Picture this for a moment: A mother walks into a clinic with an infant who is coughing and vomiting, has chills and a fever, and looks fatigued. The examining physician suspects the flu, but cannot rule out bronchitis, pneumonia or even malaria, which present similar symptoms but are deadlier. Unfortunately, the clinic lacks the capacity to carry out the appropriate diagnostic tests; the next best clinic is several hours away, but its diagnostic equipment is regularly out of service. What does the physician do: refuse to prescribe treatment for the child until there is a definitive diagnosis, or provide medication based on symptoms alone?
Diagnosing Africa’s Health Care Dilemma
Across sub-Saharan Africa, this scenario is sadly commonplace. Grossly inadequate public expenditure on health care means medical infrastructure and expertise are sparse and stretched. In fact, more than four in ten people in the region have no access at all to medical facilities or personnel. Facilities and equipment are concentrated in very urban centers, and 40 percent of equipment is out of service due to poor quality, lack of spare parts, or training for medical professionals. The result is a world where symptom-based treatment and self-diagnosis have become normalized, leading to undetected problems, delayed interventions, inappropriate treatment, and inferior health, social and economic outcomes.
Add to this scenario the world’s fastest population growth rate and a rise in non-communicable diseases on top of an already heavy infectious disease prevalence (the so-called “double burden”) and you have the ingredients for an intractable health crisis. Nowhere is this more apparent than in Nigeria. Already Africa’s most populous country with nearly 200 million people, Nigeria is on course to more than double its population by 2050 and become the world’s third largest country by number of inhabitants. Nigeria also boasts Africa’s highest GDP, yet health indicators remain among the worst in the world due to under-investment in the sector. The country spends below the sub-Saharan average health expenditure, leaving it with the world’s highest burden of malaria — a top cause of child illness and death — and the second largest number of people living with HIV. Meanwhile, the country’s prevalence of non-communicable or lifestyle diseases, such as diabetes, stroke and heart disease, continues to rise as it does across the continent.
If it makes for an alarmingly grim prognosis, the crisis also presents an opportunity for novel interventions. That is why FINCA Ventures invested in MDaaS Global (“Medical Devices as a Service”), a social enterprise with a clear diagnosis of Africa’s health trajectory and a health care solution for the continent’s next billion.
Getting Diagnostic Services to the Underserved
MDaaS, which operates locally in Nigeria as BeaconHealth Diagnostics, creates affordable and accessible diagnostic services in clinically underserved communities. It builds and runs centers that offer radiology, cardiology, and laboratory services targeted at the populations least reached by existing health services — the low- to middle-income populations outside of major cities. Its facilities serve as outsourced diagnostic centers for surrounding clinics and secondary (state) hospitals.
Core to MDaaS’ strategy is minimizing operational and acquisition costs in order to offer quality but affordable services to its clients. Tech-enabled centers and the economies of scale of running a chain of centers allow MDaaS to centralize core functions, including radiology. An intense focus on sourcing low-cost refurbished equipment has driven MDaaS to develop in-house procurement expertise that can acquire and ship such equipment to Nigeria for a price that is 60 percent below local rates. The equipment is reliable and high performing, achieving 99 percent uptime with minimal maintenance costs. The result of this strategy is that MDaaS can offer a much higher quality of service than is available locally, while also guaranteeing the lowest possible price.
Putting Clients at the Center
A diverse set of patient acquisition channels combining referrals from local clinics, insurance providers, NGOs, religious institutions, large employers and walk-ins enables MDaaS to cast a wide net and maximize utilization of the equipment. Since opening its first center in November 2017, MDaaS has acquired customers from over 100 referring clinicians and 60 health facilities and served over 8,000 patients. Customer satisfaction underpins its philosophy and operations, resulting in a modern, clean and friendly experience for every individual patient. MDaaS continuously solicits feedback on its services, prioritizes quality and timeliness in case reporting, and flexibly accommodates all referrals, a combination that not only pleases patients but engenders allegiance and high levels of satisfaction from their referring physicians. That customer-centricity has created strong client trust and loyalty, captured in the results of a recent internal survey showing that over 95 percent of its patients would recommend BeaconHealth Diagnostics to a friend or family member.
Driving Momentum for Scale and Impact
There is immense potential for scaling the centers in Nigeria. MDaaS estimates there are over 300 communities across the country that meet its selection criteria. These communities have a daily income level between $2 and $20 and a catchment area greater than 250,000 people with two or more secondary or tertiary facilities and at least 30 primary health facilities. MDaaS is also exploring ways to use a hub and spoke model to become even more accessible and rural as equipment becomes increasingly mobile.
Driving MDaaS’ momentum is a well-rounded founding team with a diverse set of backgrounds and experience. The CEO and Nigerian native, Oluwasoga Oni (Soga), brings the big picture strategy, connections to local networks, and firsthand knowledge of the health care system having grown up in a family of doctors. He is complemented by Genevieve Barnard Oni, the CFO, with both a public health background and business and financial acumen. Joe McCord (supply chain and sourcing expert) and Opeyemi Ologun (operations specialist and Nigeria Country Manager) round out this dynamic and enterprising set of co-founders.
Increasing Customer Resilience for Financial Service Providers
MDaaS is our first investment in the health space, but we can already see the potential for partnership with FINCA Impact Finance and other financial service providers. Customer health issues and medical expenses continue to be a major cause of default for lending organizations in Africa. Solutions that grow the accessibility and improve affordability of critical primary health care services, especially preventative, increase customer resilience and reduce loan portfolio default. Moreover, there may be opportunities to create medical savings and loan products and bundle mutual discounts in conjunction with MDaaS, enabling financial service providers to offer new products to existing clients as well as attract new customers.
Quite simply, MDaaS is a beacon of hope for improved health outcomes across sub-Saharan Africa, and with their continued expansion, we believe the prognosis is promising.