Personalized Caregiving Services
Personalized Caregiving Services
Business Model Description
Invest in business models for personalized caregiving services that include in-home care, companionship, personal hygiene assistance, medication management, and specialized care. There are both B2C and B2B businesses, offering services directly to customers or to beneficiaries via healthcare facilities. Customers and beneficiaries include the elderly, persons with disabilities, children as well as patients with long term illnesses requiring specialized care. Examples of companies active in this space are:
Homage Malaysia is a leading home care platform that offers a wide range of services, including home nursing, caregiving, and therapy. Their products include a mobile app to access a network of highly trained and qualified caregivers. It has raised USD 42.5 million to date including from EV Growth, Alternate Ventures, KDV Capital, HealthXCapital, Golden Gate Ventures, and 500 Startups (49).
Doc2Home is a telemedicine platform that offers virtual medical consultations. Their services include online consultations with licensed doctors, medicine delivery, and home-based health screening services. Its parent company, Doc2Us receives an average of 1,247 monthly downloads (50).
Kiddocare is a Malaysian-based start-up that provides on-demand pediatric home care services for children. Their services include doctor consultations, nursing care, and physiotherapy for children with various healthcare needs. Kiddocare has raised a total of USD 198,700. Investors include Endeavor, UN Women Care Accelerator and MyCIF (51).
Expected Impact
Increase the well-being of older patients and patients with disabilities, increase the satisfaction of basic and specific patients' needs, by providing specialized healthcare services.
How is this information gathered?
Investment opportunities with potential to contribute to sustainable development are based on country-level SDG Investor Maps.
Disclaimer
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Investment involves risk, and all investments should be made with the supervision of a professional investment manager or advisor. The materials on the website are not an offer to sell or a solicitation of an offer to buy any investment, security, or commodity, nor shall any security be offered or sold to any person, in any jurisdiction in which such offer would be unlawful under the securities laws of such jurisdiction.
Country & Regions
- Malaysia: Countrywide
Sector Classification
Health Care
Development need
The growth in the incidence of Non-Communicable Diseases (NCDs) is high and led to 74 per cent of deaths in 2021. In addition, the ageing population with related diseases are major challenges for the Malaysian healthcare system (1). Recognition and treatment of mental health issues is also a concern, which increased as a consequence of COVID-19 lockdowns (1).
Policy priority
Malaysia adopted a NCDs prevention and treatment program, as well as, in 2019, a comprehensive and inclusive national health protection scheme, offering insurance coverage to to the majority of the population (1, 3). Additionally, Malaysia is orienting its pharmaceuticals and medical devices industry towards producing higher-value products (4).
Gender inequalities and marginalization issues
Disparities in life expectancy between Malaysia's states (Perlis has the lowest, Kuala Lumpur the highest) reflects to some extent the uneven vulnerability to health risks and access to advanced medical care. Women are over-represented in the informal sector and in the unpaid care services, face higher health risks (5, 12).
Investment opportunities introduction
A new National Biotechnology Policy 2.0 was adopted in Malaysia, which plans a 5 per cent GDP growth through the development of biotechnologies (6). Moreover, the halal market, including pharmaceuticals, is growing, with halal exports amounting to RM36.3 billion (USD 7.94 billion) in 2021 with the market expected to increase to USD 105 billion by 2024 (4, 7, 8).
Key bottlenecks introduction
The healthcare sector in Malaysia is reported to be facing manpower challenges (due to institutional issues), shortage of beds, equipment and medicine, and not enough isolation facilities (9, 20).
Health Care Providers
Development need
To improve the population's health, reforming primary healthcare services delivery with the development and upskilling of the workforce is key (10, 12). Growing issues related to the staff's working environment quality (Malaysia has in average 2.3 doctors, nurse and midwives per 1,000 population, compared to 2.5 recommended by WHO) should be addressed through the creation of a pool of skilled, technical staff to support doctors and nurses (1, 12).
Policy priority
Malaysia is willing to strengthen the post-basic and post-graduate training of nurses, assistant medical officers and allied health professionals, and is willing to enhance the continuous learning for medical doctors and other relevant health professionals on clinical governance and other public health areas (14).
Gender inequalities and marginalization issues
Ministry of Health in September 2022 revealed that there were fewer than 13,000 medical specialists in both the public and private healthcare sector, and 28,000 specialists were needed by 2030. The distribution of medical personnel, particularly specialists, is disproportionately in favor of urban areas, leaving remote and interior areas, such as Sabah, Sarawak or Kelantan, with a low ratio of medical personnel to population (11).
Investment opportunities introduction
In its 2023 budget speech, the government announced an increase in public expenditure regarding health from RM 32.4 billion (USD 7.09 billion) in 2022 to RM 36.1 billion (USD 7.9 billion) in 2023 (13). Additionally, the number of older people is expected to grow exponentially (reaching an annual net increase of 100,000 older persons in 2030), increasing the demand for quality elderly care (2).
Key bottlenecks introduction
The healthcare workers face an increased workload and pressure due to a growing population, urbanization, and greater complexity of diseases. Additionally, the lack of technology use affects the clinical management and administration efficiency and prevent the provision of quality healthcare (75 per cent of public hospitals and more than 90 per cent of medical and dental clinics are manual) (14).
Health Care Delivery
Pipeline Opportunity
Personalized Caregiving Services
Invest in business models for personalized caregiving services that include in-home care, companionship, personal hygiene assistance, medication management, and specialized care. There are both B2C and B2B businesses, offering services directly to customers or to beneficiaries via healthcare facilities. Customers and beneficiaries include the elderly, persons with disabilities, children as well as patients with long term illnesses requiring specialized care. Examples of companies active in this space are:
Homage Malaysia is a leading home care platform that offers a wide range of services, including home nursing, caregiving, and therapy. Their products include a mobile app to access a network of highly trained and qualified caregivers. It has raised USD 42.5 million to date including from EV Growth, Alternate Ventures, KDV Capital, HealthXCapital, Golden Gate Ventures, and 500 Startups (49).
Doc2Home is a telemedicine platform that offers virtual medical consultations. Their services include online consultations with licensed doctors, medicine delivery, and home-based health screening services. Its parent company, Doc2Us receives an average of 1,247 monthly downloads (50).
Kiddocare is a Malaysian-based start-up that provides on-demand pediatric home care services for children. Their services include doctor consultations, nursing care, and physiotherapy for children with various healthcare needs. Kiddocare has raised a total of USD 198,700. Investors include Endeavor, UN Women Care Accelerator and MyCIF (51).
Business Case
Market Size and Environment
USD 100 million - USD 1 billion
5% - 10%
2022 child population was 9.19 million. 3.6 million people over the age of 60 in 2022 (15, 17).
260,000 PWDs registered to receive Malaysian Family Aid (government assistance programme) (16). In 2021, total care homes in Malaysia range from 1,700 to 2,800 care homes. Estimated 361 care home operators are actually licensed by authorities.
The broader home care industry was used as it covers this IOA. It was valued USD 583 million with a CAGR of 7.93 per cent between 2022 and 2030 (20).
In terms of providers, total number of care homes range between 1,700 to 2,800 but only 361 are licensed by authorities (46).
PWD population stands at 260,000 based on government assistance programme eligibility. 11.1 per cent of the population is over the age of 60.
Indicative Return
< 5%
Based on companies researched and engaged for constulations in this sector, the highest analyst PBT margin was 0.53 per cent. Other companies also yielded losses based on their most recent financial statements disclosed to the Companies Commission of Malaysia (52, 53, 54)
Investment Timeframe
Long Term (10+ years)
Expert consultations have indicated that this a long-term venture that will require a longer gestation period. This is because of the lead time for setting up platforms that can provide such services is a long-term endeavor as licensed businesses are required to align with criteria that have been set up by the Ministry of Health.
Additionally, the costs of running these businesses, be it labor or technology related costs are also high. This combined with consumer reluctance to go beyond the traditional family unit also implies higher customer acquisition costs.
Ticket Size
USD 1 million - USD 10 million
Market Risks & Scale Obstacles
Capital - Limited Investor Interest
Market - Volatile
Capital - Requires Subsidy
Impact Case
Sustainable Development Need
Malaysia is to become an aged nation by 2030 as in 2020 10.7 per cent of the population was above 60 years of age, slated to increase to 15 per cent by 2030. This increases the need for care services to address age-related healthcare issues and the resultant pressure on the healthcare system (1, 31, 10).
In 2019, at least 1.6 per cent of Malaysians lived with physical or mental disabilities requiring special personally adapted care (32). Family caregivers, especially parents of children with disabilities, face issues of high cost of care, balance work and care activities, high levels of stress (33).
The Malaysian care system is characterized by it reliance on the gig economy and a lack of properly trained workforce to address the specific needs of elderly patients and patients with disabilities (42, 33).
Gender & Marginalisation
In Malaysia, women are considered as the main caregiver for the elderly, children and other dependents, hindering female participation in the workforce (34). This trend was even worsened by the COVID-19 pandemic (35). Moreover, women and girls with disabilities suffer from more vulnerabilities (36).
Elderly are more likely to be left without care (2,144 seniors were abandoned in hospitals over the period 2018-2022) (23). It is especially the case in rural regions, since younger populations move to urban centers leaving the older family members behind (39).
Low-income segments of the Malaysian population are more exposed to the negative impacts of ageing and disability, increasing their need for care (31). They also have lower access to specialized education and services due to their high costs (41).
Expected Development Outcome
Greater accessibility and availability of personalized care, including health workers beyond urban areas, enable better response to the special needs of the elderly, persons with disabilities (PWD) and children, while decreasing the burden on the healthcare system and caregivers (31, 41).
Enhanced personalized and regular care services can improve the living conditions of people with disabilities, while reducing their social exclusion (25).
Gender & Marginalisation
Enhanced personalized caregiving services can support primary caregiver, usually women, self-care and engagement in the workforce by offering favorable choices to join the workforce (27).
A better developed and personalized caregiving service offer throughout the country will enable easier access to daily care for elderly, including living in rural areas, and a better satisfaction of their basic needs while supporting their well-being (42).
Increased offer of caregiving services, contributing to integrated care, could reduce the cost of services, enabling a broader access to these services by the low-income segment of the local population (43, 41).
Primary SDGs addressed
3.4.1 Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease
3.8.2 Proportion of population with large household expenditures on health as a share of total household expenditure or income
3.c.1 Health worker density and distribution
18.4 per cent mortality rate for 30-70 years old, in 2019 (14.9 per cent for women and 21.8 per cent for man) (38). The probability of premature death between the age of 30 and 70 caused by NCDs was of 11.3 per cent in 2019 (1).
In 2019, 0.13 per cent of households recorded an expenditure over 25 per cent and 1.52 per cent recorded an expenditure over 10 per cent of their income towards healthcare (38).
In 2019, 34.84 nurses and midwife/10,000 inhabitants, and 22.86 medical doctors/10,000 inhabitants in 2020 (38).
Reduce premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases to 15 per cent by 2025. Reduce prevalence of blood pressure to 26 per cent by 2025. (40)
8.5.2 Unemployment rate, by sex, age and persons with disabilities
In 2020, 4.54 per cent of overall unemployment, with 10.9 per cent for persons with disabilities compared to 4.5 per cent for people without disabilities (38).
5.4.1 Proportion of time spent on unpaid domestic and care work, by sex, age and location
In 2019, women spent 1.3 hour in direct care work, 2.3 hours in domestic work and 6.2 hours in unpaid work, whereas men spent 1.1 hour in direct care work, 1.1 hour in domestic work and 6.9 hours in unpaid work (44).
Secondary SDGs addressed
Directly impacted stakeholders
People
Gender inequality and/or marginalization
Corporates
Public sector
Indirectly impacted stakeholders
People
Corporates
Outcome Risks
As emotional effects of caregiving are heavy and challenging, if overwork is caused, professional caregivers might have mental health difficulties.
Without an supportive and conductive policy and regulatory environment, the delivery of care activities might not benefit the target population as fast as expected.
If factors such as training and capacity building of the care workforce are not considered and included into the value-chain, outcomes like better quality of care might not be achieved.
Gender inequality and/or marginalization risk: Increased professional caregiving might increase isolation of elderly and PWDs due to less frequent family visits.
Impact Risks
Execution risk might arise if the service providers are not correctly trained, putting patients' health and impact creation at risk.
If the price of caregiving services are too high, lower-income families might not be able to afford it, causing a stakeholder participation risk.
Mismatch between the care services offered and the patient needs might risk impact creation.
Impact Classification
What
Personalized caregiving improves the well-being of elderly and people living with disabilities, including children, through quality and adapted caregiving and by enhancing support to families.
Who
(Poor) elderly, people living with disabilities, including children and women and girls specifically. Women that are the primary caregivers.
Risk
Execution risk with lack of appropriate training, stakeholder participation risk for lower-income families, and alignment risk with a mismatch between patient's needs and services.
Contribution
Caregiving services will help palliate the decrease in family caregiving. For instance, three-generation households declined from 41.1 per cent in 2004 to 30.7 per cent in 2016 (2).
How Much
The number of persons with functional limitations in daily life activities is projected to double between 2020 and 2040 (2). Specialised caregiving will contribute to addressing this issue.
Impact Thesis
Increase the well-being of older patients and patients with disabilities, increase the satisfaction of basic and specific patients' needs, by providing specialized healthcare services.
Enabling Environment
Policy Environment
Twelfth Malaysia Plan (2021-2025): the plan addresses the wellbeing of people with Disabilities in its Chapter 5: Addressing Poverty and Building an Inclusive Society (4).
Shared Prosperity Vision 2030: the policy highlights the specific needs of people with disabilities and recognizes them as a priority group to take into consideration while working towards reduction of inequalities (30).
The Disability Action Plan (2016-2022): the plan aims to further empower persons with disabilities including through better access to basic education and skill training (24).
Malaysian Allied Health Professional Act (AHPA) 2016: The act details the formation of the Malaysian Allied Health Professions Council, establishment and the definition of Allied Health Professionals. It also sets out the issuance of certificates pertaining to Allied Health Professionals (55).
Industry4WRD Policy on Industry 4.0: The policy intends to support companies' digital transformation in manufacturing sector through incentives and support for infrastructure, human capital and technology development (56).
Malaysia Madani: The Malaysia Madani plan has six main principles including Care and Compassion, which includes access and provision of quality healthcare (57).
Financial Environment
Financial incentives: Care industry investments may qualify for the Investment Tax Allowance which allows them to deduct up to 60 per cent - 100 per cent of qualifying capital expenditure from taxable income for 5-10 years. (21)
Fiscal incentives: The Malaysian Inland Revenue Board (IRB) offers tax reliefs for carer expenses for parents, and spouses or children that are PWDs for personal income tax (48).
Regulatory Environment
Persons with Disabilities Act 2008 (PWD): recognizes 7 different disability categories: hearing, visual, speech, physical, learning, mental and multiple disabilities or impairment and established a National Council for Persons with Disabilities (NCPD) (29).
Care Centers Act 1993: provides for the registration, control, and inspection of care centers and related matters. In case of noncompliance with the Ministry's regulations and the obligations under the Act, closure of the center can be ordered (28).
Nurses Act 1950: requires nurses to be registered with the Malaysia Nursing Board (MNB) and possesses a valid Annual Practicing Certificate to be allowed to practice (26).
Private Aged Healthcare Facilities and Services Bill 2017: provides for the regulation of private aged healthcare facilities and services, including for the obligation of the employers to provide training to its employed caregivers (45).
Senior Citizens Bill Act (first reading planned for 2023): aims to protect the welfare of senior citizens, their basic rights, their empowerment, and the empowerment of family members and the community, as well as creating a strong support system for senior citizens and carers (22).
Marketplace Participants
Private Sector
Homage Malaysia; Doc2Home; Kiddocare; Care Concierge; Nurses At Home; Sitly; Teman Malaysia; Pillar Care; D2dlife.
Government
Ministry of Health (MOH); Ministry of Women, Family and Community Development (KPWKM).
Multilaterals
United Nations Development Programme (UNDP); World Health Organization (WHO); United Nations Population Fund (UNFPA); International Finance Corporation (IFC); Asian Development Bank (ADB).
Non-Profit
Malaysian Care Association (MCA); Alzheimer's Disease Foundation Malaysia (ADFM); Malaysian Association of Gerontology and Geriatrics (MAGG); Malaysian Hospice Council (MHC); Malaysian Mental Health Association (MMHA).
Public-Private Partnership
National Science Centre (NSC); Malaysian Technology Development Corporation (MTDC); Malaysian Venture Capital and Private Equity Association (MVCA).
Target Locations
Malaysia: Countrywide
References
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