Supply Of Suitable Infrastructure And Assistive Technologies
Business Model Description
Invest in businesses that provide physical infrastructure such as ramps, lifts, and handrails to enhance accessibility and safety for care recipients inclusive of Persons with Disabilities (PWDs). The sector comprises a network of B2B businesses providing infrastructure and assistive technologies to other businesses such as care homes, hospitals, and clinics, and B2C businesses providing these to individual customers who require in-home care and/or products to enable and ease daily activities. Examples of companies active in this space are:
Bawa Cane has developed a produce for the visually impaired that is able to detect obstacles and provide functionality to make navigation easier and more intuitive. Bawa Cane began with startup capital of RM100,000 (USD 21,000) . As of 2018, price points were recorded at USD 699 per device (51).
Mandi B.P Sdn Bhd specializes in sanitary and kitchen ware. They have developed a range of products for PWD and elderly including grab bars and shower seats. These products are priced at between RM100 - RM500 (USD21 - USD 108) (52).
Preventech has developed a senior emergency response smart band that monitors vital signs such as heart rate, blood pressure and oxygen. The device has an emergency button, GPS tracking and fall detection among other features. Preventech raised USD 650,000 in capital as of 2020 (53).
Expected Impact
Increase care services provision responding to growing needs for special care, improve quality of care services, enhance the skills and capacity around care economy.
How is this information gathered?
Investment opportunities with potential to contribute to sustainable development are based on country-level SDG Investor Maps.
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Country & Regions
- Malaysia: Countrywide
Sector Classification
Health Care
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 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 RM 36.3 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).
Medical Technology
Development need
6.5 per cent of Malaysians did not have access to nearby health facilities or mobile services in 2019 (1). Greater access to quality healthcare services is crucial for preventing, monitoring and treating NCDs in Malaysia (1). Improved data collection and analysis are especially key for prevention (1). 95 per cent of medical device needs in Malaysia are catered through imports (2).
Policy priority
After Covid-19 outbreak, Malaysia invested in its health care infrastructure's modernization for increased resilience, including against future pandemics. Malaysia aspires to position itself as a leader in medical tourism by reaching more than 1 million medical tourists annually, via 4IR tools adoption, and by becoming a key medical device manufacturer in the ASEAN region (2, 4).
Gender inequalities and marginalization issues
Orang Asli are among the most deprived of access to healthcare facilities in Malaysia (1). Out-of-pocket expenses tripled from 2006 to 2020, with 43 per cent being spent for out-patient care and 3 per cent in medical appliances and non-durable goods (18), increasing the burden of healthcare, especially for poor households. Finally, women are composing the majority of care workers (97 per cent of nurses and 64 per cent of unpaid care work) (19, 38).
Investment opportunities introduction
The Government announced the allocation of RM 420 million (USD 92,4 million) for the refurbishment of hospitals and clinics and new equipment (priority given to the Sabah and Sarawak), and procurement for new facilities and equipment amounting to RM 350 million (USD 76.59 million) (13). Malaysia aims at becoming a high-end medical tourism hub (4).
Key bottlenecks introduction
Investors need to resort to a local agent, representation or partner to engage with the public sector to invest in healthcare in Malaysia (2). Facilities managed by the Ministry requires upgrading (78 public hospitals are more than 30 years old). Public funds are not sufficient to fully cover the investments required in healthcare (14).
Medical Equipment and Supplies
Pipeline Opportunity
Supply Of Suitable Infrastructure And Assistive Technologies
Invest in businesses that provide physical infrastructure such as ramps, lifts, and handrails to enhance accessibility and safety for care recipients inclusive of Persons with Disabilities (PWDs). The sector comprises a network of B2B businesses providing infrastructure and assistive technologies to other businesses such as care homes, hospitals, and clinics, and B2C businesses providing these to individual customers who require in-home care and/or products to enable and ease daily activities. Examples of companies active in this space are:
Bawa Cane has developed a produce for the visually impaired that is able to detect obstacles and provide functionality to make navigation easier and more intuitive. Bawa Cane began with startup capital of RM100,000 (USD 21,000) . As of 2018, price points were recorded at USD 699 per device (51).
Mandi B.P Sdn Bhd specializes in sanitary and kitchen ware. They have developed a range of products for PWD and elderly including grab bars and shower seats. These products are priced at between RM100 - RM500 (USD21 - USD 108) (52).
Preventech has developed a senior emergency response smart band that monitors vital signs such as heart rate, blood pressure and oxygen. The device has an emergency button, GPS tracking and fall detection among other features. Preventech raised USD 650,000 in capital as of 2020 (53).
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.
260,000 PWDs registered to receive Malaysian Family Aid (government assistance programme).
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 CARG 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 (50).
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 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 (54, 55)
Investment Timeframe
Long Term (10+ years)
Expert consultations have indicated that this is a very nascent industry in Malaysia and that there is a need for further development. As such a long-term focus including efforts in research, business model innovation, policy and regulatory support needs to be adopted for this specific IOA (21,22).
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
Increasing ageing population (10.7 per cent aged above 60 in 2020, expected to rise to 15 per cent by 2030) and their age-related health risks add pressure on the national healthcare system (1). Increased demand for elderly adapted healthcare services requires institutional preparedness to meet such needs. (1).
Insufficient investment in technology in the sector decreases quality of healthcare (32). For example, challenges for persons with disabilities include poorly adapted infrastructure, low technological accessibility, lack of early diagnosis and of skilled educators (31).
The elderly care is not part of the public healthcare system (16). Thus, it is mostly informal and not institutionalized, which combined with low care workers' salaries, reduces the quality of care provided, especially for elderly and people with disabilities (14, 48).
Gender & Marginalisation
Rural elderlies are more likely to be left without care in Malaysia because of the shift in family dynamics as younger persons move to urban centers leaving the elderly without family care (41).
In Malaysia, traditionally, women are the main caregiver for elderly, children and other dependents (33). This unpaid care work reduces women's availability to get paid employment, causing many socio-economic disadvantages for women, challenging their empowerment (34).
Expected Development Outcome
Up-to-date infrastructure and increased availability of care technology leads to improvements in efficient and effective service delivery and to cost effectiveness, in turn improving the living standards of key constituents and better responding to people's needs in Malaysia (32, 44).
Technology development and adoption in care facilities significantly enhance the work of caregivers and thus improve the quality of care in Malaysia (37).
Enhanced capacity in healthcare sector through increased number of healthcare workers who are trained, certified and formally registered to utilize care technology solutions, which in turn would help formalize care economy.
Gender & Marginalisation
Enhanced care infrastructure and technology improves rural population's access to care services, notably crucial for the elderly (30).
Increased adoption and accessibility of care services can contribute, on the long-term, to reducing care burden on women, thereby reducing their stress and opening more space for their potential paid employment (38).
Primary SDGs addressed
3.4.1 Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease
3.c.1 Health worker density and distribution
18.4 per cent mortality rate for 30-70 years old, in 2019 (with 14.9 per cent for female and 21.8 per cent for male) (35). The probability of premature death between the age of 30 and 70 caused by NCDs was 11.3 per cent in 2019 (1).
34.84/10,000 nurse and midwife in 2019 and 22.86/10,000 medical doctor in 2020 (35).
9.b.1 Proportion of medium and high-tech industry value added in total value added
Medium and high-tech industry contributed to 43 per cent of the total value added created in 2020 (42).
Digital economy to contribute to 22.6 per cent to GDP by 2025 (43).
5.4.1 Proportion of time spent on unpaid domestic and care work, by sex, age and location
In 2019, women spent 1.3 hours on direct care work, 2.3 hours on domestic work and 6.2 hours in unpaid work, whereas men spent 1.1 hours on direct care work, 1.1 hours on domestic work and 6.9 hours on unpaid work (47).
Secondary SDGs addressed
Directly impacted stakeholders
People
Gender inequality and/or marginalization
Corporates
Public sector
Indirectly impacted stakeholders
People
Corporates
Public sector
Outcome Risks
If the price for care infrastructure and assistive technologies is not at an affordable price point, the access gap in care services will increase between different income groups.
Adoption of new infrastructure and technologies might cause new accident risks and other challenges for patients.
Increased technology adoption might result in data privacy issues for users, if appropriate measures are not taken by care technology providers and regulators in ensuring standard of care and data privacy.
Gender inequality and/or marginalization risk: If newly adopted infrastructure and technologies do not reach rural areas, elderly, people with disabilities in these regions might remain excluded.
Impact Risks
Without properly taking into account the care needs in Malaysia and users' experience, the care solutions might not be embraced by the target groups.
Lack of proper skills and training among the care personnel is a high external risk which might impair impact creation.
Lack of conductive environment and financial support for private sector intervention might impact its long-lasting involvement, especially because of increasing regulations for elder care (49).
Without inclusion of a supportive regulatory environment for the private sector growth in the care economy under the Senior Citizens Bill Act being drafted for instance, endurance risk might occur.
Impact Classification
What
Care infrastructure and assistive technologies contribute to healthcare provision by better responding to needs and improving the quality of care while also enhancing caregivers' capabilities and skills.
Who
Patients will benefit from better quality care, and healthcare professionals and healthcare services providers from increased efficiency in provision of services.
Risk
Solutions at risk of not being embraced by stakeholders, lack of proper skills and training of caregivers, regulation risk if the solutions necessitate extra effort.
Contribution
The need for elderly care centres will be of 2,000 centres by 2030 (36). PWD have lower access to essential healthcare services due to many challenges (1).
How Much
It is estimated that there will be 3.6 million seniors by 2030, in Malaysia, who will require specialized healthcare (29).
Impact Thesis
Increase care services provision responding to growing needs for special care, improve quality of care services, enhance the skills and capacity around care economy.
Enabling Environment
Policy Environment
Shared Prosperity Vision 2030: the policy highlights the care industry as an opportunity for better care for elderly as well as for women empowerment (39).
Twelfth Malaysia Plan (2021-2025): the plan highlights the need for better childcare and early childhood education, as well as the enhancement of healthcare services as key to address socio-economic inequalities (4).
Senior Citizens Bill (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 (49).
Allied Health Professions Act 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 (56)
Industry4WRD Policy on Industry 4.0: The policy intends to support companies' digital transformation in manufacturing sector, including medical technology manufacturing, through incentives and support for infrastructure, human capital and technology development (57)
Malaysia Madani: The Malaysia Madani plan has six main principles including Care and Compassion, which includes access and provision of quality healthcare (56).
Financial Environment
Financial Incentives: Care Industry investments may qualify for the Investment Tax Allowance which allows them to deduct 60 per cent to 100 per cent of qualifying expenditure from taxable income for 5-10 years (21)
Regulatory Environment
Private Aged Healthcare Facilities and Service Act 2018: ensures minimum standards of care to be delivered to elderly in the centers (40).
Private Healthcare Facilities and Services Act 1998: regulates and controls the licensing and registration of private healthcare facilities and services and other health-related facilities and services (45).
Medical Device Authority Act 2012: created the Authority to control, regulate medical device, its industry and activities (27).
Medical Device Act 2012: regulates medical devices and the industry, including the registration and licence of manufacturers (28).
Marketplace Participants
Private Sector
Bawa Cane; Mandi B P Sdn Bhd; Preventech Malaysia; Smart Peep; Kimda Hardware Sdn Bhd; Aatasia.
Government
Ministry of Health (MOH); Ministry of Science Technology and Innovation (MOSTI); 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; Malaysian Association of Social Workers (MASW); National Council for the Blind (NCBM); Malaysian Occupational Therapists Association; Persatuan Dyslexia Malaysia (PDM).
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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