The Challenges of Healthcare in India and East Africa and the Impact Opportunities They Unveil

During a recent panel discussion, our founder Eva Yazhari discussed the issues facing the healthcare sectors in East Africa and India. As an impact investor in healthcare and health education enterprises in these regions, Yazhari’s understanding of the scope of need is vast, as is her foresight into the related areas for investment and innovation.

Good health is the currency that allows people and communities to thrive and to prosper into the future. Yet in East Africa and India, the healthcare sector faces precarious circumstances. We pulled three key points from Yazhari’s discussion where she outlined the biggest challenges in healthcare, the areas for real growth, and the ways in which she and her team at her impact fund, Beyond Capital, are working to support the momentum of entrepreneurs building a bridge to equitable healthcare.  “The positive news is that we have seen a tremendous amount of innovation in the private sector and it's those companies that we seek out and invest in,” said Yazhari. She continued: “We believe there is a market opportunity to provide affordable, equitable healthcare for consumers at low incomes—and investments have supported that.”

Challenge: Lacking healthcare insurance

More than 40 percent of East Africans pay out of pocket for their healthcare coverage. In Kenya, almost 80 percent of the population lacks access to medical insurance, and rural areas continue to be underserved in health care, Yazhari said. This is due to poor infrastructure and limited access to clinics.  In India, residents lack accessible and equitable coverage (only 25 percent of Indians have health insurance). This causes 3 to 7 percent of the country’s population to fall back into poverty each year because of unexpected out-of-pocket healthcare costs.

Opportunity: Innovation in digital care

The lack of access to affordable public healthcare in East Africa and India presents an opportunity for innovation and growth in digital health, at-home care, and healthcare education. Within their current investment pipeline, the Beyond Capital team is reviewing a variety of impactful models that aim to directly address these significant challenges.

In India, only 36 percent of the country’s 355 million menstruating women have access to sanitary pads, said Yazhari. “We are assessing a company that aims to alleviate this gap by distributing low-cost, hygienic, and reusable pads to underserved rural communities through a network of local women agents. The company is also focused on delivering educational healthcare services via menstrual hygiene management training, with the goal of encouraging improved personal care practices and bolstering long-term health outcomes for low-income females.”

Opportunities also exist to broaden affordable healthcare access by leveraging advanced technologies to enhance medical supply chains. Consequently, Yazhari said she and her team are evaluating an Indian business that uses customized precision refrigeration technology to facilitate last-mile distribution of critical, temperature-sensitive medical supplies like vaccines to remote regions.

Within Beyond Capital’s East African pipeline, they are reviewing several businesses that aim to cater to the rising demand for out-of-hospital healthcare services. “In Kenya, where less than half of individuals requiring dialysis care can readily access this service, we are engaging with a business that provides affordable dialysis and daycare chemotherapy treatment in outpatient facilities,” said Yazhari. “Another company that we are reviewing is attempting to solve for the lack of African primary care centers with existing diagnostic capabilities by building and operating technology-enabled diagnostics centers in clinically underserved communities.”
Furthermore, Yazhari said they have also seen Covid accelerate the need for at-home healthcare consultations among rural and low income populations in India. “Undeniably, the countries where we invest could benefit from growth in healthcare innovation and there are dozens of purpose-driven companies working to meet this need at the moment.”

Challenge: Gender Inequality

Throughout Africa and India, gender inequality causes a chasm in healthcare access for women, stymying their growth. In Rwanda, nearly 18 percent of women and girls in Rwanda missed school in 2017 due to a lack of access to menstrual care products. This interrupts girls’ education and women’s careers and standing in society. It also affects the economy, as this example amounted to an estimated annual GDP loss of $115 million. In India, in-patient healthcare expenditures are significantly lower among adult women than among adult males. Women also face discrimination when healthcare spending must be financed through borrowing, particularly in low-income households.

Opportunity: Investment in companies that bolster women’s care

The dearth of women’s care has prompted innovative companies to create ways to provide girls and women the health and sex education and products they need to thrive with dignity. One example of this is Kasha, an e-commerce business for women’s health and self-care in East Africa that Beyond Capital has invested in. Kasha provides women in both rural and urban areas the ability to order affordable products—menstrual and personal care items, health products, family planning care—in a discreet way. These services fill a need, bolster the morale of a community, and positively impact the economy. According to Yazhari, Karma has helped “over 70,000 unique customers and has done pioneering work in Uganda and Rwanda in tackling the social stigma of menstruation and democratizing access to women’s health.”

Challenge: Inadequate healthcare delivery

Across East Africa (and throughout the continent) and India, various barriers prevent people from obtaining the quality healthcare they need—from education to vaccine, medication, and blood access and more. This results in declining health, poorer quality of life, impacted economies, and preventable deaths.

Opportunity: Investment in the delivery of vital services

With the African continent home to close to 1.2 billion people and 54 countries (many that are rapidly growing), there has been a strong economic response to the increased pressures the population have placed on the strained healthcare systems. “As a result, the private sector has no option but to play a substantial and important role in the delivery of vital healthcare services,” said Yazhari.  Given the clear positive social impact of these investments, healthcare has traditionally been a key sector for impact funds. Some of the many impact investment opportunities include sustainable solutions to lack of access to last-mile care, shortage of doctors, and poor logistics infrastructure.

Beyond Capital has specifically focused on ensuring access to care for consumers at low-income levels. This is evident in their investment in Karma Healthcare, a healthcare startup focused on providing equitable and affordable access to primary healthcare to rural residents in India. “Karma has treated over 72,000 patients with the average spend per visit of $3.74,” said Yazhari. Beyond Capital has also invested in Redwing Labs, a drone medical delivery company based in Bangalore, India. “We have identified various opportunities for drone-based delivery applications in India, specifically around the need for blood and vaccines,” said Yazhari.

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