Changamka Microhealth

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Changamka Microhealth : Using mobile technology and mobile money to deliver insurance to the uninsured

Year Founded:
Organization type: 
for profit
Project Stage:
$250,000 - $500,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Many families fall into poverty due to the cost of treatment of critical illnesses such as cancers and strokes. This project drastically lowers the cost of insurance by using the mobile phone for innovative crowd funding demand generation, registration, payments, servicing and claims payment.

WHAT IF - Inspiration: Write one sentence that describes a way that your project dares to ask, "WHAT IF?"

What if the mobile phone could be used to lower the cost of health insurance by 85% and save thousands of lives?
About Project

Problem: What problem is this project trying to address?

Insurance is poorly understood, unaffordable and inaccessible to the majority in developing countries. Many families fall into poverty due to the high cost of treatment of critical illnesses such as cancers and strokes. Low penetration and selective uptake by the sick drive up claims costs; whilst manual processes and operational inefficiencies raise administrative costs , all of which are borne by consumers.

Solution: What is the proposed solution? Please be specific!

● This project seeks to drastically lower the cost of insurance by using the ubiquitous mobile phone as the medium for client registration, payment, servicing and claims payment. We also tackle the key cost drivers of insurance of anti selection (the fact that only the sick seek to purchase), and low penetration, by engaging a large Mobile Network Operator on a consumer mobilization (crowd funding) activity to pre-generate demand and randomly registering 200,000 individuals. Further, all the operations: customer registration, premium payment, claims submission and claims payment are done electronically, thus not only enhancing customer experience but drastically reducing costs in the whole value chain.


2010 Kenya MDG 5 Innovation Award,Saving [email protected] seed award in 2011, Saving Lives @ Birth Transition award in 2014; UN Foundation Innovation Working Group Award in 2012; USAID HCM Grant Award 2012; White House invite to speak at GES Summit in 2015
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

Jason is a 45-year-old carpenter, running his business in Kibera, Nairobi's largest informal urban settlement. His monthly income of $300 is enough to meet his monthly expenses and even save a little. However his world is seemingly headed for a crash after his first diagnosis with early stage prostate cancer. The cost of treatment is way beyond his means...or is it? Eight months ago, Jason bought the much publicised Changamka health insurance product on his phone for a mere fraction of his monthly income. He receives a handsome lump-sum cash payout, enough not only for his medical expenses, but to meet the extra budgetary pressures of his new situation.

Impact: What is the impact of the work to date? Also describe the projected future impact for the coming years.

In 2014, Changamka together with a Mobile Network Operator and an insurance company launched a semi phone based health insurance product. Although successful in comparison to the poor performance of other insurance products in the market, the 80,000 lives covered was nowhere near the planned impact. By taking on board key learnings especially on: ease of customer on-boarding, high premiums and the lack of wide choice in hospital selection, we have designed an affordable product that plans to more than double the current 3% penetration of insurance to 6.5%. The provision of a lump sum cash benefit ensures that those who wish to seek treatment out of the country have the freedom to do so.

Spread Strategies: Moving forward, what are the main strategies for scaling impact?

The successful design of this product is the culmination of a long collaborative effort with some foreign partners engaged through the Ashoka network. Their global reach means that the successful results achieved in Kenya can easily be replicated in other countries with similar mobile phone ecosystems.

Financial Sustainability Plan: What is this solution’s plan to ensure financial sustainability?

The financial projections indicate a break even within 1 year. The crowd-funding approach ensures that sufficient demand is generated upfront! We have structured a partnership that shares roles and responsibilities in exchange for revenue share, ensuring that all parties are sufficiently motivated to be part of the innovation and good revenue. International partners have pledged technical resources to improve efficiency and reduce overheads.

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

Traditional health insurance plans are inaccessible and unaffordable and provide indemnity (guarantee of settling hospital bills). Our product reduces the cost of insurance by over 85% and provides a lump-sum cash payout, thus giving the client the freedom to choose where they wish to seek treatment, and cash to meet these and other incidental costs that accrue when one is faced with these life threatening conditions. The Non Communicable Diseases that we are addressing are excluded on most insurances or severely limited. We bring a simple product with supported by a healthy lifestyle campaign

Founding Story

One Friday evening in 2010 as I was sitting outside my rural home 400 kilometres from Nairobi, I received a phone SMS from my sister R. She was expectant and had been having complications. However not having an insurance cover, she had not had the full benefit of a professional prenatal engagement. The SMS request was for some cash enough, I later learnt, to hire a taxi to an affordable hospital across the city. R did not make it to hospital. All my energies henceforth are directed to developing health insurance products..TO SAVE LIVES.
CO-CREATION IDEA: Please offer a brief description of how you imagine a win-win partnership with Boehringer Ingelheim to better serve unmet needs in health. (Hint: Please mention the underlying business model envisioned that would make such a partnership sustainable.)

BI can bring:
-Expertise in Cardiovascular disease, Stroke, Diabetes, COPD, Cancer
-Existing network of specialists, physicians and pharmacists, many of whom are recognized thought leaders
-Contact to academia & scientific associations
-Consulting expertise in stroke management, rehabilitation and accreditation of stroke centers
-Expertise in preventional & health awareness campaigns
-Expertise in drug supply & medication adherence solutions
-Expertise in Epidemiology & measuring health impact
-Network of potential partners in the healthcare space
-Network of Community Health workers via NGOs & social netrepreneurs, as potential point of customer contact & sales
-Ability to adapt & scale a solution to other markets

NEEDS: Based on you response above, please specify which of the following resources, operations or expertise by Boehringer Ingelheim you imagine leveraging to actualize the proposed co-creation opportunity. Please check all that apply. (Hint: while financing is often critical to scale, we are also interested in understanding what other assets or expertise could be leveraged).

Research and Development, Specific Disease Expertise, Relationships/New Contacts, Marketing/Communications Support, Human Resources, Access to Capital.

EXPLANATION OF NEEDS: Please explain your choices in more detail.

Expertise in Cardiovascular disease, Stroke, Diabetes, COPD, Cancer
Existing network of specialists, physicians and pharmacists
Contact to academia & scientific associations
Consulting expertise in stroke management, rehabilitation and accreditation of stroke centers
Expertise in preventional & health awareness campaigns
Expertise in drug supply & medication adherence solutions
Expertise in Epidemiology & measuring health impact
Network of Community Health workers via NGOs & social netrepreneurs,

OFFER: What are the main assets you may contribute in a co-creation partnership with Boehringer Ingelheim that would better serve unmet needs in health?

Deep understanding of an unmet need in a specific market/context, Access to and established trust with customers/beneficiaries, Insights into pricing and financing of health products/services, Insights into marketing, Insights into distribution, Insights into behavior change.

FOCUS AREAS: Which of the following best describes the main focus of your project? (select all that apply)

Improving the affordability of healthcare (e.g., microinsurance, reducing the economic cost of care), Models that engage other industry players (e.g., nutrition, athletic, mobility organizations)., Packaging of health products and services to address needs currently unmet.

Please share what your organisation and Boehringer Ingelheim will Co-Create together

We are proposing to co-create with BI a holistic micro-insurance package for 6 critical chronic illnesses (stroke, heart attacks, heart surgery, cancer, neurosurgery, organ transplant), targeting low-income “tier 2” patients in Kenya earning approximately 5 USD/day . BI and Changamka would leverage Changamka’s developing partnership with the Munich Re group which would play the role of primary insurer and reinsurer and leading MNO, Safaricom. Changamka would oversee the client intake and management process, Safaricom would bring its client network and MPESA payment platform, BI would bring its complementary disease expertise to build out additional value-add products & services around awareness, prevention and management for the critical 6 illnesses.

Please specify what your Co-Creation will result in:

a new product, a new market/customer group.

If you selected "other" above, please explain:
Please provide a 1-2 sentence summary of your Co-Creation idea

A holistic health insurance package focused on the most critical chronic illnesses targeting low-income communities in Kenya, co-created with the complementary assets of a social enterprise, Mobile Network Operator, pharmaceutical company and global reinsurance company.

How does this project link to the core mission of your organisation?

Changamka’s mission is to use technology to deliver affordable, accessible healthcare to the millions excluded from formal health systems. The core of the proposed solution is an affordable health insurance

Beyond social impact, how does this project link to Boehringer Ingelheim’s core business?

It links to several of BI’s priority therapeutic areas, mainly stroke, and conditions related to stroke. It provides BI with access to a new market and customer group, specifically in a priority market under BI’s Africa Strategy. It provides an opportunity for BI to explore the packaging of products and services around chronic disease care. It extends BI’s current partnerships to the reinsurer space.

What are the specific inputs and actions that each side will contribute to this Co-Creation idea based on each of your unique competencies and experiences?

○ My organization will contribute:
- The Technology platform on which the product will run
- The product administration comprising:
- Customer call centre
- Set up of medical provider network and management thereon
- Market expertise based on experience in working with low income populations in Kenya
- Partnership coordination between Munich Re, Safaricom and BI
- A strong multi skilled team

○ Boehringer Ingelheim will contribute:
- Disease expertise on stroke and other NCDs
- A network of specialists that could serve for referrals and advisors
- Development of value-add disease prevention and management tools (as part of insurance package)
- Linkages to referral partners

Please describe the potential revenue model for this Co-Creation idea.

The product charges premium for each subscriber, with the premium levels graduated by age group. Munich Re actuarially determines a Net Risk Premium (NRP). This NRP is the amount required to cover the cost of risk. To this NRP is a loading factor to cover administration, marketing and profit to get a Gross Premium. The partners share the loading component based on agreed objective criteria.

What possible risks or challenges do you foresee?

Partnership risk which could materialize should any of the collaborating parties fail to honor their obligations. The product will be delivered through a mobile telephone provider network, and in collaboration with an insurance underwriter and pharmaceutical. Given the inherent diversities, there is need for commitment and alignment for success and scaling.

Product risk, which could materialize, should the scale-up project fail to capture the interest of the market as projected in the product budgets. This would be overcome by implementing an elaborate marketing strategy and feedback loop supported by all the parties in the program.

Is there anything else you would like to share about your Co-Creation idea?

Huge potential to co-create with other Ashoka Fellows working in the health care space, such as MicroClinic Technologies, Riders for Health, Medic Mobile and Access Afya, among others.

How much input do you hope to receive from Boehringer Ingelheim?

I’d like to implement together, other (Please explain below).

If you selected "other" above, please explain:

I'd like to design together

Besides Boehringer Ingelheim, what other types of partners might be valuable to carrying out your Co-Creation idea, and why?

● Referral partners that are working closely with the communities we want to serve
● Specialists to provide second opinion on contentious diagnoses
● A reliable logistics partner to receive and upload claims documentation
● Advertising and marketing agency to design and execute communication strategy
● A Monitoring & Evaluation partner
● A call centre to provide 24/7 interactive customer engagement
● The Mobile Network Operator to provide:
- Connectivity
- Mobile money payments
- Cloud for data storage