Improving to equitable healthcare using mobile technology

Based on internal needs assessment survey conducted in 2021,  we found out that 9 out of 10 informal workers in Lagos, Nigeria do not have access to or recognize a convenient means of financing their healthcare and that of their loved ones. This disparity is the largest when compared to those from the formal work sector with organised means of health security which is a ration of 1:30, for every person in the formal sector with access, we have over 30 people in the informal sector without access to quality health care services. On a broader scale, there are around 5.5 million people in the informal sector,about three-quarters of the state's 7.5 million labour force.  (Lagos state bureau of statistics 2020) 

Today, the informal sector and other vulnerable groups such as those living with rare illnesses contribute the most to any economy around the world, for instance in Nigeria, about 70% of the labour force are attributed to the informal sector - identifying the existing gap in healthcare delivery for developing economies around the world and the fact that those in the informal work sector are highly underserved indicates how targeted solutions to address the problem of access to quality healthcare, financing and infrastructure development among this huge population will take the world closer to achieving the universal health coverage agenda in Nigeria and the rest of Africa. Below are specific problems Hi-FIn Care seeks to solve:

• Increasing healthcare delivery and access gap in Nigeria and the rest of Africa.

• Inaccessibility to safe social and medical hub to connect persons with rare diseases to quick medical and psychosocial interventions.

• High neglect for the informal work sector by health insurers that have heavily concentrated on satisfying the formal and corporate work sector only accounted for about 30% of Nigeria's labour force.

• Ineffective health financing structure for low-income earners.

Technology and access to mobile phones have continued to show a lot of promise in the last 5 years in Africa with several innovations linked to owning a mobile phone, especially in Nigeria where internet and mobile phone penetration has increased to over 60% and more people and businesses can easily be connected by tech-driven solutions.

At Hi-Fin Care we leverage the use of technology and adapt the existing financing model that exists in the informal market where those in the sector save periodically using a thrift contribution model in meeting their financial obligations in creating a web-based and mobile application where our customers can sign-up to access and stay connected with health institutions such as hospitals, clinics, pharmacy, laboratories in their neighbourhoods as well as health professionals while having the option to personalize their medical savings for immediate, or future medical emergencies. The underlisted are some of the solutions:

1. Hi-Fin Care offers health institutions push messaging services to send instant messaging to pool of beneficiaries  in the designated  communities by promoting up to date and reliable health information. 

2. Provide access to telemedicine support and ambulance services for emergencies

3. Engage, educate and enquire with artisans and those in the informal work sector to understand social and behavioral barriers existing for them to access healthcare while using the feedback to improve Hi-Fin Care digital platform

4. Customers can create a personalised savings plan for their healthcare, share resources using community financing model to contribute to other member of their community, and pay for subsidized healthcare in their community using H-Fin Care platform.

5. Persons with disabilities and rare diseases are able to signup on Hi-Fin Care digital platform to access educational information, therapy and medical aid as well as support groups in a click of button

Hi-Fin Care's target population are the close to 6million persons in the informal workforce with lagos Nigeria (artisans, traders, blue-collar jobs, apprentices) male-female aged 16 - 55 years old in Nigeria and Africa. 9 out of 10 these individuals in Nigeria do not have access to health education, insurance or information about health solutions in their communities thereby exposing them to the risk of self-medication, and the use of unorthodox medical practices using unregulated traditional herbal products which often have a long term effect on their health. Our solutions are accompanied by education to sensitize our target population about health choices and how their mobile phones can solve a lot of problems associated with locating health institutions in their community, saving the disposable income they spend on herbs periodically to finance their healthcare, and access community health information at their fingertips

Secondly, Hi-Fin Care is testing its digital platform among those with rare diseases in Nigeria (which consists of 4% of the overall population) in order to connect them to specialise medical and therapy services available in Nigeria. There is also a psycho-social support and peer-to-peer digital services to support the wellbeing of those living with rare diseases.

Our big idea is that the informal workforce within the low-income bracket with a mobile phone can access quality healthcare, health services and health information that they deserve regardless of their economic status, tech exposure or education. To achieve this, our plan is to:

   6 Months

• Recruit 5 - 10 Field Officers

• Onboard 2400 new users from 2 locations in Lagos

• Connect 10 healthcare providers to Hi-FIn Care digital platforms, at least 5 from each location identified

• Deploy USSD infrastructure to support Hi-Fin Care subscribers

• Launching and scaling

3 Years

• Have over 50,000 active users of our platforms in Lagos

• Nationwide service coverage

• Cross country market scoping

• Acquire advanced technology infrastructure to support Hi-Fin Care growing users and team

• Provide over 2500 jobs across Nigeria with various functions, roles and departments

Hi-Fin Care has its office headquartered in Lagos, Nigeria and its operation is currently based in 2 communities in Lagos. We have 3 teams supporting our operations;

1. The Customer Engagement Team comprising of 5 Field officers and 1 Customer care officer. The field officers mostly visit potential and existing customers in the informal industries in the 2 communities we serve to set up and enrol customers on our platform, educate customers on the features and benefits Hi-FIn Care offers, and support in collecting data to support Hi-Fin Care tech development, and other business agenda. The Customer Care officer provide telephone and social media support to meet customers' complaints or provide assistance in areas where customers are trying to access healthcare services in their communities or have questions.

2. The Tech Team is comprised of 2 persons whose responsibilities are to develop new features for Hi-Fin Care digital platforms based on the insights observed from customers' feedback, and they ensured Hi-Fin Care website and mobile apps are updated and optimised to support customers and health institutions using Hi-Fin Care platforms to facilitate communication and connections.

3. The Administrative Team are responsible for strategy development, partners' engagement and essentially talking to health institutions and stakeholders in the communities we serve or communities we have identified as interested in starting operation to understand and identify opportunities and threat for collaboration and partnership in meeting the needs of the customers that are using our platforms in their communities

Hi-Fin Care aims to be the leading company in the world that is solving the global healthcare challenges for developing economies with a scalable model. Becoming MIT Solver will enable Hi-Fin Care to be able to:

• Improve its upscaling design for customer acquisition and retention

• Benefit from MIT Solve enterprise networks to support, understand and scope Hi-Fin Care technology infrastructures and rollout

• Be part of MIT Solve's success in becoming an economically viable institution contributing to the growth of Nigeria's economy and solving global health issues for developing economies

• Access mentoring, funding and community support

Hi-Fin Care solutions address specifically those working in the informal sector who are least prioritised by health insurers because of the real and perceived risk of low disposable income, cultural block to accepting new innovation, among other economic issues associated with persons from this sector. Hi-Fin Care recognised this threat as an opportunity to educate persons from this sector to appreciate and be aware how technology through the use of their mobile phones can make life easy, learn about their health and community and get support when necessary which they have often considered stressful in real-time. 

Hi-Fin Care is building a new approach to telemedicine where customers considered not ready for change can engage with healthcare institutions, and in the same breathe support and encourage health institutions to improve their services for underserved members of their communities using push-messaging support and other digital campaigns available to them via Hi-Fin platforms by just signing up.  

To address the issue of financing, Hi-FIn Care model the existing thrift contribution model used by persons in the informal work sector to save for their monthly or periodic obligations to create a personalized digital wallet for users of the Hi-Fin Care app to save from time to time based on a defined choice of daily, weekly or monthly.

Hi-Fin Care will have an evolutionary impact as it continues to scale potential to integrate and close massively the healthcare and financing gap in Nigeria and Africa, as well as improve healthcare service delivery and infrastructure development in the future, especially as access to technology continues to grow in Africa

In next year, Hi-Fin Care will be scaling its operations from Lagos State of Nigeria to other 35 States of Nigeria with the projection of increasing our active customer base to 300,000 and over 1000 health institutions partners.

In the next five years, Hi-Fin Care will be operating across 2 to 3 African countries, upgrading its services to fully support health insurance, health infrastructural developing and financing among other health fintech possibilities.

Some of the ways we are measuring progress toward impact are:

1. Reducing out-of-pocket health financing burden on those in the informal sector who have difficulty prioritizing and saving for their healthcare. Hi-Fin Care presents its customers with support to save the least disposal income for their health and those of their loved ones without fear of health emergencies

2. By helping health institutions increase their service delivery more efficiently in managing community health, medical appointments and service referrals

3. As Hi-FIn Care continue to expand its operations to new communities, it presents members of the community and people job opportunities to work with us, reducing unemployment and improving the economy of Nigeria

Some of the factors contributing to the healthcare gap in the informal work sector in Nigeria are trust, education and lack of institutional support. Hi-Fin Care approach to use its community and field officers in educating and training persons in the informal work on healthy living and flexible mobile financing choices in modern times. These activities are important to reduce the trust deficit affecting our customers in accessing healthcare, eliminate the precarious habit of depending on unprofessional street herbs products for their healthcare. While engaging in the education and training of our customers, Hi-Fin Care introduces the use of mobile technology to our customers who do not recognise its importance in supporting health financing with their mobile phones - introducing this technology to our customers also further strengthens the advancement of mobile money and promotes the cashless economy policy of the Nigeria government.

Our solutions are primarily driven using the mobile application which is currently accessible to our customers on Google Playstore, this solution is supported with SMS technology to facilitate push notification services for healthcare providers, and the use of Unstructured Supplementary Service Data (USSD code) to support service delivery to customers who are not using smartphones.

Data is aggregated at the backend and used to inform strategic actions for the improvement of service delivery at the primary health care center

Hi-Fin Care's leadership structure is very diverse in terms of the skillset and industry experience of its founding members with over 35 years work experience combined cutting across Research, Public Health and Infrastructure Development, Law and Geospatial-Intelligence; the leadership of Hi-Fin Care's effort and strategy is focused and specifically targeted towards persons with informal jobs in Nigeria and Africa who are structurally categorized and systematically excluded by health insurers in Nigeria. The history of health financing in Nigeria has always been linked to supporting primarily those in the corporate business environment and some of those working in government evident in the Nigeria Health Financing Schemes and policies. Our work is deliberately focused on addressing the equality issues found as limitations to universal healthcare fundament to everyone regardless of the nature of one work or sector. Supporting this claim, our interactions, and engagement strategy are tied to only those in the informal work environment, artisans, and apprentices in that sector who do not have the technology or structural support to integrate them into the public or private healthcare system of Nigeria.

Our value proposition is that Hi-Fin Care users and customers can get fast and real-time connections to health institutions close to them in their community, save conveniently for their healthcare and that of their loved ones using our digital platforms. Customers can pay for health insurance using the Hi-Fin Care platform providing monthly or yearly cover for subscribers, their families and apprentices that work under them. Some of the customers we are targeting are local and big industries with a large chain of bottom line workers on the field who do not have health or accident insurance cover considering the affordability and reach of our services in the local communities in Nigeria hosting persons with informal jobs.

On the other hand, our partners in the health institutions such as hospitals, clinics, labs benefit from the pool of subscribers signed up to Hi-Fin Care digital platforms which can be reached with ease to promote community health and their services

Hi-Fin Care is currently funded by its co-founders (out-of-pocket). This funding has gone into activities related to research, tech development, fieldwork, medical outreach, and business operations.

From January 2021 till date Hi-Fin Care has spent:

Market Research = N2,814,000

Website Hosting and Mobile App Setup = N 510,050

Developer Wages = N1,250,000

Corporate Registration = N 250,000

Office Gadgets (Printer, Laptops, Phones) = N457,000

Total = N5,281,050

Revenue 2021 till Date:

Co-Founders Contribution = N7,000,000

Subscription Sales = N 342,000

Consulting Services = N475,000

To get more funding Hi-Fin Care needs to:

• Scale its users and active subscribers (Current products and pricing includes Bronze (Individual) N2,000, Silver (Family) N8,000, Gold (Artisan/Apprentices/SME) N12,000, Platinum (Family and  Artisan/Apprentices/SME  N18,000)

• Get partners and health institutions to subscribe to some of our health services.

• Provide consulting services to healthcare institutions and facilities.

One of the ways we have been able to sustain our operations and pay our staff salary is the business funding support we got from the Nigeria Fund for Small Industry and Youth Development fund of about N3,000,000 gotten late 2021 when Hi-Fin Care participated in a business pitch competition. Hi-Fin Care has also been able to use this money to support its ongoing customer onboarding and engagement exercise going on in Lagos, as well as support some of the revenues raised from sales and co-founders contributions