Ensuring that promising mobile healthcare initiatives achieve long-term financial sustainability is not always easy. Proactive monitoring and constant re-balancing of the value chain are among the keys to success, a recent report indicates.

mHealth: Emerging Country Projects Need Firm Backing All Along the Value Chain

Achieving financial sustainability for m-health sector business models is a far from straightforward matter, and project managers and donors often encounter difficulties getting their projects on to a firm footing. The mHealth Alliance, a Washington DC-based organisation whose activities focus on strategic priorities for addressing the gaps in the mHealth ecosystem, has just published a report*, which underlines the need to constantly re-evaluate the viability of the supply and demand situation in a given area. This goes especially for the emerging countries that are among those spearheading development of mobile healthcare services. Moreover, mHealth project managers must focus attention on each of the various players – governmental organisations, NGOs, health sector workers, suppliers of hardware and the end- buyers of the product or service – who together make up the project’s value chain. Keeping the project on a financially stable footing depends on understanding and managing this value chain properly, which is not always the case, the report points out. All the links in the chain, whoever they are, are subject to change, and market conditions may also vary due to economic or political factors, frustrating the plans of the project originators.

m-health projects also have a life-cycle

The report stresses that achieving financial sustainability, especially for projects in emerging countries, is not a one-time event. Even when a project has matured and has become financially stable, this state of affairs “can only be maintained through a process of ongoing monitoring and evolution.” Even though smooth communication between the various players may seem to have been achieved, the report recommends nevertheless that the primary donors verify that all the infrastructure has been set up, especially that the necessary channels for selling the product are in place. If a product fails to achieve success, this should spur the project originators to look again at the value chain and bring in more players as necessary. The report quotes the example of the Changamka Microhealth service in Kenya, which provides a mobile technology micro insurance service. In order to make the project viable, Changamka had to go into partnership with leading Kenyan insurance company GA Insurance.

Achieving long-term stability

The Changamka example illustrates one of the main recommendations of the report. An mHealth project must remain differentiated in the local marketplace. Changamka offers both medical insurance and a Smart Card system which provides a format for saving up for medical treatment – especially related to maternal healthcare – and also administers voucher programmes to help women access and use government health subsidies. And it seeks to offer its services at an affordable price. A range of services such as that provided by Changamka enables project managers to demonstrate the value of the investment to NGOs, public sector bodies and private partners, as well as to the purchasers of the services, which should help to ensure project sustainability over the long term, the report argues.

*Sustainable Financing for Mobile Health (mHealth): Options and opportunities for mHealth financial models in low and middle-income countries; © 2013; commissioned by the mHealth Alliance from Vital Wave, a consulting firm based in California

By Guillaume Parodi