There have been debates over the last few years about the appropriateness of the traditional Y Combinator-style accelerator programme to the needs of African startups.
Sandheep Ramluckan, managing director (MD) of Cape Town-based programme StartUp90, told Disrupt Africa last year traditional accelerators had not worked in Africa due to the lack of VC funding, while Chika Nwobi of 440.ng said it remained to be seen whether the concept employed by the VC firm last year in Nigeria had worked.
Sector-specific accelerators, however, appear to be growing in popularity, and no more so than in the e-health sector, an area where a number of African startups have been making waves.
Disrupt Africa reported in July African entrepreneurship initiative AMPION and healthcare firm Merck had partnered to launch Africa’s first healthcare accelerator, while in South Africa advisory firm Visions2Ventures has partnered Impact Amplifier and Entrepreneur Traction to launch the Enterprise Elevator accelerator programme, which will focus on high impact healthtech startups.
According to Max Pichulik, partner at Impact Amplifier, the attraction of e-health startups to investors is the size of the challenge they are tackling and their scalability. He says the large potential impact of such startups and the fact they can serve Africa’s emerging middle class better than the private sector, makes them viable investment destinations.
“We’re very excited about next wave sequencing machines, and the ability to cost effectively treat a whole range of illnesses using DNA sequencing,” said Pichulik.
“Public health care innovation, public market access and technology proliferation is slower with large donor and 3rd party funded projects by agencies taking the role of innovation initially. However, the impact potential in the public health system is massive, and the private sector will increasingly play an important role with the underserved population.”
According to Pichulik, Impact Amplifier and its partners are seeing a lot of movement from a mobile perspective in home-based care – in tracking visits, treatment, patient records and referrals.
“The key for entrepreneurs trying to play in the public health system, is that it takes patience, international networks and the wisdom to sometimes not start with that market segment in the beginning. But impact it over the medium and long term,” he said.
“The ability to increase healthcare access, speed up diagnostics, reduce costs and aggregate research data provides a very exciting step change potential for tech-enabled health businesses.”
It is not just those investing in e-health that sense there are serious opportunities within the sector in Africa. Dr Etienne van Wyk, healthcare programme manager at Frost & Sullivan Africa, says e-health innovations will drastically impact both access to and cost of services.
“In Africa more people have access to mobile networks than to water and electricity. This in turn makes e-health solutions immensely scalable, which will naturally drive down the cost. With a growing penetration of mobile devices in Africa, access to products and services will be greatly impacted as well,” he said.
Van Wyk sees “enormous potential” especially in solutions that incorporate sensors or wearable technology, along with the role they can play in remote monitoring and the management of non communicable diseases (NCDs) such as diabetes, and cardiovascular and chronic respiratory diseases.
“Until now, technology in wearables has been focused on lifestyle and fitness solutions, but there is a lot happening in the sensor technology space that could alter all of that very soon. The main area of value, that is potentially being developed, is how data is analysed and interpreted in order for consumers to derive value from it,” Van Wyk said.
Opportunities also lie in the provision of patient portals. In its recent Patient Portals in Africa analysis, Frost & Sullivan said African healthcare providers are gradually recognising the convenience and cost benefits of adopting patient portals integrating financial and clinical data, giving a boost to a number of startups operating in the e-health sector.
Brett Steingo is managing director of one company providing such portals, Medishare, which is focused on communication and collaboration between healthcare professionals. It features a community-based assistance platform for doctors, with GPs able to get advice from many of the country’s leading specialists and academics.
Steingo said there were a huge range of scenarios where electronic solutions can be of benefit to African doctors and patients.
“In terms of EMR (electronic health records kept by the doctor) and EHR (Electronic Health Records normally owned by the patient), having this information better managed can lead to improved patient care as well as better privacy protection,” he said.
“In an emergency situation, there could be pre-approved procedures for medical personnel to access important details about a person not able to supply the required information. Patients often have to fill in the same details repeatedly at different hospitals, departments or at each doctor they visit. Doctors do not always get complete histories from referring colleagues.”
Steingo said electronic solutions can potentially solve these problems, define how information is shared and make important records available to all authorised medical professionals that need them in order to best assist the patient. Doctor’s billing can also be simplified, while information sharing between healthcare professionals is improved.
Puseletso Mompei is new business director CenHealth, which allows users to keep an electronic version of their health records, storing information from weight and height to allergies and allowing South Africans to keep a health diary of all doctor appointments.
Mompei said the benefit of CenHealth is that it puts the patient in control and makes them an active player in their healthcare, by providing a platform that enables the patient to give doctors and other health care practitioners accurate facts on their history.
This reduces the incidence of errors or misdiagnosis, while patients can also be advocates for their own health and spot changes or patterns in their health, which they can report to their doctor.
“Imagine the power of you being able to recall with great accuracy your visits to the Doctor, the prescriptions given and also the timelines of the symptoms you experience? This is very valuable to both patient and doctor as, more detailed diagnosis is available and better treatment plans are given by the doctors,” Mompei said.
“This is a win-win for all. Especially with the challenges we have in Africa, where patients generally have little or no access to their health history- which is usually scattered around different doctor’s rooms or hospital files, with no visibility to the information held. Giving patients the ability to hold on to their information allows for portability, which is important in today’s world where trends such as urbanisation and migration are driving mobility, which means many people travel without any means of storing their health history.”
Public, private collaboration
Being able to work with the public sector is crucial to the development of e-health businesses in Africa. Mompei says there has been a lot of innovation in recent years from the private sector, but to gain true scale they need government participation.
Partnerships are crucial for scaling private innovations to populations, as is the pooling of resources,” he said.
“In our case, we recognise that our health system is stretched with priorities ranging from infrastructure to staffing, if we can empower patients to store and manage their health information, then that reduces the burden on hospitals and health practices which don’t have the extra cash to invest in expensive solution.”
Mushambi Mutuma of South Africa’s SmartPrac, which provides cloud-based electronic health record and practice management software, said partnerships between the public and private sectors are necessary given the fact that across the continent health systems are too weak or under-resourced to adequately address the high burden of disease and demand.
“Our healthcare systems do not have the capacity to match the scale of it’s problems and core issues like primary access to care,” Mutuma said.
van Wyk says solutions will naturally be developed and brought to market by private companies, and that it is up to government to adopt the technology as it becomes available and shows efficacy.
“The most predominant challenge is that governments need to start offering a transparent regulatory environment for the use of technology,” he said.
“Africa is especially lagging in this department in comparison to the rest of the world. The private sector needs clear direction and certainty with regards to future regulation from government; otherwise they will not invest in developing and implementing e-health solutions, the cost is simply too high.”