Health4Moni

Health4Moni seeks to solve the problem of lack of access to quality healthcare services amongst women due to the inability to afford health coverage leading to high mortality and morbidity amongst women, preventable deaths! During our research with our target market, we discovered poverty as the underlying cause for why many informal sector women cannot afford health insurance, followed by low awareness/knowledge about availability of health insurance.

According to WHO in 2021, 50% of the people in the world do not receive the health services they need. 930 million people spend at least 10% of their household income on health care. 100 million people are pushed into extreme poverty each year because of out-of-pocket spending on health (WHO, 2021). 

A study carried out by Aregbesola & Khan 2018 found that 97.9% of women in Nigeria (103 million women, over 50% of Nigeria's population) were not covered by health insurance and this is largely made up of informal sector women unprotected by the NHIS Formal Sector Social Health Insurance Programme. The 5% Nigerians c0vered by the NHIS are largely formal sector Nigerians, leaving the informal sector uninsured and limited in seeking healthcare. 

70% of Nigerian women lack access to quality healthcare. 50% of Nigerian women are financially excluded, limiting their economic mobility. 

The above numbers are wild and an intervention that provides women access to quality and affordable healthcare is needed. Women face different health risk and difficulties in accessing healthcare services. They also bear a greater burden of disease and have limited access to resources.

The ability of women of reproductive age to access affordable health coverage and care has important implications for society and it depends on economic benefits for women and their families. (Bailey and LIndo, 2017). Despite this, the coverage of healthcare services among women of reproductive age remained low, especially in low- and middle- income countries (LMIC) with financial constraints as a major barrier. (Kimani et al., 2014).

And this is why I developed Health4Moni.

Health4Moni is a digitally equipped program that provides affordable and instalmental health insurance to informal sector women (a demography largely uncovered by the NHIS Formal Sector Social Health Insurance Programme) via a digital daily savings system that allows women access quality healthcare without fear of finacial burden or risk. Health4Moni also provides financial literacy, business trainings and microcredit services to this women, this in turn tackles poverty, an underlying reason for low health insurance coverage amongst informal sector whilst reducing preventable morbidity and mortality among women.

To be honest, the goal was to provide better access to quality healthcare for women to reduce the high mortality rates amongst women but we discovered that these women are daily earners and hence cannot pay the premium required by the NHIS at once. So we came up with the finacial inclusion arm of the solution to tackle poverty, help women save, build wealth whilst accessing quality healthcare. Everybody wins!

How HEALTH4MONI Works:

• User makes Minimum daily savings of #200 ($0.4)
• Health4Moni deducts #1,250 ($2.5) monthly
• Health4Moni pays #13,000 ($26) premium per user to the NHIS
• Health4Moni takes service fee of #2,000 ($4) per user
• At the end of the year, balance of remnant savings belongs to the user (minimum of #58,000/$116) which can be invested on the digital savings platform.
• User has access to quality healthcare covered by health insurance (NHIS) and digital financial literacy and business trainings.
• Qualified users have access to microcredit services to scale their business, increase their savings and investment and build wealth.

We are establishing partnerships with two key partners; the
National Health Insurance Scheme (NHIS), the key providers of health insurance for our beneficiaries and HerVest, a digital platform providing financial inclusion for women. We are already in conversations and in agreement with these partners, waiting to sign the memorandum of understanding once we are ready to launch. 

Beneficiaries of Health4Moni are informal sector women. Why? The National Health Insurance Scheme (NHIS) in Nigeria covers less than 5% of the entire population and a bulk of that number are the Formal Sector, leaving the informal sector uncovered. Examples of our target demography includes market women, female artisans (tailors, hairdressers, etc), female entrepreneurs, techpreneurs and creatives, daily earners, between ages 21-65 years, some learned and unlearned. 

Despite women bear a greater burden of disease and are high users of health due to their reproductive abilities, they have limited access to resources and hence the quality healthcare they need. 

It is common practice to see a pregnant woman in rural Nigeria opt to give birth at home assisted by elderly women in the neighbourhood in the absense of a skilled birth attendant due to inability to afford hospital bills, even if the pregnancy is a high risk one that could require ceasearean section, oxygen for the baby, an incubator or medical intervention for postpartum hemmorrhage. These cases lead to high morbidity and mortality in women, injuries and deaths that are highly preventable in the presence of quality healthcare.

Another case study is Aisha. Aisha is a 42 year old mum of 2 and a pepper seller in the general market. She is an hardworker who raised her daughters via her business proceeds. Whenever she fell sick, she went to the chemist in the market to get OTC drugs. That was the same thing she did when she had these persistent headaches, afterall she couldn't afford what they charged at the general hospital. She didn't bother much about the persistent thirst, sweating and peeing either. 

It was until she suffered a stroke and was rushed to the hospital, that it was discovered she had a deliriously high blood pressure, was diabetic and was obese, a serious diagnosis that could have been prevented by early diagnosis and treatment if Aisha had health insurance that covered her from financial burden or risk whenever she needed medical care.

This is the story of many women who work in the informal sector in Nigeria, who are not covered by the Formal Sector Social Health Insurance Programme of the NHIS. They suffer injuries and death that could be prevented by early detection, diagnosis and treatment.

Implementing the Health4Moni solution ensures these women are covered by the NHIS, giving them unhindered access to quality healthcare, as well as providing them access to save, invest and build wealth to eradicate poverty. It means better standard of living and better health outcomes.

After I completed my first degree in Human Anatomy, I volunteered as a Physician's Assistant in rural Nigeria, there I saw first hand the struggles of Nigerians to access the medical care they desperately needed & the financial constraints they experienced. I saw critically ill patients discharged against medical advice due to lack of finances. 

I particularly remember this 55 year old woman, she had advanced stage breast cancer, her condition was so bad her breast tissues were rottening. When asked why she allowed her condition get that bad before visiting the hospital, she mentioned that initially she sought medical care but after a while she couldn't afford the bills and had to borrow since she was a petty trader, she eventually had to resort to traditional medicine. She only came back to the hospital when she saw she was dying. I Truly felt compassion for her but the cancer had metastasised.

So I started to wonder how many more women were dying daily due to financial constraints preventing access to medical care? The statistics were glaring. I wondered what I could do to drastically reduce these numbers. So I registered for a Masters in Public Health and my research specializes on Factors Affecting Uptake of Health Insurance Amongst Women in Nigeria. Using design thinking tools, I defined the specific challenges experienced by women in the informal sector since NHIS doesn't have a functioning coverage plan for them. My team and I met with our target population and carried out a survey,  asking them questions around awareness, knowledge and preception of health insurance, affordability, willingness to pay, etc. 

From this survey, we discovered that the inability to pay caused by poverty is an underlying reason for women not uptaking health insurance, followed by low awareness/knowlege about the availability of health insurance and wrong perceptions about health insurance. We also got their input and ideas to build a realistic solution that could save millions of lives. It is from the design thinking we discovered providing an affordable health insurance wasn't enough it needed to be coupled with daily savings since our target population are daily earners hence can't afford the NHIS premium required to be paid at once. We also decided to add financial inclusion services to help our beneficiaries build wealth and overcome poverty. 

This is how we came up with the Health4Moni solution, through empathy, definition, ideation, prototyping and now we are at testing stage.

As team lead, I am a mid-level consultant at a nonprofit consulting firm in the US and I've supported over 1,000 social enterprises scale their impact and income across program planning, grant writing, M&E, since the last 3 years.

Feranmi, our General Manager has over four years experience managing and overseeing the execution of social projects. 

Ayo, our head of marketing is an expert in developing marketing plans to reach enterprise goals. A digital marketing specialist implementing traditional & digital marketing strategies for breaking tech startups into the African market. 

Health4Moni is a prototype because we already have a product that we are ready to test with a number of users. We have done the research, carried out a survey and on the design thinking scale, we are at the prototype and testing phase. 

Health4Moni is not yet serving anyone, as we are at the prototype and testing phase.

At the moment to scale the Health4Moni solution, we need the guidance and support of expert mentors who have experience in African startups, to ensure we don't make repeated mistakes. Becoming a Solver has been a life long dream since I heard the story of Mrs. Temi Giwa of LifeBank, a Solver, it has been a dream to receive the support Solve offers to social innovators.

I'm looking forward to the network of partners and peers to partner with and build mutually beneficial relationships that could scale our innovations beyond Nigeria to Africa and hopefully, across the world, providing access to quality healthcare for millions of women worldwide whilst reducing mortality rate amongst women. 

Also, excited about the funds to implement and test our innovation. I believe Becoming a Solver will radically transform the work we do at Health4Moni and open mutiple doors of opportunities for greater impact for us. 

Health4Moni is innovative and different from previously existing solutions due to the instalmental element of paying premiums for health insurance. From our design thinking, we realised our target population, informal sector women are daily earners and hence can't afford the NHIS premium, which can only be paid at once. So our instalmental payment via the daily savings system is innovative, diffeerent and really fixes the problem encountered by our target population, preventing them from getting health coverage. 

Secondly, we are moving beyonda band-aid approach of just the surface of providing access to healthcare which is the important need, but we dive deep and fix the underlying causal agent which is poverty, the inability of women to afford healthcare. This is done via the davings, investment, financial literacy and microcredits. So they are not only getting access to quality healthcare without fear of financial burden or risk, they get to save, invest, financial literacy and build wealth.

1. 1 million women enrol in the Health4Moni program and get access to quality healthcare. 

2. Increased access to healthcare services by informal sector women without fear of financial risk due to health insurance coverage

3. Improvement in the health outcomes of women such as controlled high blood pressure, diabetes, pre, delivery and postnatal care.

4. Reduced morbidity and mortality rates amongst informal sector women

5. Improved perception of women about health insurance enabling referrals of friends, family and more informal sector into the program

6. Increase in the savings and investment capacity of women before Health4Moni

7. Increase in revenue of businesses, business growth and production capacity of users.

8. Improved standard of living and decrease in number of poor women

1. In 5 years, provide access to quality and affordable healthcare to 1 million women in Nigeria, to achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

2. 90% of users who save regularly

3. Total amount saved by each user (to check for defaulters)

4. Reduced morbidity and mortality rates amongst informal sector women

5. Improved perception of women about health insurance enabling referrals of friends, family and more informal sector into the program

6. Increase in the savings and investment capacity of women before Health4Moni

7. Increase in revenue of businesses, business growth and production capacity of users.

8. Improved standard of living and decrease in number of poor women

ACTIVITIES:

1. Sign a Memorandum of Understanding (MOU) between our two key partners; the National Health Insurance Scheme (NHIS), the key providers of health insurance for our beneficiaries and HerVest, a digital platform providing financial inclusion for women

2. Team training and facilitation to equip them on the strategies to accomplish the goals of the project as well as deliverables and timeline

3. Awareness, education and enrolment drives to promote and educate prospects about the benefits and advantages of health insurance, savings via the Health4Moni program.

4. Run PR & Ads and radio jingles to provide awareness and information to women online and offline about Health4Moni

5. Provide digital financial literacy trainings and business support trainings to enrolled users

OUTPUTS: 

1. 10,000 informal sector women enrol in the Health4Moni program

2. 90% of users who save regularly

3. Total amount saved by each user (to check for defaulters)

4. Number of users who take financial literacy and business trainings

5. Number of users who qualify for microcredits: (qualification: taking all trainings and 80% score in assignments)

OUTCOMES:

1. Increased access to healthcare services by informal sector women without fear of financial risk due to health insurance coverage

2. Improved perception of women about health insurance enabling referrals of friends, family and more informal sector into the program

3. Increase in the savings and investment capacity of women before Health4Moni

4. Increase in revenue of businesses, business growth and production capacity of users.

5. Improved standard of living and decrease in number of poor women

Health4moni will use the existing savings, investment and financiaiteracy app; HerVest. 

We also utilise evidence based research from literature review around heath insurance aong women and finances of women in developing countries, this is couple with our team lead's research on Factors Affecting Health Insurance Uptake Among Women in Developing Countries, gotten via surveys, questionnaires, focus group discussions and indept interview of our target population.

We also look forward for the support and counsel of SOLVE to synergise the best technology that can effectively sustain the innovation

We are a diverse team, and there are discriminations between gender, sociocultural status. We provide equal access to opportunities for advancement for everyone within the team. Our measurement and evaluation relies on diligence, committment and results. We do not discriminate marginalised groups. At Health4Moni, everyone is welcomes, respected, supported and valued for their genius, skills, passion and compentence.