn double minimum wage

- Access to on-demand training

STAKEHOLDERS: COMMUNITY HEALTH WORKER NGOS

Enablers/ Value

-Track employee time

- Measure value of services provided

ACTIVITY

- Track home care visits for donor/ Government contracts

- Improved patient outcomes reporting

- Collect local data on disease burden, access to care

OUTCOME

- Reduced overhead and waste

- Higher quality home care to more patients  

IMPACT

- Increase in number of patients served

- Improved morbidity and health outcomes, reduced hospital readmission rate

STAKEHOLDER: Healthcare Providers/ Primary care doctor

Enablers/ Value

- Monitor and evaluate patients unable to visit a clinic 

ACTIVITY

- Regular updates on patient’s medical condition

OUTCOME

- Higher quality care monitoring

IMPACT

- Improved morbidity and health outcomes, reduced hospital readmission rate

- Better care collaboration with families

Jamii Life is on track to launch in July 2020.  We aim to serve 120 care receivers in year one and increase that to at least 10,000 that we directly serve in year five.  Jamii Life’s work with Community Health Worker NGO’s targets increasing the number of patients that they serve by 10% in year one, rising to 25% in year five.  The number of NGO partners is planned to increase from one to at least 30 over five years.  Community health workers serve at least 600,000 people in South Africa if we can support 20% of the NGOs that provide the service for free, we will increase their capacity to serve an additional 30,000 people.

Jamii Life is on track to launch in July 2020.  We aim to serve 120 care receivers in year one and increase that to at least 10,000 that we directly serve in year five.: 

 Our goals for the next year is to:

1. Employ 10 health workers

2. Develop technology to build a fully functional app vs. web-based

3. Develop an on-demand training curriculum

Jamii Life is working to double the number of health workers annually resulting in almost 300 health workers in South Africa by year 5. Health workers will be trained for one year in advance. Therefore, almost 600 health workers will be trained in South Africa by year four.  Extending these projections will result in almost 600 health workers employed and earning a liveable wage in year five.

Jul - Dec 2020

Jan - Dec 2021

Jan - Dec 2022

Jan - Dec 2023

Job Creation

10

70

140

285

No. of health workers trained

20

140

280

570

No. of health workers employed

10

70

140

285

% increase in NGO patients

10% 

15%

20%

25%

No. of NGO Partners

1

5

20

30

No. of Countries 

1

1

2

3

No. of patient re-admissions

Not tracked

-2%

-5%

-5%

• Health worker safety: Health workers rely on public transportation and walking to get from patient to patient. High levels of crime in the communities they work in threatens their safety and affects health worker health, their emotional well-being and their ability to deliver reliable service.

• Prolonged COVID-19 outbreak: Our patients are especially vulnerable to contracting COVID-19. This risk delayed the start of commercial operations. Through this time, we’ve continued to build capacity and to partner with essential service NGOs. 

• Secure funding for 5 years to breakeven: Jamii Life is committed to paying health workers at least double the minimum wage and 80% of revenue from caregiving operations. To maintain this rate of pay, and to build the supporting technology and training content, we need to raise approximately $320,000 in grant funding or very patient capital.

• Government support to scale: Jamii Life’s vision includes working across the ecosystem to build a social care infrastructure for the elderly.  A scalable intervention will require Government support.  We believe that before we can formally request assistance as part of a national rollout, we need to show traction and have built the team and capability to integrate into the public system.  We anticipate that this will take significant goodwill, resources and expertise.

• On-demand training: Jamii Life’s vision is to ensure that all health workers and families that need training can access the training on-demand.  This includes work to update training content and expertise to partner for online training development.

• Health worker safety: Involving health workers in our design process has already helped us iterate our design to include a panic button, to partnering with emergency response companies and to include lower-cost mobile and medical devices.

• Prolonged COVID-19 outbreak: Our hygiene and PPE standards match the highest hospital standards.  In addition, to minimise the risk to health workers we are providing private transportation to patients and working with them to deliver essential goods like groceries to their homes.  Our hope is that these interventions will protect our health workers and our patients.

• Secure funding for 5 years to breakeven: Jamii Life has secured $60,000 to date.  We continue to pursue as many opportunities to secure unrestricted grant funding to build our health worker capabilities and develop the Jamii Life care platform.

• Government support to scale: Jamii Life needs highly trained, highly motivated individuals who are often expensive to ensure that we are able to integrate with existing public health interventions.  These include data scientists, a development team, etc.

• On-demand training: There are several MIT/ Harvard online training initiatives that we hope to be able to better access through the Elevate prize resources.  Getting online training right for health workers would be incredibly valuable across the continent.

To date, we’ve partner with St Johns home-based care service, one of the most substantial and most credible community health worker NGO’s in South Africa to test our solution.

We’ve also worked with the University of the Western Cape to understand community health worker training and to recruit health workers.

Appy Apps is a technology development house in Cape Town that have been instrumental in helping us to design a minimally viable product.

Jamii Life allows family members and care receivers to request care.  The care instruction goes to a vetted carer, who delivers the service that the care receiver needs.  Tasks performed based on standard protocols, health readings and emotional state is recorded in the Jamii platform.  With the consent of the care receiver, families can view progress and progress can be shared with doctors if appropriate.

We’re starting with providing care directly to the customer, targeting a price point of approximately $3 per hour.  This price point is essential because it allows for a daily care session that the patient can pay for themselves from the state pension (assuming that families cover their loving and food costs).  The intention is to cross-subsidise operations by charging more in communities that can afford to pay more.

Jamii Life breaks even after approximately 200 health workers delivering care 7 hours of care per day. At least 80% of the revenue from patients go to the health worker, with a minimum salary of $400 (double minimum wage).
 
The operational benefits of our platform can help NGO’s providing care for free increase capacity by up to 25% and allowing them to serve 25% more patients.  The operational benefits will also benefit traditional home care agencies, allowing them to focus on providing care and helping them to decrease operational costs.  The service to traditional home care agencies will be at a fee.

Over the next five years, we will need a further approximately $315,000 in grant funding or very patient capital to breakeven on the path to serve the 66 million people that will need care across sub-Saharan Africa.

We’ve spent time understanding the community we will serve and learning from the health workers whose lives we hope to enhance.  

Our current funding of approximately $60,000 will fund close to one year of operations.  To achieve functional sustainability, we will need to raise an additional $255,000 over the next two to three years.

We expect that within five years, revenue generated from operations will exceed operating costs, allowing Jamii Life to be financially sustainable.

In the five years leading up to that, we have identified key opportunities (including MIT Elevate). We are working on applications in South Africa to support technology development and South African Government funding aimed at developing enterprises that create employment and delivers social impact.

$30,000 Grant, Received in June 2019 ($27,000 still available) from Harvard Social Innovation & Change Initiative, New World Fellowship grant for an early concept of Jamii Life

$35,000 Grant, Received in June 2020, for winning the Skoll Venture Award

To supplement health care worker salaries until breakeven, build the technology that can be expanded for use by community health worker NGOs and to build the content and online on-demand training, we need an additional $250,000 across year two and three.  We hope that this funding will be available as grant funding.  If we are not able to secure grant funding, we will seek patient, affordable capital.

Our estimated expenses for 2020 (annualized) is approximately $66,000. 

Government: The Elevate Prize will help us access the financial and talent resources to gather the traction that we believe is needed to demonstrate traction to the South African national Government and other Governments like Ghana and Zimbabwe.

Innovation: One area that we would like to explore with MIT’s Professor Alex Pentland is to develop a data co-ops to make it easier for people to control and analyse their own financial and health data.  We believe that this will go along way to alleviating some of the data privacy concerns that Governments may have with this work at scale.  And will give the power of data to the individuals to whom the data belongs.

Training: Training at scale is a crucial enabler of our work.  The rate of innovation in delivering education online is rapidly increasing.  We can't think of a better organisation to partner with than MIT to understand changes and how best to leverage for low-resource settings.

1. Our funding model is highly correlated to health worker activities, and I would love to work with partners to develop additional revenue models to release pressure from health worker operations. I would also like to design an incentive structure that incentivises health workers to provide the highest quality of care while maintaining financial sustainability.
2. It is challenging for start-ups to attract talent in South Africa because the risk of failure, especially for previously disadvantaged South Africans who have to help provide for their families - is too high. We don't have financial safety.
3. Given that our work is with health and personal data, and because we would like to innovate using MIT Professor Alex Pentland to develop a data co-ops to make it easier for people to control and analyse their own financial and health data.

• MIT Professor Alex Pentland:  To develop a data co-ops.

• Withings: The Withings health ecosystem of connected devices & apps are designed to improve daily wellbeing and long-term health.  We believe that their clinical, innovative approach complements ours.  We hope to partner with them in Africa.  

• MIT Open Learning

• Community Health Academy: To collaborate to train health workers at scale

• Medic Mobile: To collaborate on tech development