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 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.

From next year, “i&i” 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, “i&i” would be replicated in other West Africa countries.

The quality of services, and especially of health services, has substantially received little consideration in many African countries (Adindu, 2010). In Guinea for example, insurance companies offer to employed/wealthy people a health insurance pack of average amount of USD32/month for 3-members family. This result in 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/affordable healthcare for West African citizens 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 WHO recommended a 10% healthcare spending allocation, Guinea’s annual budget allocated an average of 4.84% of GDP from 2014 to 2018 on healthcare spending (World Bank, 2021).

In 2001, African countries agreed to allocate at least 15% of their budgets to healthcare, and regretfully failing (Africa Renewal, 2017). This suggest an appalling healthcare system in Africa. According to a report, whiles Africa’s health market is valued at USD35million, the share of out-of-pocket health payments as a portion of health expenditures in SSA rose from 40% in 2000 to 60% in 2014 (Africa Renewal, 2017).

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.

“i&i” is an application that will give users such easier access to quality and affordable healthcare services. The ecosystem platform enables a collaboration between beneficiaries and service providers (mobile phone operators, hospitals, laboratory services, and pharmacies).

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

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

The process used is simple and straightforward:

• Mobile phone operators provide seamless platforms such as USSD to enrol local community members on the “i&i” program; provide off-line payment options such as mobile money to collect premiums.
• "i&i" platform enrol members, collect premium and pays same day all service providers. 
• Healthcare service facilities provide medical treatments, laboratory services, and medications based on “i&i” program and submit their invoices onto "i&i" platform for payment.

“i&i” targets low and middle-income population in the age range of 15-54 years within the West African region and mainly women as in Africa, 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). This come from the fact that women are the backbone of most families in Africa and we believe that the healthier they are, the healthier is the family.

A macro market research in Guinea with favourable feasibility was conducted using triangulation of interviews, field visits to stakeholders, and observation of a sampled population. The finding of this research concluded that 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 the 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. This will result in the reduction of delays in hospital care and eventually reduce the mortality rates. The later will then enable the upbringing of children in a more secure environment. 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 low and middle-income population within the West African region. “i&i” would enable access to and pay for healthcare services, improve health outcomes, and improved livelihood.

“i&i” currently has groups of partners for application and ecosystem platform development and initial piloting:

• 9 Series, an USA/India-based leading IT development company as technology partner.
• Clinique MAHAWA, a private medical clinic located in Conakry, to use their database and staff members as first customers.
• ORANGE Guinea, a mobile phone operator is ready to participate in the project with a preferential price on transactions. 

Additionally, the Mathematics Department of the University of Liverpool (UoL), is engaged to analyse data collected, do the modelling, and come out with pricing solution to be implemented by all service providers. With a well-regarded artificial intelligence/machine learning program, the partnership with UoL will allow us to integrate artificial intelligence and big data into the “i&i” platform to improve product pricing, claims management (e.g., optical character recognition to handle handwritten documents), and fraud detection and data security management. 

“i&i” 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 “i&i”, they do not need to have a bank account. The payment to “i&i” platform will be done daily through 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. 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 “i&i” 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 “i&i” 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 first year, “i&i” would serve about 525,000 people 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 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, “i&i” 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 “i&i” ecosystem platform from the sixth year. 

• 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.

1 full-time staff and 4 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 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. 

From its foundation, “i&i” leadership is a diverse team from different 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.  

”i&i”’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.

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 2021 Challenges to improve the lives of low and middle-income population within the West African region.

The support our 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. 

To boost our partnership with the Mathematics Department of the University of Liverpool (UoL) to integrate artificial intelligence and machine learning, big data, and data security management into the “i&i” models, The AI for Humanity Prize would help to advance our solution by bringing this planned second phase at the initial phase.

“i&i” intends to fund research projects pertaining to the derivation of more refine microinsurance products based on the data collected and tailormade to the need of the customer. This will be done in collaboration with the UoL. It is worth mentioning that such research area has not been explore thoroughly in West Africa.

With a well-regarded artificial intelligence/machine learning master’s program, the partnership with UoL would allow us to deliver across-board improvements to “i&i”’s mandate to improve health outcomes for low and middle-income population especially, and individuals living in their communities.

Research shows 95% of the population in Guinea did not have access to health insurance (WHO, 2008). In a best-case scenario, claims processing in Guinea takes at least 9 business days. The administrative burden and cost of processing health insurance claims is also quite high due to manual procedures and processes. 

Healthcare service providers (hospitals, pharmacies, and laboratories) often delay treatment until a manual verification of insured patients’ coverage is confirmed. Insurance companies also manually review claims, which leads to long lead times before reimbursement of healthcare service providers. This reduces willingness of healthcare service providers to accept insured patients, often preferring patients who pay cash. Insured patients often pay the full cost upfront at healthcare service providers and seek reimbursement from insurance companies. 

“i&i” will process and manage large amounts of healthcare data. This data will help train our artificial intelligence models to reduce patient wait times and claims processing times. AI-assisted engines will automate the claims review process, using OCR to process hand-written documents. Our AI model will also provide efficient, fraud detection. With predictive analytics from our platform, our product pricing will be continually adjusted to provide the best possible value-for-money for patients and other stakeholders. 

We will partner with the University of Liverpool (UoL), to integrate artificial intelligence and machine learning into the “i&i” models. 

We expect information synthesized from the “i&i” platform will be used to inform Guinea's leadership decisions and be used to adapt current healthcare policies accordingly.