A feat of ingenuity: Social entrepreneurs transforming healthcare access through innovation

In LMICs, access to healthcare is limited by several factors. It is either too expensive, of poor quality, or simply unavailable. Limited government investment in community and primary healthcare services, and an over-representation of private sector healthcare providers not covered by national insurance, warrant new solutions. Impact-driven local entrepreneurs are rising to the challenge and making a difference in their communities, taking responsibility where other actors fall short. This drive – to create a positive, scalable, and financially sustainable impact – is the mark of true social entrepreneurship.  

Social entrepreneurs in the healthcare space can offer innovative and disruptive models to solve health access issues, as well as complement existing health systems by deploying solutions designed for underserved settings. To encourage this new way of improving access to healthcare, Philips Foundation established in 2021 Philips Foundation Impact Investments B.V., to support social enterprises, through early-stage investment, and help accelerate opportunities to improve and sustain access to healthcare in underserved communities.

Designing innovative service delivery models

According to Dr. Daphne Ngunjiri of Access Afya, urban poor and peri-urban poor populations in Kenya struggle to access healthcare services, and when they do, they struggle to pay out-of-pocket for treatment, and quality is unreliable.

34% of clinics in Nairobi are operating illegally, unable to provide quality health services. To create sustainable healthcare models for the mass market, Access Afya designed a healthcare platform called Curafa, enabling local healthcare workers to be primary healthcare entrepreneurs through two initiatives. The first is to propose franchise clinics that offer affordable healthcare, combined with high availability of essential medicines. This standardized “clinic in a box” model is able to deliver family planning, laboratory testing, child immunizations and nutrition, pre- and post-natal care, general outpatient consultations, first aid and more. They also offer virtual medical consultation through an application with an affordable subscription rate. This approach adds value for healthcare workers, who can apply standardized best practices, and for patients, who are guaranteed affordable and high quality care.

Given the widespread issue of low quality of healthcare delivery in Kenya, Penda Health, founded in 2012, chose to focus on delivering patient-focused care, to address an erosion in patient trust. They offer a combination of 19 medical centers in the Nairobi metropolitan area, and telemedicine offered nationwide. In this blended care model, a patient can access services from Penda Health anytime, anywhere, using WhatsApp chat. To further build patient trust and ensure a high healthcare quality, they integrated an e-learning platform available for clinicians, allowing them to stay up to date on the most recent evidence-based treatment options. Similarly to Access Afya, they also offer a subscription model, to move away from the transactional aspect of healthcare access and encourage patients to view healthcare as a continuous service instead of a one-off appointment.

It is crucial to meet the patients where they are – by offering local and affordable healthcare in small clinics, and by remaining available through accessible technological solutions like WhatsApp. This also helps address the current issue of healthcare staff shortages, by reducing the need for in-person appointments.

Innovative solutions to healthcare staff shortages

Human resource shortages often hinder efforts to improve access to healthcare in underserved communities. A combination of new technology and innovative service delivery models can however overcome this.

Rology, an AI-assisted teleradiology platform, decided to tackle the serious shortage of radiologists in the Middle East and Africa. This chronic shortage leads to a high latency in disease reporting times and contributes to the mortality rate from preventable diseases in LMICs. Rology matches hospital cases with radiologists available remotely, based on their availability and specialization. It allows faster, specialized, more accurate and affordable treatment, with no set-up costs, leveraging technology to increase access to radiology care.

A further obstacle to tackling healthcare workforce shortages is an unsuitable working environment and sociocultural barriers that restrict female healthcare providers from participating in the health workforce. According to DoctHERs, over 300.000 female healthcare workers are currently excluded from the workforce, because of hostile work environments, ways of working that have not adapted to their needs, and existing child and senior care duties. DoctHERs leverages technology to address the problem by instantly connecting female healthcare providers with millions of underserved patients – bypassing societal and cultural obstacles that confine women to their homes, restrict their access to quality medical care, and exclude them from the profession. 

Beyond reintegrating them into the workforce, DoctHERs streamlines healthcare delivery, by giving the patient access to the whole network of healthcare providers via WhatsApp or phone calls. This upholds real human interaction, whilst leveraging solutions offered by technology.

DoctHERs also tackles the lack of available healthcare in peri-urban and rural areas in Pakistan by training, equipping, and deploying women as frontline health workers. Giving these women the possibility of delivering home health visits with connected tablets, and hosting local town halls, gives them the opportunity to be resources for their communities. They also contribute to giving women the confidence to receive the care they need. 

Scaling solutions in a sustainable way

Addressing gaps in healthcare delivery and workforce shortages, is necessary to improve access to healthcare in LMICs. However, it can be challenging to scale the model, to attract funding for an innovative solution, and finetune the business model to ensure sustainability and expansion. 

According to Access Afya, affordability is key in Kenya. Therefore, it is essential to build an initial solution focused on drastically reducing costs to ensure it is scalable in the future. It is crucial to carefully consider the location of service delivery, workforce deployment and the technological solutions that will be used, such as point of care ultrasound, telehealth, and shared assets, all digital health solutions that help drive costs down. This point of view was shared by Dr. Amr AboDraiaa of Rology, who believes healthcare entrepreneurship is driven by finding the most affordable solution for the patient, not just by profitability. Starting with the goal of affordability for local populations enables scalability, and investors will be more inclined to step in once there is a valuable proposition.

Philips Foundation is determined to support social entrepreneurs and their disruptive models, who solve healthcare challenges through their innovative approach, while complementing existing healthcare systems. This is why Philips Foundation established a social impact investment vehicle that will support social enterprises through early-stage and situation-specific investment and support. Philips Foundation Impact Investments B.V. takes an integrated approach in assessing the potential scalability of enterprises by not only looking at their technology, business model or another partial aspect of their solution, but rather at their overall readiness to make a meaningful impact within the healthcare systems in which they operate. You can learn more about Philips Foundation Impact Investments B.V. here.