Telehealth services
Telehealth services
Business Model Description
Offer medical consultations and health monitoring via online platforms.
Expected Impact
Reduce the barriers to access healthcare, which can raise the number of consultations and enhance the overall wellbeing of Kenyans.
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
- Kenya: North Eastern
- Kenya: Rift Valley
- Kenya: Nairobi (Province)
Sector Classification
Health Care
Development need
The Sustainable Development Report 2020 indicates Kenya's performance against SDG 3 - Good Health and Wellbeing is moderately improving, yet it is considered a major challenge.(1) COVID-19 has reversed some of the progress made on this goal by overwhelming health systems, and reducing access to health services for the population, especially vulnerable groups.
Policy priority
The Government of Kenya prepared a project called Transforming Health Systems for Universal Healthcare (THS-UC) with the World Bank to improve primary healthcare, focusing on reproductive, maternal, newborn, child, and adolescent health services.(2) Among the 'Big Four' policy agenda of the Third Medium Term Plan is reaching 100% universal healthcare coverage by 2022.(3)
Gender inequalities and marginalization issues
Around 25% of Kenya's population lack regular access to healthcare, which is exacerbated by poverty and gender. Studies estimate that each year, approximately 2.6 million people fall into poverty traps due to ill health.(26)
Investment opportunities introduction
Kenya is currently undergoing a transformation in its healthcare system to increase the affordability of services and medicine. Healthcare exhibits high policy momentum, and as such, presents attractive opportunities for investors. COVID-19 has also brought attention to new healthcare technologies / medicine / treatment methods that present a potential for innovation.
Key bottlenecks introduction
The main bottlenecks include regional disparities in services coverage, the low numbers of medical staff, low qualifications of medical personnel, limited healthcare infrastructure, lack of medical equipment and spare parts, high cost of medical equipment (mostly imported), limited access to drugs and medicine, difficulty in accessing medical universities and the lack of medical waste disposal.
Health Care Providers
Development need
Kenya requires a solution for its understaffed medical centers. Kenya has only 14 doctors and 42 nurses per 100,000 people according to data from 2016, while the World Health Organization recommends a minimum of 21.7 doctors and 228 nurses per 100,000.(6) There is also a significant geographical difference in the availability of health services in rural and urban areas.
Policy priority
The Kenyan Government prepared a project called Transforming Health Systems for Universal Healthcare (THS-UC) with the World Bank, to improve primary healthcare focusing on reproductive, maternal, newborn, child, and adolescent health services.(2) Among the 'Big Four' policy agenda of the Third Medium Term Plan is reaching 100% universal healthcare coverage by 2022.(3)
Investment opportunities introduction
With the government priority of achieving universal healthcare by 2022 and COVID-related demand, the sector offers profitable investments especially in implementing modern technologies like mHealth or 3D printing. For example, telehealth is expected to grow by 50% between 2020-2022.(5)
Key bottlenecks introduction
Regional disparities in service coverage and internet penetration, low numbers of medical staff, low qualifications of medical personnel and the high cost of medical equipment and drugs are among the key bottlenecks.
Health Care Delivery
Pipeline Opportunity
Telehealth services
Offer medical consultations and health monitoring via online platforms.
Business Case
Market Size and Environment
USD 100 million - USD 1 billion
Mobile penetration rate (114.7/100), internet penetration (83.4%)
The mHealth market amounted to USD 275.7 million in 2019 and is expected to rise to USD 557.1 million in 2022.(7)
Telemedicine in Kenya has high customer access potential, reflecting the mobile penetration ratio of 114.7 per 100 inhabitants in 2019 and internet penetration ratio of 83.4% in 2019 (both by number of subscriptions).(8)
Outpatient services increased by 90% to 9.1 million in 2018. However, the number of patients who reported a sickness but did not seek care reached 28%. 3% of the population with diseases mentioned distance to health facilities as a prohibitive factor. The average time to reach medical facilities was 46 minutes in 2013.(9)
Indicative Return
15% - 20%
The estimated return rate for investors is 18.3% - 22.3%. This rate is a benchmark calculated as a cost of equity.(10)
Investment Timeframe
Medium Term (5–10 years)
On average it takes 5 years to achieve a return on telemedicine investments, but small standalone solutions require even lower timeframes to achieve returns.(11)
However, the medium term is expected for large-scale digital healthcare projects which may take up to 9 years to break even.(11)
Ticket Size
USD 500,000 - USD 1 million
Market Risks & Scale Obstacles
Business - Business Model Unproven
Business - Supply Chain Constraints
Business - Supply Chain Constraints
Impact Case
Sustainable Development Need
Medical centers in Kenya are understaffed. There were only 14 doctors and 42 nurses per 100,000 people in 2016, while the World Health Organization recommends a minimum of 21.7 doctors and 228 nurses for the same population.(13)
Moreover, there is a significant geographical difference in the availability of health services in rural and urban areas. Around 70% of the population living in rural areas mostly rely on community health volunteers and health facilities staffed by nurses, who provide only basic services.(14)
Gender & Marginalisation
Current data shows that in 2015 only 65% of women on average visited a healthcare facility during the whole year. The lowest score was reported in Northern counties. Women mentioned getting permission, distance, money and not wanting to go alone as the main obstacles to their visit.(15)
Around 25% of Kenya's population lack regular access to healthcare, which is exacerbated by poverty and gender. Studies estimate that each year, approximately 2.6 million people fall into poverty traps due to ill health.(26)
Expected Development Outcome
Improvements in health and wellbeing, the prevention of illnesses
Increased support for nurses in rural areas via doctor online consultations
Gender & Marginalisation
Increased access to healthcare, especially for remote communities and women
Primary SDGs addressed
3.1.1 Maternal mortality ratio
3.1.2 Proportion of births attended by skilled health personnel
3.7.1 Proportion of women of reproductive age (aged 15–49 years) who have their need for family planning satisfied with modern methods
3.8.2 Proportion of population with large household expenditures on health as a share of total household expenditure or income
510 per 100,000 live births (27)
61.8% (27)
77.6% of married woman (27)
N/A
Less than 70 per 100,000 live births (27)
100%
100%
N/A
5.6.1 Proportion of women aged 15–49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care
56% in 2017 (27)
100%
Secondary SDGs addressed
Directly impacted stakeholders
People
Gender inequality and/or marginalization
Indirectly impacted stakeholders
Corporates
Outcome Risks
Inadequate digital architecture may lead to systems fragmentation, poor communication and poor interoperability.(16)
Security, privacy and confidentiality issues may arise (risk of data security and privacy breaches).(17),(18)
Impact Risks
Execution risk: The probability that the activities are not delivered as planned and do not result in the desired outcomes. (Low uptake of digital health among the population)
Gender inequality and/or marginalization risk: Stakeholder participation risk - Rural populations and women who lack access to digital infrastructure may receive no positive returns from this investment opportunity area.
Impact Classification
What
Telemedicine is likely to reduce the barriers to access healthcare. It can raise the number of consultations and enhance the overall wellbeing of Kenyans.
Risk
While the model is proven, telemedicine may diminish the quality of consultation due to the lack of personal contact. There is a risk of data privacy breaches.
Impact Thesis
Reduce the barriers to access healthcare, which can raise the number of consultations and enhance the overall wellbeing of Kenyans.
Enabling Environment
Policy Environment
Transforming Health Systems for Universal Healthcare (THS-UC): This policy aims to improve primary healthcare services, focusing on reproductive, maternal, newborn, child and adolescent health.(19)
Medium Term Plan III: One of Big Four Agenda of this plan is reaching 100% universal health coverage by 2022.(3)
Kenya’s Primary Care System is undergoing a major transformation, resulting from the constitutionally mandated devolution of health services delivery. The country is implementing policy and regulatory interventions to healthcare financing models.(20)
The government has put in place a robust approach to address the COVID-19 threat. As a part of the response, the Ministry has constituted a National Coronavirus Taskforce to advise the government on the appropriate measures for the pandemic.(21)
eHealth Policy: Although there are limited regulations for eHealth, the Ministry of Health has a vision for its development in Kenya. The eHealth Policy 2016-2030 explores potential public-private partnerships (PPPs) with the private sector.(10)
Financial Environment
Financial incentives: Kenya doesn't provide any incentives for this investment opportunity area because eHealth is largely unregulated by the government.
Fiscal incentives: Newly listed companies receive preferential corporate tax rates, depending on the percentage of listed shares. (The normal rate is 30% for resident corporations and 37. 5% for non-residents.)(24)
Regulatory Environment
The African Charter on Human and Peoples' Rights (ACHPR) and Constitution of Kenya 2010 states that all people have the right to healthcare.
Kenya National E-Health Policy 2016-2030: This policy aims to enhance interactions between client and health service providers, accelerate achievement of universal health coverage and enhance electronic exchange of health data and information.(19)
Health Bill 2016: This Bill defines the roles of county and national governments, and allocates primary healthcare functions fully to county governments.(22)
Kenya Vision 2030: This policy identifies two approaches as key in pushing the agenda of an efficient health system: devolution of funds and management to counties, and shifting the bias of national health from curative to primary healthcare.(3)
Kenya Quality Model for Health (KQMH): This model defines healthcare standards that facilities offering various services must meet.(23)
Marketplace Participants
Private Sector
Carepay, Flare, Health-E-net, AfriDOKTA, The Daktari Popote, MedAfrica, MYDAWA, Hello doctor, Minet Kenya, Pharmaccess
Government
Ministry of Health
Multilaterals
African Development Bank (AfDB), Villgro Kenya, VC4Africa
Non-Profit
Kenya Medical Association, Kenya Healthcare Federation
Target Locations
Kenya: North Eastern
Kenya: Rift Valley
Kenya: Nairobi (Province)
References
- (1) Sachs, J., Schmidt-Traub, G., Kroll, C., Lafortune, G., Fuller, G., Woelm, F. (2020). The Sustainable Development Goals and COVID-19. Sustainable Development Report 2020. Cambridge: Cambridge University Press.
- (2) World Bank (2021). Transforming Health Systems for Universal Care. https://projects.worldbank.org/en/projects-operations/project-detail/P152394?lang=en&tab=procurement
- (3) Republic of Kenya (2018). Third Medium Term Plan 2018 – 2022 Transforming Lives: Advancing Socio-economic Development Through The 'Big Four', 2018.
- (4) UNKenya (2020). Articulating the Pathways of the Socio-Economic Impact of the Coronavirus (COVID-19) Pandemic on the Kenyan Economy.
- (5) Frost and Sullivan (2018). Digital Market Overview: Kenya. https://ww2.frost.com/files/5915/2878/3560/Digital_Market_Overview_FCO_Kenya_25May18.pdf
- (6) Robert, M., Helen, K. and Paul, B. (2019). Policy Brief: Human Resources for Health - Gaps and opportunities for strengthening. Ministry of Health Kenya.
- (7) Frost and Sullivan (2018). Digital Market Overview: Kenya. https://ww2.frost.com/files/5915/2878/3560/Digital_Market_Overview_FCO_Kenya_25May18.pdf
- (8) Kenya National Bureau of Statistics (2020). Kenya Economic Survey 2020. https://www.knbs.or.ke/?wpdmpro=economic-survey-2020
- (9) Dutta, A., Maina, T., Ginivan, M. and Koseki, S. (2018). Kenya Health Financing System Assessment 2018: Time to Pick the Best Path. Washington, DC: Palladium, Health Policy Plus.
- (10) PwC analysis based on Prof. A. Damodaran data, 2020 .
- (11) Drury, P., Roth, S., Jones, T., Stahl, M. and Medeiros, D. (2018). Guidance for Investing in Digital Health, Asian Development Bank.
- (12) Kenya National E-Health Policy 2016-2030. Ministry of Health. https://health.eac.int/file-download/download/public/86
- (13) Robert, M., Helen, K. and Paul, B. (2019). Policy Brief: Human Resources for Health - Gaps and opportunities for strengthening. Ministry of Health Kenya.
- (14) Hood, L. (2020). COVID-19 exposes weaknesses in Kenya’s healthcare system. And what can be done. The Conversation. https://theconversation.com/covid-19-exposes-weaknesses-in-kenyas-healthcare-system-and-what-can-be-done-143356
- (15) Fraym (2019). Women’s Access to Health Facilities in Kenya. https://fraym.io/womens-access-to-health-facilities-in-kenya/
- (16) Piette, J., Moura, L. and Lun, K. (2012). Impacts Of E-Health On The Outcomes Of Care In Low- And Middle-Income Countries: Where Do We Go From Here?. World Health Organization. https://www.who.int/bulletin/volumes/90/5/11-099069/en/
- (17) Zriquat, I. and Altamimi, A. (2016). 'Security And Privacy Issues In Ehealthcare Systems: Towards Trusted Services', International Journal of Advanced Computer Science and Applications, vol. 7. https://www.researchgate.net/publication/308803282_Security_and_Privacy_Issues_In_eHealthcare_Systems_Towards_Trusted_Services
- (18) Sahama, T. and Simpson, L. (2013). Security And Privacy In Ehealth: Is It Possible?. Healthcom. https://www.researchgate.net/publication/269329631_Security_and_Privacy_in_eHealth_Is_it_possible
- (19) Kenya National E-Health Policy 2016-2030. Ministry of Health. https://health.eac.int/file-download/download/public/86
- (20) World Health Organization (2017). Primary health care systems (PRIMASYS): case study from Kenya, abridged version. Geneva.
- (21) UNKenya (2020). The Socio-Economic Impact of COVID-19 in Kenya.
- (22) ) Health Bill, 2016, http://publications.universalhealth2030.org/uploads/the_health__bill_2016.pdf
- (23) Docplayer. An Overview of the Kenya Quality Model for Health (KQMH). https://docplayer.net/45611696-Module-2-an-overview-of-the-kenya-quality-model-for-health-kqmh-unit-2-1-introduction-to-kqmh.html
- (24) KENIvest. Investment Incentives. http://www.invest.go.ke/starting-a-business-in-kenya/investment-incentives/
- (25) Healthcare Global (2020). Digital healthcare startup Vezeeta launches app in Kenya. https://www.healthcareglobal.com/telehealth-and-covid-19/digital-healthcare-startup-vezeeta-launches-app-kenya
- (26) Oxfam. Kenya: extreme inequality in numbers. https://www.oxfam.org/en/kenya-extreme-inequality-numbers
- (27) SDG Tracker (2021). End poverty in all its forms everywhere. https://sdg-tracker.org/no-poverty