Inclusion & Impact (i&i)

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."i&i" would foster collaboration between mobile phone operators, insurance companies, and healthcare professionals to enable access to quality/affordable healthcare services for the region’s informal sector workers. This would enhance financial inclusion and improve livelihoods. Within the next year, “i&i” would be implemented in Guinea and by the end of the fifth year it would have been replicated across West African countries. To achieve the MVP, application grants would submit for 60% of the funding. The remaining 40% would be sourced via Equity Funding and profits generated would be used to replicate “i&i” in other countries.

The quality of services, and especially on health services, has substantially received little consideration in many African countries (Adindu, 2010). In Guinea for example, insurance companies offer an average amount of USD388/annum or USD 32/month for 3-member families. This is a total annual health expenditure of 4.12% of GDP. Thus, for a population that earns about USD2/day, there is an expenditure of USD89.17/capita (World Bank, 2017). Access to quality and affordable healthcare for West African citizenry living in low and middle-income communities is limited (Adindu, 2010). This inadequacy creates dependency on their relatives, and often increases stigmatization within their communities. Additionally, while the World Health Organization recommended a 10% healthcare spending allocation, Guinea’s annual budget allocated a measly 3.5% on healthcare spending (Pacific Prime). Africa’s healthcare system is appalling. In 2001, African countries agreed to allocate at least 15% of their budgets to health care, and regretfully failing (Africa Renewal, 2017). According to the World Bank report, whiles Africa’s health market is valued at USD35million, the share of out-of-pocket health payments as a portion of all health expenditures in sub-Saharan Africa rose from 40% in 2000 to over 60% in 2014 ( Africa Renewal, 2017).

“i&i” targets informal sector workers 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) A macro market research in Guinea with favorable feasibility was conducted using triangulation of interviews, field visits to stakeholders, and observation of a sampled population. Thereafter, an agreement was made with a local insurance company and private hospital to use their database to develop and test the product, using their staff as initial clients. This ecosystem platform would ensure that the targeted population are able to access health insurance without having access to a bank account. Other burdensome administrative and payment processes would be omitted. Furthermore, this insurance cover 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 male 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.

Accessing quality, affordable and utilization of healthcare services within West African countries is quite limited. Nor is accessing public and private health insurance. In Guinea for example, only 5% of 12.4 million people had public health insurance, with an additional 0.4% covered by private insurance companies. “i&i” is an application that enables a collaboration between beneficiaries and service providers and give users such access to quality and affordable healthcare services. The target population is the informal sector workers within the West African region. “i&i” would enable access to health insurance, improve healthcare outcomes, and improved livelihood (Spaan et.al., 2012)

Although BIMA (https://bimamobile.com/about-us) - an “insurance company” uses similar products, it operates essentially in Anglophone African countries such as Ghana, Gambia, Tanzania and Kenya. Our solution significantly stands out in focusing on un-tapped and unreached populations. Also, as an ecosystem platform ensuring stakeholder collaborations, we are not mandated to have a fund management license. Our targeted market would be initiated with the informal sector workers in Guinea, then to other West African countries. Although CAREPAY (https://www.carepay.com/), a Kenya-based company uses products akin to that of “i&i”, our solutions are greatly different from theirs especially as they use a Free-For-Service funded by national and international humanitarian and charity donors, and like BIMA, it is operational in Kenya with plans to expand to Tanzania and Nigeria only.“i&i” is a uniquely offering targeting beneficiaries within an under-served segment at the bottom of the social pyramid such as the informal sector workers, with long lasting effects, when implemented in a successful manner.

Mobile network micro-payment technology (mobile money) is mature and has high penetration in Africa. West Africa has become a force in Africa’s mobile money revolution. Safaricom’s M-Pesa and MTN Group’s Mobile Money (MoMo) are two of the largest examples of a very vibrant mobile money sector in the continent. Using a conventional or feature phone, consumers can conveniently and instantly transfer money to pay for goods and services. Link: https://qz.com/africa/1721818/africa-mobile-money-industry-is-entering-its-next-stage-of-growth. One of the fastest ways to transfer money to Guinea from other continents is through MTN mobile money. In Ghana, MTN and Airtel Tigo have spurred a 20% increase in financial account ownership. Mobile money transactions in Sub-Saharan Africa were an estimated $26.8 billion in 2018, with now more live mobile money services offered in West Africa (59) than in any other region in the world (GSMO Report, 2019).

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 1.04billion 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, insurance companies and healthcare professionals (hospitals, labs, and pharmacies) to provide services to the informal sector workers within the West African region, as well as people living in low and middle-income communities, “i&i” will enable easy access to 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 “i&i”, the financial inclusion of informal sector workers in West Africa will increase with a health insurance 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). “i&i” is aiming to reduce the impact of catastrophic epidemics like Ebola or Covid-19 on the West African informal sector workers specifically.

“i&i” is an innovative technology that improves the quality of life of informal sector workers specifically, and individuals living in low and middle-income communities, by positioning insurance power and control in their hands. As a technology-focused product, “i&i” provides simple, convenient, and hassle-free insurance to ensure informal sector workers can manage their varying insurance needs on the go. This would minimize dependency, and curb stigmatization within communities. Using a conventional mobile phone to access and pay for healthcare insurance would increase their financial inclusion. “i&i” improves lives by enabling the provision of quality, affordable, and accessible healthcare services. With their savings pocket (“tontine” or “sousou”), users would have access, and be able to make distributions to and within their social networks, and relatives in the diaspora would be able to contribute to their wellbeing with a direct contribution to their “i&i” account by eliminating all costs associated with intermediaries. We anticipate that information synthesized from the “i&i” platform would be used to inform decisions made by the Governments within the West African region and be used to adapt to current healthcare policies. For example, beneficiaries’ account could be used to populate the WURI program and respective Governments would use “i&i” platform to provide assistance to their subscribers during a disaster management period.

“i&i” application and web platform is a simple design with easy to access all menu and overall flow; it is a seamless user on-boarding and check-out process for varied users, and its intuitive navigation makes the app user-friendly. Additionally, users would get necessary information about plan & premium related information with just a couple of clicks. Finally, with its quick payment, “i&i” is a true mobility friendly app for insurance payment. This personalized experience would keep the mobile app experience relevant and ensure users continue coming back. We anticipate that information synthesized from the “i&i” platforms would inform decisions made by the Governments within the West African region and be used to adapt to current healthcare policies. For example, beneficiaries’ accounts could be used to populate the WURI program, and respective Governments would use “i&i” platform to provide assistance to their subscribers during a disaster management period.

The technology stack of the “i&i” platform comprises open source software such as postgres relational database management system and the python programming language. Our external APIs are RESTful, which ensures interoperability and integration with other systems.

Our primary point of contact with beneficiaries is an Unstructured Supplementary Service Data (USSD) application, which does not require a smartphone. The only requirement is a feature phone. The USSD application does not require an internet connection and is incredibly well-suited for low-connectivity environments. The application interface will be bi-lingual - French and English - at launch. Guinea is a French-speaking country and most of the population have basic French literacy. Additional local languages will be added as we expand into other West African countries

Within the first year, “i&i” would serve 750,000 people(38%) of the population of Conakry “i&i” would be then replicated to the suburbs of Guinea’s capital city of Conakry to serve an additional 650,850 people from the second year. Within this same year, there would be an expansion to other West African countries notably Liberia, Mali, and Sierra Leone. By the fifth year of implementation, “i&i” would be serving a minimum of 1,400,850 (70%) informal sector workers in and around the city of Conakry alone. Furthermore, at the minimum, 15% of the West African informal sector workers within each country should have a considerable access to affordable and available healthcare services using the “i&i” ecosystem platform.

Within the next year, “i&i” would initiate the implementation of the app in Guinea which would have been successfully achieved nation-wide by the second year. By the third year, “i&i” would have been expanded to integrate a savings (susu) and pension funds while West African citizens living out of their countries (diaspora) would be able to pay for their relatives back home. Within the fifth year, and in collaboration with national authorities, data collected would facilitate accessible 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 “i&i” in Africa to meet the needs of the uninsured. As an ecosystem application and web platform, “i&i” by the end of the fifth year would have been replicated across West African countries to increase the financial inclusion of informal sector workers, and individuals living in low and middle-income communities with access to health insurance services, and subsequently access to affordable and quality healthcare services.

• Negative reaction from conventional insurance companies.
• Other entities duplicating our idea, becoming competitors.
• Clients’ inability to adapt to latest technology.
• Insurers becoming direct competitors with similar digital solutions.
• Newcomers looking to quickly cash-in on the opportunities.

• Through meetings and workshops, we will bring insurance companies to better understand the win-win concept behind the ecosystem platform offered by “i&i” and collaborate with us.
• Our creative ideas translate to better marketing strategy and continued innovation will allow us to lead on the market.
• Door-to-door campaigns in the local dialect by our brokers from unemployed graduate and postgraduate students, and essentially composed with at least 80% girls and women
• Aggressive marketing and consumers’ incentives will help us as first comer in the market to conquer new and maintain already enrolled subscribers.
• Analyzed data by some of our partners will allow us to influence decision makers and the market on the best pricing by healthcare services providers.

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1 full-time staff and 3 part-time staff.

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. 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 has the ability to 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.

“i&i” currently has groups of partners for application and ecosystem platform development and initial piloting: WIREDIN, a Rwanda-based leading IT development company as technology partner. SOGAM, a private insurance company in Guinea. CLINQUE MAHAWA, a private medical clinic located in Conakry. CELLCOM Guinea, a mobile phone operator is ready to participate in the project with a preferential price on transactions from consumers to insurance companies. This will be extended during the rollout phase to ORANGE Guinea, as well as AREBA Guinea, among others. To reach the goals mentioned above, “i&i” seeks partnerships to: Mentor and advice to strategic planning and products development. Support marketing and communications that clearly distribute data. Build connections to investors and grantors to progress our fundraising strategy. Additionally, the African Institute for Mathematical Sciences (AIMS), partnering with the Mathematics Department of the University of Liverpool, will be engaged to analyze data collected after year one, to do the modelling and come out with pricing solution to be implemented by all service providers to the benefit of the people living in low and middle-income community groups. With a well-regarded artificial intelligence/machine learning program, the partnership with AIMS will allow us to integrate artificial intelligence into the “i&i” platform to improve product pricing, claims management (e.g. optical character recognition to handle handwritten documents), and fraud detection. We expect information synthesized from the “i&i” platform will be used to inform West African countries including Guinea's leadership decisions and be used to adapt current healthcare laws accordingly.

“i&i” is an application and web platform which enables informal sector workers especially, and individuals living in low and middle-income communities to have easy access to affordable and quality healthcare services as and when they require it within their environment to improve lives. They will access healthcare services using their mobile phone to pay for healthcare insurance, which increases their financial inclusion. With “i&i”, they do not need to have a bank account. The payment for “i&i” will be done daily through Mobile Money according to their daily, weekly, or monthly earnings. We aim to significantly reduce administrative burden of traditional insurance companies and upfront cash payments at hospitals, labs, and pharmacies.

It has been assumed that a donations and/or grants of 30% of the total funding requirement will be applied for by “i&i” 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. "i&i"’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 below 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 “i&i” 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 $758,000 and the net profit after taxation to US $137,000. For year-one, the total premiums collected (sales) will be US $391,5M and the premiums paid over (cost of sales) will be US $387,6M with a premium collection fee retained (gross profit) of US $3,9M. The company is projecting an Internal Rate of Return of 467%.

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"i&i"’s funding requirement at this stage amount to US $258,000 to get to the Minimum Viable Product (MVP).

Year-One operating expenses is estimated at US $123,000.

We are applying to Mission Billion Challenge WURI West Africa Prize to receive mentorship from Google Developers Experts and be invited to a high-level event at the World Bank 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. Google Developers Experts community's support will help us navigate potential negative reactions from conventional insurance companies, which are one of our key partners 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 Google Developers Experts’ networks. Furthermore, the team is applying to the Mission Billion Challenge WURI West Africa Prize to have access to prize funding for 2020 Challenges to improve the lives of informal sector workers within the West African region.

The support the team requires includes relevant advice on the best solution technology to develop and implement “i&i”. Also, to enable us to enhance our partnership drive, we would require mentorship in fine-tuning our funding strategy and the revenue model. Additionally, the expansion of our partnership portfolio to benefit from experiences from companies in marketing, the media, and exposure would assist us better position our impact solution within the local, regional, and continental market.

To ensure international recognition for the solution technology for our impact solution, we would like to partner with Google Developers Experts. In terms of funding, revenue model, marketing, media and exposure, MIT Solve’s Network of cross-sector community would better assist us build the needed partnerships to accelerate our work, validate our impact and business model, and scale our solution. Also, we would partner with the African Institute for Mathematical Sciences (AIMS), and the Mathematics Department of the University of Liverpool (UoL), to integrate artificial intelligence and machine learning into the “i&i” models. With a well-regarded artificial intelligence/machine learning master’s program, the partnership with AIMS would allow us to deliver across-board improvements to “i&i”’s mandate to improve health outcomes for informal sector workers especially, and individuals living in low and middle-income communities.