USING MOBILE MONEY TO PREPAY FOR HEALTHCARE IN KENYA

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1 USING MOBILE MONEY TO PREPAY FOR HEALTHCARE IN KENYA Mexico City, November

2 PHARMACCESS GROUP 1

3 Connecting people to quality healthcare Kenya s health system challenges, opportunities & strategies Problem Challenges Stuck in a vicious circle Low demand and low-quality supply - no quality standards Mortality <5yr 108k, Maternal 5.5k at birth Health Expenditure $17, OOP $21, Donors $19 / capita 43% of 42 mio live below poverty line Institutional environment is weak, little enforcement Lack of trust & low level of investments due to high risks Lack of reliable data and information Opportunities Kenya is developing rapidly Economic growth 5-7% and growing middle class, increasing demand for quality healthcare Mobile penetration 93%, M-PESA penetration 85%, 60% of GDP flows through M-PESA Government dedicated to work towards universal health coverage and acknowledges role of the private sector New constitution states right to quality health services

4 Movie: Mobile Health Research Lab started in July

5 mhealth: THE SOLUTION A matrix for development of products & services mhealth landscape - examples - mhealth opportunity Payer Producer Enrollment Advocacy Health status reporting Quality assurance Inventory & logistics Drug check Premium collection Access to public and donor benefits Claims payment Reimbursement Reporting services Drug credit facility Provider P2P consultation Task shifting Education Patient records Reimbursement Reporting services Patient Call center consultation Logistical services Education - Prevention Mobile vouchers Mobile health wallet Voice SMS Data Communication Payments, Savings & Loans Financial transactions

6

7 M-PESA is Kenya s income redistribution model Transformed from a cash economy to a digital mobile-money economy Usage by region Facts Amounts sent/received More users in Nairobi & Central region than elsewhere (remitting money from urban to rural) 2. Typical transaction size is KES (5-10 euro) 3. Larger amounts (>25 euro) are sent by a small group of people: more receivers than senders 4. Group structures play an important role in raising and saving money, often with mandatory contribution because of strong peer pressure Source: FinAccess Annual Survey 2013 Recent study: Shocks, remittances, insurance and M-Pesa, Evidence from western Kenya VU Amsterdam - Vera Nicole Ide

8 CONNECT PAYERS, BENEFICIARIES AND PROVIDER Das Bild kann nicht angezeigt werden. Dieser Computer verfügt möglicherweise über zu wenig Arbeitsspeicher, um das Bild zu öffnen, oder das Bild ist beschädigt. Starten Sie den Computer neu, und öffnen Sie dann erneut die Datei. Wenn weiterhin das rote x angezeigt wird, müssen Sie das Bild möglicherweise löschen und dann erneut einfügen.

9 Das Bild kann nicht angezeigt werden. Dieser Computer verfügt möglicherweise über zu wenig Arbeitsspeicher, um das Bild zu öffnen, oder das Bild ist beschädigt. Starten Sie den Computer neu, und öffnen Sie dann erneut die Datei. Wenn weiterhin das rote x angezeigt wird, müssen Sie das Bild möglicherweise löschen und dann erneut einfügen. Mobile money payments can be made virtual and conditional, increasing trust and control Condition: only for health Condition: only if medical data is submitted CLINIC SUPPLIER Condition: based on pay per use

10 Start of the M-Pesa - PharmAccess Partnership Rapid testing of prototypes in the Mobile Health Research Lab (since August 2013) Provider signs up with M-PESA Provider gets unique shop number Provider agrees to participate in SafeCare Patient uses M-PESA to pay for healthcare by transferring money / entitlement to the provider Patient does not pay transaction fee Transaction successful if a) both patient & provider are known to the system, b) patient has sufficient balance or entitlements, and c) patient approves the transaction with their personal PIN (=empowerment) Currently being installed at health facilities

11 Mobile Health Research Lab Lessons learned (1) Effects of introducing digital payments Safety / Security Pregnant women coming to the clinic after dark can no longer # hits be on robbed USSD menu of their cash More women coming to the clinic to deliver More women able to pay for delivery themselves, remittances are received real time Less leakage (i.e. money disappearing), estimated at 25-35% Lower cash-handling usage & by administration age group cost, less security risk at the clinic

12 Mobile Health Research Lab Lessons learned (2) Mobile Health Wallet People at the bottom of the pyramid have no trouble operating mobile technology. # hits on USSD menu Both patients & providers are willing to use mobile health wallet Women organized in savings groups ( chamas ) are willing to save for health Trust plays an important role who will be holding my money? Participants used usage their by (donor-supplied) age group funds sparingly. Only one family spent the full amount, to pay the morgue

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