Speetar

Nearly 50 years ago, the global health community penned the Alma Ata Declaration, coming to a consensus that primary health care (PHC) is the key strategy to achieving Universal Healthcare (UHC) (World Health Organization Declaration 1978). Although the global health community still presently agrees about PHC’s importance to achieving UHC, ways to measure PHC performance and improve its delivery are lacking in countries with infrastructure limitations. As such, the countries that stand to benefit most from delivery of quality PHC with continuity are lagging behind.  

Efforts to measure PHC performance in the past have focused on high income countries and/or used indicators that are not available in low and middle income countries (LMICs) (Macarayan et al 2018). As such, in LMICs, PHC performance measurement historically has not only been limited in availability but also limited in scope: when available PHC performance measurement in LMICs has relied mostly on input (e.g. the number of providers per capita), spending (e.g. government healthcare spending per capita) and/or availability of specific services (e.g. family planning) (Macarayan et al 2018). These traditional methods on their own overlook a key factor: quality of care, a factor rooted in 1) the experience of patients and providers, 2) the ease of access to care and 3) the follow-through or continuity of care. 

These gaps in data and access to quality care with continuity lead to a dual problem: where health care delivery is limited, health care data is even more limited and thus quality and continuity of care suffer. 

The bottom line: In the absence of robust healthcare delivery and data collection systems, the burden of access to care in LMICs falls on the patients who in the most isolated regions often travel hundreds of miles and spend exorbitant amounts out of pocket to reach the necessary care, facing so many barriers that they sometimes go without care; and the burden of data collection in those same contexts, healthcare delivery, and continuity as well–  for entire communities– falls on physicians themselves leaving less time to ensure quality of care.  

With limited solutions to these healthcare delivery and data gaps in LMICs, efficient improvements to PHC performance that are fit for purpose cannot be easily made and better healthcare outcomes on the road to UHC cannot be easily reached.

In the absence of a health system we build one. As the continuous point of care across the board Speetar measures and tracks patient progress, creating a new and powerful way to monitor PHC performance and target goals across a patient's lifetime. Even as providers change or move, they maintain access to patients through our platform and if providers move on to other patients, Speetar’s robust data system and connection between providers streamlines the care process ensuring that patients’ records, history, and care plans are easily accessible both to patients and providers in our global network and beyond and can inform patients’ future/ongoing care ensuring continuity of care no matter the circumstances.

Speetar is a Telehealth platform that provides accessible, affordable quality healthcare in adverse conditions and creates centralized health data to protect increasingly mobile populations. A powerful, novel healthcare delivery and monitoring tool, Speetar goes beyond access to deliver quality and continuity as well; it goes beyond data collection and factors in healthcare monitoring, building a robust healthcare ecosystem that streamlines the care process on each level: serving patients, providers, caretakers and communities, safely, efficiently, and effectively. 

We provide 3 main services to the most vulnerable: Speetar Remote visits make quality healthcare accessible, Speetar health records allow providers to review results and treat patients with ease and our Speetar treatment and referral system provides continuity of care across a patient’s lifetime. Our unique business model includes homecare, scheduling, and both standard and specialty healthcare consultations. Patients can access telehealth through our app, text and voice channels, as well as through our wifi-equipped Health dot locations where we also provide in- person care when needed. All the while, Speetar is the patient's continuous point of care.

We created Speetar to help limit exposure and provide quality care at a lower cost both on the patients’ end and at the point of care thereby, alleviating some of the strain health systems face in conflict-affected areas in an innovative way. 

Our pilot country of Libya showed tremendous success with Speetar and we will innovate even further as we turn to our early stage countries like Nigeria and Sudan with similar country profiles, pronounced need, and translatability. 

We offer accessible, affordable quality healthcare particularly in the adverse conditions of conflict-affected communities through our three-pronged model rooted in a drive for greater access to quality care with continuity. It is (1) a patient mobile app (2) a doctor web-based app, and (3) an on-ground patient site so patients simply schedule, pay and receive timely medical consultations regardless of the low-resource setting they live in. 

Our App currently offers three main services:

1) Flagship Doctor-Patient Telemedicine Platform 

2) Electronic Healthcare Record System

3) Clinic Scheduling Platform

Our mobile and website app, developed by local medical professionals in our Pilot country of Libya, is embedded in a unique, local support ecosystem and integrates language- and culture-matched UX/UI. Speetar’s unique platform is tailored for patients with low technological, financial, or health literacy and marginalized communities who would otherwise be prohibited from receiving comprehensive health services. 

One of the most powerful elements of our robust healthcare ecosystem is the access that patients have not only to providers and quality healthcare, but to their own records and care plans as well; our philosophy and practice ensures that our patients and caretakers are part of their care plans from the outset, creating community buy-in through inclusivity and education — Speetar keeps patients and communities informed, equipped, and on board when it comes to their own healthcare progress. We take the burden of tracking off of physicians, leveraging existing networks to expound on system strengths and identify and correct weaknesses. Our healthcare delivery and monitoring system makes Speetar a powerful tool that not only reaches people where they don’t expect to be reached, but also makes it possible to keep things going once they’re off the ground.

In order to alleviate the burden of data collection and reporting on physicians, Speetar leverages existing systems. We provide inclusive healthcare delivery and monitoring by complementing, rather than “fully” replacing existing occasional in-person diagnostics. This occurs, among other ways, by using our remote visits to reduce the number of in-person consultations required (i.e. virtual pre-diagnostics, referrals, follow-ups etc), reducing healthcare costs, increasing healthcare systems’ capacity, and providing streamlined access to medical records and appointment-booking services that altogether make healthcare more affordable, safer, and more efficient. As the continual point of care throughout its entire digital health ecosystem, Speetar is able to make healthcare data reporting more simple and follow up care more targeted. 

Many people in the conflict-affected communities that Speetar operates in (e.g. our pilot country of Libya) do not have access to any care whatsoever. For these patients, seeing any specialist care provider beyond a local nurse may mean a 500 mile trip to the capital or even a flight into a neighboring country. For most, this is not financially attainable and, even if available, the trip may not be feasible as travel is unsafe due to ongoing conflict. Often these patients end up not receiving any care at all.

For those communities, Speetar has developed the “health dot” program. Speetar’s “health dots” are physical kiosks integrated with the local clinics, pharmacies, or businesses in order to complement the virtual encounter whenever an extra tele-diagnostic assessment is needed for the case. Our Health Dot locations serve as innovative data collection points training and leveraging non-physician providers to administer and collect data from vital tests bridging a crucial healthcare delivery and data collection gap. 

Our patient-to-doctor platform enables underserved patients (currently in Libya, with imminent expansion to other countries regionally) to access affordable, language/culture-matched specialists (practicing locally or abroad).

Speetar addresses brain drain and builds capacity by training local specialists and mobilizing the large Libyan medical diaspora. Our most used specialties serve senior citizens and women (chronic disease, OB/GYN) and mental health, which is a particularly underserved taboo specialty in the region. Our approach opens a new trajectory for systemic change of the collapsing healthcare systems in conflict-affected countries and equalizes access for underserved and intentionally overlooked populations, putting historically marginalized communities back on the map when it comes to healthcare data.

Of particular importance is the improvement of equitable health care access for migrant/refugee/IDP communities and women/girls. Informed by our team’s experiences (over 65% women or displaced/marginalized individuals) we architect locally owned, transformative approaches to health care delivery and monitoring. Speetar has partnered with the two national mobile companies in Libya to serve those with no data/smartphones through SMS and Health Dots (tailored remote diagnostic and treatment kiosks). We provide care at no cost to those who qualify through unique health sponsorship programs. Our platform is intentionally accessible with audio and visual features for the 8% of illiterate Libyans. These principles are key to our approach in our early stage countries like Sudan which has a similar country profile to our Pilot country of Libya. 

We recently worked with the Ministry of Health in Libya, with support from our partner UNDP to act as the COVID-19 triage and tracking system in Libya. Our triage tool focussed on viral transmission proving instrumental in the Government’s approach to addressing COVID-19 in Libya. 

In our early-stage countries like Nigeria, Somalia, and Sudan, in order to decrease out of pocket costs and high costs of travel, we aim to expand our triaging tool beyond COVID-19 tracking and tracing. This will streamline the consultation and referral process and consequently minimize unnecessary travel time and reduce time spent in hospital to only what is deemed necessary after consultation through our telehealth service. This is of particular need in countries like Sudan given that the current national facility-based disease surveillance system extends to only 40 per cent of health facilities across the country which greatly limits health monitoring capabilities. As such, our triaging tool innovation will work to absorb the role of health monitoring over time and work in tandem with our treatment and referral system to improve overall health in the long run. This powerful tool will add diagnostic indicators to our PHC measuring capabilities, widening the scope of Speetar’s novel healthcare delivery and monitoring system even further.

Our referral system currently focuses on making sure that patients have access to specialists when needed. While expanding to our early stage countries, we will address the staff shortages by leveraging the diaspora and higher concentration of medical professionals in key regions to expand our referral system through inter-hospital, international, and collaborative dialogue between providers.

The side-effect of reducing out of pocket costs and costs of care will be that available government and Humanitarian spending– a key PHC performance indicator– will be free to go toward essential health services and not only healthcare management / operations overhead. As the WHO has established, a little goes a long way when it comes to healthcare spending in developing health settings as essential health services like vaccination can drastically improve the lives of patients: in Sudan for example, only 0.69 USD per capita investment is needed to achieve one year of increased life-expectancy and even less, 0.045 USD is needed to Save 1 Under 5 Years Old Child from Premature death according to a 2015 analysis on differential spending in WHO’s Eastern Mediterranean Regional Office (EMRO).

Access to regular, quality telemedicine not only transforms the lives and opportunities of our constituents in the short term but targeted systematic data collection creates opportunity for longer-term solutions as well. 

On a human level, creating better health outcomes, investing in people and recognizing their dignity and agency has an unbound impact: from ensuring better quality of life for indigenous peoples, women, children, and other vulnerable populations to increasing economic opportunity and reinvestment in our communities, the impact is immeasurable.

Our team– our team lead included– which is 65% women and/or displaced people knows what it's like to not have access or support. We are members of the communities we serve and are intimately familiar with the urgency of Speetar's mission. That is why we built it. As such, our constituents are patients and healthcare providers, in particular the most underserved populations on the continent (in Africa) and the untapped provider network they do not yet have access to. In 2021, the Africa Health Agenda International Conference (AHAIC) found that more than 600 million people (greater than half of Africa’s population) are without access to healthcare. Among those citizens, some of the most vulnerable are in Sub Saharan Africa (SSA), where the infant mortality rate exceeds 5% and communicable diseases– largely preventable– are the leading cause of death (Falchetta 2017). Another large barrier that exists across contexts in our target region is the lengthy and costly travel often required to seek healthcare due to a lack of existing options. Since expanding beyond our pilot country, our early stage countries– including Nigeria, Somalia, and Sudan– are all among the population of SSA. Not only is PHC lagging in this region, but little is known about PHC performance, delivery, and improvement in our target countries. 

The number of physicians per 100,000 people is well below WHO’s minimum requirements for universal health coverage of 445 health workers per 100,000  people; in Sudan, the number of doctors per 100,000 was merely 54.6 in urban centers like Khartoum, the capital and only a shocking 3 doctors per 100,000 in South Darfur as recently as 2014. While the number of doctors per 100,000 people has now increased to 81 in areas like Khartoum, the disparity remains according to the most recent UN Humanitarian Needs Review of Sudan. Nigeria and Somalia follow closely in provider deficits. High-turnover rates and low retention due to armed conflict, health facility closures and brain drain as is the case in most conflict-affected countries, particularly in the region– have led to significant staff shortages as well. On top of all of this, ongoing conflict continues to put patients and physicians in danger while seeking and delivering care respectively.  The collapsing systems in these areas also lead to drastic measures from people seeking healthcare for example: India's medical tourism which has increased by 30 percent in recent years is reportedly mostly due to visitors from Nigeria and Ethiopia. As such an increasing number of patients have not been able to afford to seek treatment. 

And last but not least, also due to ongoing conflict both in neighboring countries and internally, growing populations of refugees, displaced people, and internally displaced people are added among the population of people violently excluded from accessing proper health care. All of these factors add up to populations that have not only been subject to erasure in practice grace a ongoing conflict, systemic disparity, and deep levels of inequity, but also again subject to erasure on a global scale: relegated to the periphery of international agendas, who we serve are those who are most vulnerable, the historically marginalized and forgotten among us. Through Speetar, we aim to put our constituents back on the map both in practice through healthcare delivery and in terms of achieving UHC through our health record systems. As we work to build access to quality care with continuity in contexts that have historically been deemed too risky and/or not lucrative enough for modern healthcare solutions to operate in, we leverage data to improve performance provide, improved measurement methods, and work with local communities every step of the way to understand healthcare in their context, adjusting and improving systems one step at a time. 

The issues laid here disproportionately affect indigenous people, displaced people and women, especially women of reproductive age. Currently, nearly a quarter of healthcare facilities in Darfur, Sudan for example are not functioning and nearly 30 percent of refugees are without access to primary health care services while those who do have access are routinely charged higher fees than Sudanese nationals. Similar disparities abound across the region.

Our Telehealth solution will enable our vulnerable, hard-to-reach communities/target audience to access quality/specialized care that otherwise requires thousands of miles of dangerous, costly, and burdensome travel. Amid active conflict, these challenges have caused many to defer care or not access care at all. In settings like these, preventive care is almost entirely inaccessible.  

By renewing our focus on strengthening our service delivery and monitoring capabilities and expanding our triaging tool, our innovation will protect the health of vulnerable populations while providing the tools necessary to strengthen and refine existing PHC performance. It will 1) reduce unnecessary travel, 2) streamline point of care processes for providers and 3) ensure that, if travel is required, patients will not be refused care at their destination as we’ve been able to demonstrate in Libya through our viral transmission-focused triaging tool during COVID-19.

For patients, shorter wait times, lower costs, and centralized medical records will promote earlier diagnosis, better treatment outcomes, and accessible follow-up care. The efficiency and collaborative approach of our innovation will build capacity and allow for holistic care for our providers. 

Complementing its direct service delivery, Speetar creates a sustainable Telehealth infrastructure and communal literacy to establish a more equitable system. Facilitating new streams of systemic investments in marginalized communities and driven by inclusive data collection and incentives (e.g. through government partnership, Speetar provided COVID-19 support and care for previously overlooked populations in Libya and similar work can be done in Sudan looping in B2NPO partnerships). The inclusivity of the healthcare monitoring system will upscale the data collection process in protracted vulnerability situations providing important insights not only on the individual patient level but on the community and societal level as well, laying the framework for PHC performance improvement on the road to UHC. 

End-state PHC performance improvement in an equitable fashion will improve the lives of millions without healthcare access or who have to travel exorbitant distances to see a doctor– an issue that currently disproportionately affects people in protracted vulnerability situations (e.g. displaced people). Our solution also has particular implications for women: from improving access to family planning tools & making it possible for women to meet at least the minimum requirement of four antenatal care visits during pregnancy to providing proper CRM in relevant contexts. The benefits of our innovation will potentially go beyond health as well, benefiting all vulnerable communities including the elderly by reducing the burden on patients and providers through increased economic opportunity and community reinvestment in health in general.

My family escaped to Yemen when I was only one year old as we fled the brewing conflict in Sudan that would later become the Darfur Genocide. From Yemen, we came to the US on the Visa lottery where I saw my parents work to recreate a life for us here, heal from the trauma of escaping the war, and work to end the violence back home as our family members perished. Growing up in Philly as an indigenous African woman, I came to realize that it isn’t enough to end literal violence, but we must address the deeper systemic, structural violence if there is any hope for lasting change. It isn’t enough to stop destruction, but we must also rebuild if there is any hope for a return to peace, to safety, to home; if there is any hope of reversing our continued erasure. Finding refuge in education and healthcare advocacy work, I’ve worked to foster and facilitate the inclusion of historically marginalized voices in every aspect of my work. 

Whether it’s the Sickle Cell Organization I co-founded at age 19 which served the marginalized, indigenous Tharu population in Nepal or my continued work with UNHCR as a Goodwill Ambassador, My passions are deeply rooted in uplifting our communities across contexts. Having personally lost many family members not only to the genocide but also to the collapsing health system in Sudan– as recently as this January 6th, we lost my great uncle, he’s buried in Hydrabad where he was forced to seek care due to a lack of access in Darfur and Sudan at large– I am intimately familiar with the problem we are aiming to solve. Having lived a life deeply informed by loss, by grief, but also by hope, I can firmly say that the honor of serving our communities on a team led by people from our communities is something I never knew I would live to see. My hope is to see this mission through, addressing the needs of our communities and opening the door to a drastically improved quality of life, reversing the decades of erasure both in practice and on paper that our communities have endured.

At Speetar, there is no greater resource than our people, with their extraordinary collective talent, vision, and experience. Our forward-looking, dynamic and diverse leadership team of dedicated medical providers, engineers, and business leaders, bring 50+ years of professional experience in global health access and social innovation, with a proven track record spanning across leading tech, nonprofit and humanitarian organizations such as Harvard Medical School, MIT, UNHCR, WorldBank, Google, Walmart Ventures, and the Danish Refugee Council. 

Our CEO and Speetar’s founder, Dr. Mohamed Aburawi, for example grew up amidst Libya’s tribalist dictatorship, spurring a passion for equity. When war broke out in his final medical school year, Mohamed mobilized ad-hoc teams to organize frontline clinics for the many civilian casualties. This experience informed both Speetar’s foundation and today’s progress: 90+% of Speetar’s team are local care providers who gained a thorough understanding of the health system and patient demographics during protracted conflict. They were and continue to be on the frontlines of systemic change only this time around, we are with them, sharing the burden of change, lifting some of the pressure of bridging the healthcare delivery and data gap in crumbling health systems.

Many organizations parachuted in (and out) during the wars in both of our countries. Our team thus works to highlight that those most impacted are the most informed and have unique credibility, networks, and experiences to create sustainable change. Change that is not only people-centered, but also powerfully and efficiently informed by data and insights derived from the ease of access to our growing healthcare monitoring tool. 

Finally, Speetar’s local ownership focus, KPIs, and staff composition (53% women leadership) are an inclusive reflection of Speetar’s partner communities; e.g. Speetar’s most effective teams comprise local practitioners, mental health patients, senior citizens, and displaced people and I can’t say enough how meaningful it is to be a part of this.

The value of thought leadership cannot be understated when it comes to creating solutions of value in areas of pronounced need and deep complexity. Our team knows this personally and professionally with our histories and expertise speaking across cultures, sectors, and experiences. For this reason, and because we are intimately connected to the needs we hope to address as well as the people we hope to serve, MIT and the Bill and Melinda 

Gates Foundation’s partnership appeals to every aspect of our future plans. Not only are we aligned with MIT and the Gates Foundation’s joint mission of spreading access to lasting technology based solutions from diverse tech entrepreneurs to “address the world's most pressing problems”, but we also share their multi-faceted and interdisciplinary approach to changemaking. Having Access to MIT’s global network of experts who deeply understand the unique challenges we face working in high risk areas with limited resources will be instrumental in achieving our goals in the coming years– allowing us to innovate even more effectively with best practices in mind. 

As a global thought leader and global health expert organization with access to multiple innovation partners and a global network of changemakers, the Gates Foundation’s partnership and guidance in expanding our technical expertise and amplifying our data reach would help us leapfrog our target communities toward better health outcomes efficiently, effectively, and innovatively. 

What’s more, the Gates Foundation’s expertise in effecting social change will help us take our solution to the next level– beyond the individual, community, and national context and onward to the societal context. With MIT’s support in turn, a move in this direction will allow us to bring the people we serve up to speed in terms of healthcare data and progress in the international context (i.e. ensuring our PHC indicators remain translatable as the global health community’s targets and approaches evolve). After all, UHC is a global goal and without concerted and targeted efforts on every level, the most vulnerable populations will continue to be violently excluded.

In fact, we ourselves are a team of changemakers first and foremost, addressing the systemic oppression our communities face in our own way as individuals and through our innovation as a team. For this reason, the community of fellow entrepreneurs we would access through this opportunity, in-kind support from industry experts, and access to the larger MIT and Gates Foundation support systems will prove invaluable to our process as we aim to complete our ultimate mission: bringing quality health care access to all. 

The guidance the MIT and Gates Foundation partnership provides as well as the access to new partners will help us develop further our innovations expanding the capacity of Speetar as a data tool to inform PHC performance improvements that are fit for purpose and targeted towards achieving UHC in our target populations. This partnership opportunity would bolster our capacity to deliver, monitor, manage PHC and continue to inform health policy by fostering and facilitating the inclusion of marginalized voices in healthcare planning and backing it with data. As our capacity to share a larger portion of the burden of managing collapsing health systems grows, the capacity of our providers to focus on treatment and not expend resources, time and energy bridging healthcare delivery and data gaps without any support will grow in turn. 

With access to other mentors and experts who also know what it means to bring quality solutions to vulnerable populations, we will no doubt make incredible strides toward our goals as our knowledge base grows and our capabilities transform through this partnership. Further, our MIT student roots as a company, our recognition from MIT Legatum Center, and the humanitarian global health roots in our leadership will only evolve with this new partnership of MIT and the Gates Foundation as we move from a group of student innovators to a group of industry disruptors. 

Finally, as an activist, advocate and author with a background in Anthropology and Molecular, Cellular & Developmental Biology as well as a Certificate in Global Health I operate at the intersection of the humanities and sciences, often bringing together humanitarianism, health and advocacy in support of my work. In the past 6 years, this work has often come in the form of my role as a Goodwill Ambassador for UNHCR, the UN Refugee Agency. In this role, I continue to help grow and uphold strategic partnerships with communities, sponsors, universities and more; advocate for refugees, meet with stakeholders, decision-makers, fieldworkers and families on the ground; and contribute to the evolution and representation of UNHCR’s message on a global scale, helping raise millions in funding for refugees the past 6 years. Now as a member of Speetar’s executive team, I’ll be able to bring what I’ve learned thus far and transform it into something more if given the chance to be in partnership with MIT and the Gates Foundation to improve PHC performance measurement on the road to UHC. At this point in Speetar’s journey and my career as well, MIT and the Bill and Melinda Gates Foundation’s support would be invaluable.

Speetar’s community-centered ecosystem, design, and implementation methodology is at the heart of Speetar’s approach to telehealth delivery and monitoring and truly distinguishes Speetar’s innovation. Speetar, led by Libyan medical practitioners who worked for years at the Civil War's frontlines, reflects the needs of the population it serves and is co-architected by the community. Built with quality, access, continuity and above all equity in mind, this landmark innovative approach will be applied as we expand in our early stage countries as well with our team lead not only being experienced in fieldwork in the region as well as refugee and IDP advocacy, but also herself is an Indigenous Darfuri woman with family members in the most affected regions. Her experience and personal ties to our constituents deeply represents our pedagogy at Speetar: promoting ownership in our communities and advancements in health led by the people for the people as we facilitate the inclusion of marginalized voices in every aspect of our work, from research to point of care. In other words, our solution addresses decades of erasure, platforming and including the most vulnerable among us when modern healthcare solutions tend to reinforce erasure instead, deepening existing barriers (e.g. expensive solutions geared toward higher income populations, high-bandwidth solutions inaccessible to people in remote areas) when our system works to remove them. We go the extra mile, meeting patients, providers, and entire communities where they’re at.

Many people in the conflict-affected communities that Speetar operates in (e.g. our pilot country of Libya) do not have access to any care whatsoever. For these patients, seeing any specialist care provider beyond a local nurse may mean a 500 mile trip to the capital or even a flight into a neighboring country. For most, this is not financially attainable and, even if available, the trip may not be feasible as travel is unsafe due to ongoing conflict. Often these patients end up not receiving any care at all.

For those communities, Speetar has developed the “health dot” program. Speetar’s “health dots” are physical kiosks integrated with the local clinics, pharmacies, or businesses in order to complement the virtual encounter whenever an extra tele-diagnostic assessment is needed for the case. Our Health Dot locations serve as innovative data collection points training and leveraging non-physician providers to administer and collect data from vital tests bridging a crucial healthcare delivery and data collection gap.

Speetar’s “health dots” are physical kiosks integrated with the local clinics, pharmacies, or businesses in order to complement the virtual encounter whenever an extra tele-diagnostic assessment is needed for the case. Each Health Dot includes a micro-partnership with a local clinic/health affiliate in the target area. While these local health clinics do exist, they are drastically under-resourced and, with few exceptions, do not have any doctors on site. Speetar delivers dedicated training to local responsible community healthcare practitioners or “affiliates” to act as access facilitators, educators for patients to consult with the wide range of doctors and specialists available on Speetar’s digital platform, and data collectors. 

The training of the affiliates combined with the resources of the Health Dot (i.e. expensive internet access, selected e-diagnostic tools tailored to complement existing on-site services, data collection, record-reporting and monitoring capabilities), the Health Dot infrastructure overcomes the current access barriers for communities who are violently excluded from healthcare access and are also affected by the digital divide. Our affiliate training system is instrumental in alleviating many of the burdens both patients and physicians face in adverse conditions.

What’s more, Speetar’s Telehealth solution (full IP ownership) combines language- and culture-matched design with a tailored focus on conflict-affected markets shaped by low financial/health/ technological literacy; restricted connectivity, as well as complex governance and risk environments. We embed our technological innovations in a community-owned approach, creating a programmatic architecture centered on local ownership and multi-stakeholder partnership. We architect an equitable, sustainable, innovative transformation of health systems in conflict-affected countries to manage capacity, effectively triage and reduce viral transmission. Our community-ownership approach creates buy-in from patients, caretakers, and communities which strengthens our solution’s ability to deliver on progress. Because our language and culture-matched approach ensures that communities are part and parcel of what we do, our data-backed insights into health system performance improvement is people driven, people centered, and uplifts the voice of the people. We don’t only give our constituents a powerful point of care, but we stay in dialogue with our patients, providers and other stakeholders through our feedback routes (e.g. ratings, reviews, dialogues and more). In this way, we can identify strengths and address weaknesses both in existing systems and in our own healthcare delivery and monitoring work. 

Backed by data, affected populations, providers, and caretakers, we have been and continue to be able to garner support and buy-in from governments and ngos when informing policy changes/changes to health systems approaches. A key example of this achievement is our roll out of the entire UNDP-backed, Ministry of Health-approved Covid 19 response in Libya during the height of the pandemic, fully created by Speetar in partnership with key stakeholders. We’ve reached 1.8 million people to date.

Traditionally, in conflict-affected communities, few alternative approaches exist to sustainably address the healthcare collapse amidst insecurity, fragmented governance, and resource scarcity. 

Complementing insufficient humanitarian aid patchworks, few Telehealth providers typically operate in these high-risk markets; where they do, they, like medical tourism companies, focus on high-income patients. None of these current approaches address systemic inequities or leverage diaspora resources. 

Neglected by the market, vulnerable and conflict-affected communities stand to benefit most from Telehealth since they are most impacted by expensive/dangerous travel to receive healthcare - and often end up receiving no care at all. Without care they are in turn essentially made invisible to the global health system– excluded from PHC delivery and data collection.

The introduction of Speetar’s Telehealth services constituted a breakthrough in the Libyan healthcare ecosystem and will be completely transformative in our early stage countries’ – Sudan, Nigeria, and Somalia– healthcare ecosystems.  Regionally and globally, Speetar’s design, community-led approach and systems change rooted in conflict-affected countries’ complex realities, is proven and unparalleled. 

By strengthening our triage and referral system we will add more diagnostic indicators to our measurement capabilities and establish and bolster a patient and provider network through our services in a way that mitigates risk for our people on the ground. In this way, our work will free up frontline health workers from the burden of playing every role in a healthcare ecosystem from delivery, to data collection, to monitoring and more. When we do our job, our providers are free to focus on treating their patients, our patients are free to focus on healing, and quality and continuity of care increases.

Impact Metrics

One-year target:

• 200,000 new acquired users with a retention rate of ≥30%, with each of them having at least one paid consultation.

• On-board ≥1000 physician providers, ≥ 2,000 non-physician providers, and ≥5,000 healthcare affiliates

• Cover ≥5 new medical specialties (we currently cover 40+ specialties in our global Speetar provider network)

• Setup ≥4 patient sites in 3 early stage countries: Somalia, Nigeria, and Sudan

Five-year target: 

• 5 Million acquired users with a retention rate of more than 60%, with each of them having at least two paid consultations.

• On-board ≥2,000 providers. ≥ 4,000 non-physician providers, and ≥10,000 healthcare affiliates

• Cover ≥15 new medical Specialties.

• Setup ≥20 patient sites in Sudan, Somalia, and Nigeria

Breakdown down:

1. Healthcare delivery and monitoring platform development/optimization

2. Sales and Marketing

3. On-ground patient treatment and healthcare data collection sites

The immediate impact of the 12-months period will be providing direct and, beyond the project period, sustainable, scalable healthcare access to an estimated 200,000 individuals in vulnerable communities in the rural, politically marginalized Darfur among other areas in our target countries of Sudan, Somalia and Nigeria, with statistically significant improved health and financial outcomes for beneficiaries.

Following an adjusted model of Speetar’s scale-up plan, the desired impact will require an investment in (1) offline marketing, (2) financial/health/tech literacy (3) the creation of “Health Dots,” with on-site diagnosis technology, internet hotspots, healthcare record reporting and monitoring tools and (4) the expansion of Speetar’s triage and referral system through research and product development to add diagnostic indicators to the vitals and standard healthcare records in our monitoring system. Each Health Dot features a micro-partnership with a local, under-resourced clinic/health service point in the target area. The training of the affiliates combined with the resources of the Health Dot (i.e. internet access, data collection), the Health Dot infrastructure overcomes the current access barriers for Speetar’s comprehensive adoption in Nigeria, Sudan, and Somalia. 

Longterm

Speetar will deploy the scale-up plan through its existing and growing partnership ecosystem: 

1) Key international stakeholders: Speetar has closely partnered with UNDP; complementing other engagements (i.e., GIZ, Japan MFA), this partnership will look to leverage UNDP’s previous central role in rebuilding Libya’s health systems to create inroads into Sudan’s humanitarian infrastructure. .

2) Clinical partnerships; business partnerships with local clinics and pharmacies as well as a growing number of non-physician providers and healthcare affiliates. 

3) Pre-existing relationships with local Indigenous and IDP populations among the vulnerable constituents we aim to serve

4) Knowledge partnerships. Strategic, technical, and evaluation support through Speetar’s partnership ecosystem with Harvard Innovation Labs and MIT Legatum Center and if given the opportunity, MIT Solver Network and the Bill and Melinda Gates Foundation support networks.

5) Track record: through partnerships and healthcare roll-out initiatives akin to our UNDP-backed and Ministry of Health Approved Covid 19 response roll-out in Libya, we will establish Speetar as a go-to solution and information source for patients, providers, stakeholders, policy makers, community leaders and more when it comes to improving healthcare delivery, monitoring, PHC performance, and access to quality care with continuity.

Complementing Speetar’s overall KPIs framework and impact measurement efforts (quantitative and qualitative data collection), Speetar will develop a project-specific methodology for internal monitoring and evaluation of the project, presented at the end of the inception phase. For this purpose, Speetar will contract an external and independent Monitoring and Evaluation Consultant who, jointly with Speetar’s Chief of Staff, will be responsible for the Monitoring and Evaluation of the project and associated data gathering. Speetar will additionally leverage its existing support networks at MIT and Harvard University to support impact monitoring and evaluation. 

The monitoring of the project will be based on the final logical framework indicators annexed to the project inception report. This log-frame will include indicators measuring health, financial, awareness/education, healthcare access benefits, and broader systems-change impacts. It will provide a clear, measurable definition of project success in line with the project’s stated objective of increasing inclusive and sustainable healthcare access to vulnerable, hard-to-reach groups in Sudan.  

There will be one inception meeting during which Speetar will outline a baseline for the project and against which we can measure progress. The Monitoring and Evaluation Consultant will oversee the baseline, midline, and endline data collection (implemented by local Speetar staff) and synthesize the data, corresponding findings, and applicable proposed adjustments in a mid-term evaluation and a final evaluation. KPI data (i.e., enrollment numbers and satisfaction) will be captured and presented monthly. 

Healthcare providers, healthcare recipients, local community stakeholders, regional and national healthcare stakeholders will collect quantitative and qualitative data on-site in the target areas and virtually (i.e., through the Speetar platform). 

At the end of the project and following the final evaluation, we will convene a “lessons learned” workshop for the final assessment of project impact and progress. We will outline the findings in our Final Report.

At Speetar, we believe data that does not fully represent the population will only lead to solutions that do not fully include the population thereby reinforcing existing disparities. As such, inclusive data collection is instrumental in achieving better health outcomes and PHC performance improvement. With that same notion of inclusivity in mind, we believe in a holistic and collaborative approach to care– partnering with communities, working to deliver equitable access to quality care, putting historically marginalized communities back on the map when it comes to UHC because we are aware of and sensitive to the unique needs of communities facing health crises after conflict and continued erasure (both in practice and in data). 

Our ambitious telemedicine service was born at an MIT Media Lab class by founders from MIT and Harvard Medical School. Speetar redesigns healthcare delivery by providing cultural-language matched high-quality specialty care for patients in underserved regions needing medical diagnosis and follow-up, through an advanced telecommunication platform that allows patients to reach remote skilled specialists practicing within their country or abroad. Our robust healthcare record and monitoring service streamlines reporting and review of patients’ health indicators, histories, updates, and testing records. Our secure, easy access database and our provider network makes it possible for providers to communicate and share data through our treatment and referral system to design patients’ follow-up care more effectively and efficiently. We firmly believe that inclusive, streamlined data collection that doesn’t exclusively rely on physicians is not only instrumental to achieving better health outcomes on the individual level, but is also the key to creating improvements on the community and societal level in the future.

Matching culture and language, we provide care that is sensitive to and representative of the communities that we serve. We improve care by improving access and ensuring patients are seen by appropriate & qualified providers at the right time and setting to receive high quality, convenient & affordable care with accurate, easy to access, securely share, and utilize records. 

On a macro-level at the intersection of peace and health, multiple studies show that if individuals/groups enjoy equitable access to health services fulfilling their rights to physical and mental health AND health actors design health interventions (informed by affected populations and backed by data) that promote trust and dialogue AND communities are empowered to cope with violent conflict; THEN health coverage is universal, grievances can be heard and addressed to generate trust around emergency health concerns, affected communities are more likely to make meaningful contributions to peace and reconciliation, and resist incitements to violence (WHO Theory of Change underpinning Health and Peace). As such, our technology provides patients with immediate access to quality and secure healthcare while also recognizing the unique needs of people living in active conflict and leveraging diaspora and other language and culture matched physicians to support the national demand. 

Positive user evaluations during our Pilot in Libya underscore Speetar’s strong growth rates and app stores ratings (4.7 in 1299 reviews on Google and 4.6 in 121 reviews on Apple) as well as quantitative surveys showing an outstanding Net Promoter Score of 91.7%, a Telemedicine Satisfaction Questionnaire score of 79.25% (Journal of Telemedicine and Telecare peer-reviewed methodology) and Patient Trust Assessment Tool score of 77.93% (BMC Medical Informatics and Decision Making peer-reviewed methodology). 

Beyond Speetar’s early success in achieving broad adoption for digital health solutions in the context of COVID-19 triaging, independent research shows the need and interest of people in Libya and other conflict-affected countries in telehealth. In 2017, volunteers conducted nationwide market research in Libya in partnership with the University of Tripoli and the Ministry of Health, surveying 17,000 Libyans. The analysis revealed that 40% of respondents had traveled abroad for health-related reasons, 68% of which were seeking medical diagnosis and follow-up care. Over 90% of those surveyed were willing to try telemedicine as an alternative option to travel. In another study (Elhadi M. et al. (2021), Utilization of Telehealth Services in Libya in Response to the COVID-19 Pandemic: Cross-sectional Analysis. JMIR Med Inform. 2021 Feb 26;9(2)), interviewed 2512 respondents in Libya. 1546 (61.6%) participants reported they experienced problems covering medical costs and 1429 (56.9%) avoided seeking medical care owing to financial concerns. Regarding the feasibility of the telehealth system, approximately half of the participants reported that telehealth services were useful during the COVID-19 pandemic, and 1545 (61.5%) said that the system was an effective means of communication and obtaining health care services. This data further demonstrates the need and willingness of Speetar’s target population to use its service and the effectiveness of our Theory of Change.

Our Flagship Doctor-Patient Telemedicine Platform 

Using a simple web/mobile app, participating specialists set up a professional account which includes their qualifications, field of expertise, and availability. On the other side, patients will create an account, enter their chief complaint and request an appointment with an available specialist. When a request is received, the practitioner can accept the patient, reject the request or refer him/her to another available specialist who is better suited to respond to the specific complaint.  

Before seeing a patient, consulting physicians are given access to a cloud-based electronic health record containing the patient's medical history presented in a standardized format, including uploaded up-to-date medical reports, lab results, and radiology images. If needed, additional relevant tests/images can be pre-ordered. Patient records for first time users are collected during their initial consultation including important vitals and test results that providers can pre-order. Using our affiliate system, patients are not turned away at the point of care as their nearest point of care and all required elements are organized through Speetar before patients even leave their homes/during their initial consultation. 

The standardized record system and ability to update and review patient records through the platform gives providers access to key PHC indicators that inform care plans for each patient over the course of their lifetime. The availability and accuracy of the data, its security, and inclusivity as well as the option to freely share the data between providers for the sake of the patients care (and in line with HIPAA regulations) makes out health record system not only convenient, but also crucial to ensuring quality and continuity of care.  In absence of local regulation, Speetar is made to comply with the U.S. HIPAA Privacy Rule which provides data privacy and security provisions for safeguarding medical information. 

If a patient request is accepted, the system will automatically confirm the appointment. If any tests, procedures or follow up are needed, Speetar directs the patient to the closest HealthSpot, where the consultation can be conducted via high definition video conferencing. HealthSpots are designated service sites equipped with advanced telemedicine diagnostic devices and supplied with broadband internet connection. These sites will have a junior medical trainee present to perform essential physical exams and resolve technical issues.

The scheduling system is strict. Appointments are restricted to the available date/time slots, patients abusing the system will be rejected from rebooking (unless a valid reason is provided). A physician can conduct the virtual consultation anywhere where there is a reliable internet and privacy.

Understanding the sensitivity of the health-related data being transferred especially in relation to psychiatric care, reproductive diseases, sexual disorders and other culturally sensitive issues, special effort has been taken to ensure privacy and confidentiality of patients is maintained at all times. In absence of local regulation, Speetar is made to comply with the U.S. HIPAA Privacy Rule which provides data privacy and security provisions for safeguarding medical information. 

The data is protected from hackers and attackers not only while in transit, but also while stored on our servers and databases. We will utilize industrial-strength 256-bit SSL/TLS encryption on all connections as well as NSA standard AES-256 encryption for data at rest, along with strong firewalls and multi-level access checks.

In-Depth Technological Solutions

As Speetar's platform integrates the patient-doctor mobile app and web browser platform (both fully developed and tested at scale), we offer the following use cases to patients. None of these services would otherwise be accessible in Libya's current healthcare crisis nor applicable in Sudan’s health crisis as we move forward:

- Digital patient engagement and outreach tools that health workers, home care workers, and providers can use;

- Responsive healthcare provision during conflict or in rural and marginalized communities;

- Centralized, secure, and accessible health data that can be reviewed and updated with ease, accessible to patients and providers;

- Tele-consultation and care coordination platform based on personalized care plans;

- Collaboration tools to help health organizations manage chronic diseases in diabetes, heart diseases (e.g., CHF), mental health (includes specialists, treatment planning processes, and care coordination tools);

- Real-time health outcomes and health service process metrics to enable ongoing improvements in care delivery and patient satisfaction, all digitized and added to the patient record system;

- Early detection and treatment planning of serious ailments with physician consultation, e.g., cardiovascular issues such as congestive heart failure (CHF);

- Diagnostics informed by diagnostic indicators and patient histories + records available in the digital record system;

- Facilitates referral appointment scheduling with physicians/hospitals;

- Track and trace disease outbreaks and integration into the government's disease control, prevention, and triage systems. 

Speetar provides these services by leveraging the following technological features (all natively developed, customizable, and fully IP-owned by Speetar):

(1) Speetar provides an ability to connect patients and doctors through scheduled appointments or instant consultations;

(2) The advanced consultation system allows patients and doctors to conduct medical sessions through text, audio, video, or phone calls to account for scenarios where users have limited internet access. Speetar's system leverages AI to detect anomalies in internet connectivity and upgrades or downgrades audio and video quality to provide a seamless experience to the users;

(3) State-of-the-art real-time instant consultation feature allows patients and doctors to connect in real-time. Powered by a highly robust and scalable messaging and queuing system, the platform enables doctors to be more productive and patients to have minimal wait times; All the while, providers have ease of access to digitized records, test results, vitals, and diagnostics and can update the patient’s records in realtime. 

(4) Advanced scheduling system allows Speetar to review doctors' schedules in real-time and filter out any incorrect or no-show appointments. Speetar uses advanced data science, machine learning, and AI techniques to detect erroneous or no-show appointments. This increases the overall productivity of the doctors and their revenue;

(5) Leverage AI and Machine Learning techniques to triage patient complaints and match them to the correct specialty and the most appropriate care based on their health records and concerns.

Reception of our Technology to date

Following an initial test and product development phase (2019-2020), Speetar powered Libya’s CDC and MoH’s COVID-19 triage and information center as part of Libya’s National Response Plan (2020), serving 1.8+M beneficiaries across the country. In Q1/2021, Speetar launched the commercial pillar of its social enterprise operations. Since then, active (commercial) users of Speetar services (direct beneficiaries) have grown 61.66% in Q2 and 105.74% in Q3 to reach 12,526 as of October 2021 (including more than 4659 female users). Telehealth consultations conducted through Speetar grew 1300% in Q2 and 322.22% in Q3 to 532 consultations in October 2021, mirroring a similarly rapid growth of doctor’s availability 127.41% in Q2 and 518.57% in Q3 to a total of 1899 monthly hours (248 doctors across 38 specialties). 

Positive user evaluations complement these strong growth rates on the app stores (4.7 in 1297 votes on Google and 4.6 in 121 reviews on Apple) as well as quantitative surveys showing an outstanding Net Promoter Score of 91.7%, a Telemedicine Satisfaction Questionnaire score of 79.25% (Journal of Telemedicine and Telecare peer-reviewed methodology) and Patient Trust Assessment Tool score of 77.93% (International Journal of Medical Informatics peer-reviewed methodology).  Qualitative key informant interviews conducted with care receivers and providers underscore that doctors and patients find a high degree of utility and benefit in Speetar’s service against the backdrop of conflict and pandemic impacts.  

One example of our early impact metrics is the significant improvement of diabetic patients outcomes-- due to our delivery and measurement capabilities-- (evidenced by their Hemoglobin A1C levels as treatment compliance) residing in Libya’s predominantly low-income southern districts. Coupled with more frequent follow-up (type 2 DM patients need to see their doctor on average four times/year), lowered health care costs (they no longer had to travel for continued care) led to much tighter control and maintenance of their blood sugar. By keeping track of both a vital and diagnostic PHC indicator, we were able to improve healthcare outcomes for our patients and inform their treatment plans.

Beyond the testimonies and impact data shared in the proof-of-concept section, this is particularly clear from Speetar’s work with the Ministry of Health in the national COVID response. Speetar partnered with the Government, with support from UNDP and others, to be the triage and tracking system for COVID-19 in Libya. Speetar is also building infrastructure to create a more equitable system that supports inclusive data collection. Due to our partnership and advocacy, the Government is actively investing more resources in local clinics and investing in expanded technologies (a decision accelerated and increased due to the COVID pandemic). This serves millions who previously had little to no local healthcare access or had to travel 12+ hours to the capitol to see a doctor (a privilege reserved for those capable of paying). It has particular implications for women and the elderly. Our model not only works on the individual level, but on the community and societal level as well.

From the inception, our solutions in the field are always contextual. We work closely with local practitioners, local leadership, and the community including patients and healthcare stakeholders to understand what is currently locally accepted and expand or bolster existing capabilities. In our most remote areas, the first point of contact for PHC is not a hospital or clinic, but often a pharmacy. Our healthcare affiliates program and * “Health Dot” initiative are built with this in mind. As such, our training program leverages pharmacists, community healthcare workers, and other affiliates to fill gaps in healthcare delivery and monitoring. Vitals, physicals, PHC tests and check-ups are often done through our affiliates who in turn collect patient PHC data and inform their continuity of care through our treatment and referral system. This makes it possible for physicians to focus on treating patients and contribute to health record data during their own consultations as opposed to building a patients entire PHC record and history from scratch.

In our experience, the best way ensure that our patients are equipped with the tools they need not to be turned away at the point of care nor excluded from important PHC data collection initiatives is to forge partnerships with local practitioners, pharmacists, and pharmacies to determine what is locally available as a standard of care and expound on the existing system through policy changes we co-architect with local leadership and communities. 

For example, in Libya, many certified unemployed medical physicians work in pharmacies to help in making ends meet. More often than not, patients seek medical consultation from their local pharmacies where physicians offer primary care. Speetar has been able to leverage this situation by partnering with 30 pharmacies in the western region of Libya, and 10-15 pharmacies in southern Libya e.g., Ghat, Sebha (located in the project’s target regions, these pharmacies will be leveraged through focussed engagement during the inception and implementation period). Through this partnership, Speetar had posters and brochures disseminated throughout these pharmacies where patients seeking medical consultations from specialists or health providers to administer invasive medication learn about the telemedicine and home care services offered by the Speetar platform. Patients are also guided by pharmacists on how to download and use Speetar’s mobile application (e.g. book appointments, make payments, etc.) and during consultations and other health interventions their data is efficiently, securely, and accurately collected for the use of their future and follow-up care. All the while, patients have access to their own records and providers are able to share the information between providers through the treatment and referral system for the purposes of follow-up care.

Speetar’s most recent project with the pharmacies is the e-prescriptions project. Speetar is working on integrating the inventory management system of these pharmacies. Once patients who are using the Speetar application for medical consultations are prescribed medication, they will be automatically informed on the availability of the medication in their nearest local pharmacy partner pharmacy and equipped with the proper prescription.

As we build on, we will work closely with local leadership and affected communities as we’ve done in Libya to co-architect policy changes that allow for ease of access for patients and help streamline the administrative aspects of care for practitioners. Not only will we look to our pharmacist programs, but we will build on our existing healthcare affiliate programs to reach and train more non-physician providers and community health workers to fill the data collection and reporting gap. Not only will our healthcare affiliates collect vitals and administer tests + checkups, but they will also help to bridge the access gap when it comes to care. In this way, we’ll address healthcare delivery deficits and healthcare data gaps in a powerful way, informing PHC performance improvement on the road to UHC. Together with our healthcare affiliates and providers, we will continue to lift barriers and allow our affiliates and doctors to work closely with other local practitioners to fill any gaps, including through our health dots.

Finally, in our work we continue to connect local and regional healthcare providers as well and where we identify gaps in access, we will combine our healthcare affiliates and referral system with our home-care service and figure out a solution that is fit for purpose for the given context, collecting PHC data in even more innovative ways. Our solutions are not one size fits all, but rather co-designed from the ground up with local practitioners and communities. 

By forging partnerships with both practitioners, appropriately licensed pharmacists, and healthcare affiliates to share the burden of PHC data collection and healthcare delivery, we expand the capacity of individual physicians directly and the entire healthcare ecosystem implicitly, making it possible for patients to get the care they need without undue strain to neither patients, affiliates, nor providers. 

*Each Health Dot includes a micro-partnership with a local clinic/health affiliate in the target area. While these local health clinics do exist in some areas, they are often drastically under-resourced and, with few exceptions, do not have any doctors on site. Speetar delivers dedicated training to local responsible community healthcare practitioners or “affiliates” to act as access facilitators and educators for patients to consult with the wide range of doctors and specialists available on Speetar’s digital platform. The training of the affiliates combined with the resources of the Health Dot (i.e. internet access, selected e-diagnostic tools tailored to complement existing on-site services, record-reporting and monitoring capabilities), the Health Dot infrastructure overcomes the current access barriers for communities who are violently excluded from healthcare access and are also affected by the digital divide. Our affiliate training system is instrumental in alleviating many of the burdens both patients and physicians face in adverse conditions.

We often overlook local leadership, yet, in conflict, it is local leaders who implement ideas, and it's through their amplification and cultivation that communities are sustained. I have experienced this firsthand when all we have to fall back on is ourselves. When we reference peace, it is often viewed as the absence of conflict. In reality, peace is about how many schools are established, how many companies can thrive, the exchange of knowledge, and the appreciation of dignity. This has been a critical component of our theory of change. That it is only with and through our community that healthcare can become sustainably accessible and improve consistently with time. 

We co-design research and programs at the inception phase because local practitioners best understand how to access their communities (particularly important in politically maligned/ under-resourced or where tribes and families maintain and hold access and power). Our constituents/partners co-build programs, advocate local authorities, and create and refine forms of awareness-raising. 

Our staff is a reflection of the communities we work in, is known to them and trusted by them. For example, one of our most effective teams is composed of local practitioners, mental health patients, senior citizens, displaced people, and women. This has been critical because team members reach into their respective communities advocating for our constituents and for Speetar. 

Our projects to date have all adopted this approach:

Libya: Partner to Libyan MoH and CDC to create: (1) national COVID-19 triage process, (2) sustainable telehealth ecosystem, communicating to a very technological-averse population the merits of centralized health services and data (incl. partnering with pharmacies and women/youth organizations), (3) previously non-existent electronic blood delivery system, (4) national registry portal where healthcare providers verify credentials.

Jordan: Community of local doctors and specialists are enrolled to provide telehealth services to Libyan customers. By the end of 2022, service offers to Jordanian patients will be provided as well.

Egypt: Speetar partnered with Egyptian digital healthcare company Smart Doc to launch the “Yashfii” telemedicine platform, recognized as one of the top 3 companies at the Egypt Pandemic TechHack (currently scaled to help combat COVID in Egypt).  

Syria: Speetar initiated a COVID19 related project in partnership with the Syrian Expatriate Medical Association to create a primary tool for health screenings and tracing.

Further, we incorporate beneficiaries through direct feedback lines via mobile, radio, and social channels to ensure we iterate, refine and measure impact in partnership with communities. Our KPIs incorporate communities’ perception, local ownership, patient experience, and have specific inclusion criteria.

This is reflected in our team (53% women leadership and 65% women and/or displaced/marginalized individuals with regional representation and consensus-driven decision making), and in how we recruit board members, which have gender, race, socio-economic, and regional MENA representation. As we expand in our early stage countries of Nigeria, Sudan, and Somalia, our team lead is a member of one of the indigenous communities in Sudan we hope to serve. Not only is she representative of the community, but she has an added sensitivity and level of expertise from her Global Health and refugee advocacy background. This is not altruistic, we know inclusion is critical for sustainable impact.

Our business model is three pronged drawing revenue from three customer groups 1) Patients and insurance, 2) Clinical practices, and 3) Labs and Pharmacies. The majority of our customers are Patients and insurance who comprise the main portion of our revenue for the services we provide. In some of our early stage countries like Sudan, the added component of potential NGO partners given our target population will contribute to this metric. Our second largest contributor group to revenue is made up of Clinical practices to which we provide EMR and scheduling services. The final group comprises Labs and Pharmacies and contribute licensing fees for one of our other services. For the purpose of this project into Sudan, the Speetar E-wallet is key

SPEETAR E-WALLET

Patient Wallet: Pay-as-you-go model.

Doctor Wallet: Once an appointment is successfully conducted, money will be debited into Doctor’s Wallet.

If the Patient does not show up,  money will be debited to the Doctor Account.

Speetar Wallet: For pending appointments, patients’ payment will be held here until the appointment is successfully conducted. Otherwise, it will be refunded to the patient's wallet. 

Finally, some of our revenue models are as follows:

Business to Customer (B2C):

The new triage system will allow patients to save time and money and when obtaining their consultations, reducing the cost and exposure from unnecessary travel. This value will be provided in exchange for a transaction fee for the services provided, or a discounted recurring subscription fee. As a key diagnostic tool, it will allow us to add additional diagnostic indicators to our PHC performance data collection and inform future healthcare monitoring and delivery improvement. 

Business to Business (B2B): 

• Clinical Practices are incentivized  to provide a transaction fee to Speetar for every the services provided and patients routed to them in exchange for the additional volume of sales generated. 

• The data accumulated on the EMR database is expected to be of great value to Health practices in providing continuity of care and streamlining the referral process in our early stage countries. Health insurance providers provide a transaction fee to Speetar for using our service as well.

Business to Government (B2G): 

Through an annual licensing contract, the public health authorities will have access to comprehensive real-time data tracking the health market, which will help in making data-driven decisions and policy decisions. Through this strategic plan, our healthcare monitoring and data collection will serve to ensure the inclusion of the most vulnerable populations in healthcare improvement plans.

Business to Non Profit Organizations (B2NPO): 

Many local and international aid organizations will have an interest in procuring anonymized data sets that would help with research, analysis and improving resource allocation as well as partnering with Speetar to more equitably distribute health services to our constituents.

Speetar’s recent growth of its commercial B2C operations (complementing a previous focus on B2G/B2NPO) charts solid progress on the path to financial sustainability. Most importantly, the in-depth development and product testing process (incl. In the context of COVID-19 crisis response settings) provides strong confidence in the product development journey. 

Strengthening its platform business strength beyond telehealth consultations to include improved e-pharmacy network integration, expanded triaging system, insurance products, and data valorization constitute key milestones towards furthering financial sustainability. From an impact perspective, scaling rural access and reducing acquisition costs for marginalized communities is a crucial sustainability impact factor. Furthermore, Speetar seeks to find a regulatory solution that will enable the platform to contract refugee doctors to provide telehealth consultations to members of their global refugee communities or their communities at home who may suffer from medical brain-drain and staff shortages. This would provide both employment and integration benefits to the refugees, their host communities, and the communities they would be providing services to while adding yet another historically excluded community to the pool of PHC performance data. 

The rapidly increasing availability numbers of doctors on the platform (127.41% in Q2 and 518.57% in Q3 2021), the exponential growth of active (commercial) users of Speetar services (61.66% in Q2 and 105.74% in Q3), and the positive patient feedback (91.7% NPS) have laid the foundation for Speetar to transition to scale. With current investments, Speetar is on the path to achieving significant market adoption rates in Libya in 2022 and is well-positioned to expand its services to Nigeria, Somalia, and Sudan. This Transition to Scale investment proposal complements Speetar’s existing growth trajectory (most prolific in sub-urban environments) and bodes well for a similar system in our early stage countries with the specified innovations. Speetar now seeks to accelerate and improve the service ecosystem for each of our early stage countries' disconnected, rural communities (e.g. in Sudan) who stand to benefit the most from telehealth innovation. For Speetar, this investment constitutes an indispensable growth component in the pursuit of its mission to provide accessible and inclusive healthcare access to all people affected by conflict.  While we do prioritize the most in need during our initial roll-out, the population in each of our early stage countries as well as in Sub Saharan Africa at large presents a key opportunity to partner with local providers and communities providing more opportunities for revenue streams in the future. For now, the revenue projections and entering our pre-series A round make it feasible to fund the initial stages of the expansion projects in Nigeria, Sudan, and Somalia as we move forward.

Following an initial test and product development phase (2019-2020), Speetar powered Libya’s CDC and MoH’s COVID-19 triage and information center as part of Libya’s National Response Plan (2020), serving 1.8+M beneficiaries across the country. Since then, active (commercial) users of Speetar services (direct beneficiaries) have grown 61.66% in Q2 and 105.74% in Q3 to reach 12,526 as of October 2021 (incl. 4659 female users). Telehealth consultations conducted through Speetar grew 1300% in Q2 and 322.22% in Q3 to 532 consultations in October 2021. By 2023, Speetar aims to have 300,000 active users in Libya. We currently have a projected recurring annual revenue of $300,000

Recognition and Track Record: 

Over the past 3 years, Speetar has been awarded several entrepreneurship grants from MIT Sandbox Innovation Fund, The Legatum Center for Development, The Social Innovation and Change Initiative at Harvard Kennedy School. In addition to being selected for the prestigious Harvard Medical School Dean’s Award for Community Service and the First Place Prize at both the COVID19 Maghreb Bootcamp and Egypt Pandamic TechHack.

Our work has been recognized by the Bill and Melinda Gates Foundation and The Aspen Institute as well as featured by several leading national and international outlets and publications including Forbes, BBC, Aljazeera, PRI, PRX, WGBH, CodeOntheRoad, The New Humanitarian, Gomytech and StartupScene ME.   

Our team’s efforts in improving healthcare access to underserved populations have also been highlighted and supported by:

2022 Solve Equitable Health Systems Finalist

2019 Top 3 Startups in Libya (SeedStars Tripoli) 

2018 Gates Foundation SDG GoalKeepers

2017 First Place in Healthcare Solutions (Harvard Hack a Vision) 

2017 MIT Pan-Arab Finalist.

2016 Post-Hack Prize (MIT Hacking Medicine).