Project name:
Rise Above
One-line project summary:
Rise Above uses transformational technology to scale inclusive entrepreneurship & employment opportunities for female healthcare providers
Present your project.
The exclusion of women in the workforce in both developing countries and mature markets has resulted in not only a massive loss of human potential but also loss of human life - especially in developing countries such as Pakistan where over 140 million people continue to lack access to quality, affordable healthcare.
doctHERs elevates humanity by enabling women to achieve their full potential. We match the under-utilised capacity of female doctors to the unmet needs of health-seekers.
We recruit, train and equip female frontline health workers (FHWs) with 4G wifi-enabled tablets. We deploy these FHWs in communities and industrial venues (e.g. textile factories) where they are able to connect health consumers (especially female factory workers who otherwise have highly restricted access to women's health) to remotely located female doctors. Our trusted intermediaries are trained to conduct sophisticated diagnostic and interventional procedures under the guidance of a remotely located female doctor.
Submit a video.
What specific problem are you solving?
The exclusion of women in the workforce in both developing countries and mature markets has resulted in not only a massive loss of human potential but also loss of human life - especially in developing countries such as Pakistan where over 140 million people continue to lack access to quality, affordable healthcare.
In Pakistan, the good news is that over 65% of the graduating medical classes over the past 5 years have been women. The bad news is that over 70% of these doctors are not participating in the workforce.
Reasons for exclusion of female doctors include: (i) socio-cultural barriers that discourage women from working in public spaces (ii) unsafe work environments where gender harassment is a major issue and (iii) rigid public health systems that prohibit doctors from working part-time or flexi-time and that have not adapted to the agile, work-lifestyle needs of contemporary women.
What is your project?
Female frontline health workers (community health promoters, nurses and midwives) are recruited, trained and equipped with technology - hardware, software and wifi/broadband connectivity. They are then deployed in corporate offices, factories, retail clinics and ambulances where they are able to connect health consumers (especially female workers who otherwise have highly restricted access to women's health) to remotely located female doctors. These trusted intermediaries are trained to conduct sophisticated diagnostic and interventional procedures under the supervision and guidance of a remotely located (home-based) female doctor.
In the 'Guddi Baji' (good sister) project, in collaboration with Unilever and UKAID, Grand Challenges Canada, Philips Foundation & Pfizer Foundation, doctHERs has deployed 150 Guddi Bajis who cross-function as last-mile retailers and mobile money agents. These GBs also provide their underserved communities with access to essential health/hygiene supplies and are playing a crucial role on the frontlines in the midst of the COVID-19 pandemic.
In 2019, doctHERs impacted over 1 Million women and girls across 1500+ villages via the FHW-assisted telemedicine model.
Who does your project serve, and in what ways is the project impacting their lives?
Our target population are women (ages 18+) and children (ages 0-18) living in: (i) rural villages and (ii) peri-industrial zones in the provinces of KPK, Sind & Punjab (Pakistan). Women living in rural villages tend to be self-employed farmers with an income of less than $3/day whereas the women in industrial zones tend to be working in garment factories and have an average income of ~$4-$5/day.
When designing our model, we immersed ourselves in the target population we are serving so we could observe their natural behaviour. As a result we have a more nuanced understanding of their actual needs (in addition to the needs they verbally expressed). We rapid prototyped our model to deliver different types of frontline health interventions with or without remotely connected doctors. The model which received the most positive feedback and which we continue to iterate on is the nurse-assisted video-consultation model. We also have created tight customer feedback loops that feed directly into our service design.
Which dimension of The Elevate Prize does your project most closely address?
Elevating opportunities for all people, especially those who are traditionally left behindExplain how your project relates to The Elevate Prize and your selected dimension.
(i) The reintegration of women healthcare providers into the workforce (i.e. doctors, nurses and community health workers at the frontlines) via the Guddi Baji Project helps to address one of the key market failures that doctHERs seeks to address, i.e. the exclusion of women from the workforce (and from financial autonomy).
(ii) The other market failure (on the demand side) that doctHERs tackles is providing access to high-quality healthcare
(iii) The 'Guddi Baji' frontline health workers originate within their communities. These GBs convene interactive workshops which enable the target women to co-create interventions, relevant to their unmet needs.
How did you come up with your project?
Growing up in the UK and coming of age in Pakistan, doctHERs' CoFounder, Asher observed a vast discrepancy: those with and without access to basic healthcare, and the devastating social consequences of this disparity. He narrates the story of how he witnessed a single health disaster ruin the hopes of his childhood friends in this TED Blog: https://blog.ted.com/working-for-the-health-of-the-many-how-asher-hasan-is-bringing-insurance-coverage-to-pakistans-low-income-workers/ This tragedy compelled Asher to attempt to transform a broken healthcare system with his Pakistan-based health micro-insurance company, Naya Jeevan, which offers both quality, affordable healthcare to underserved communities and the financial and social inclusion the rest of us take for granted.
Between 2011 and 2012, female health plan members of Naya Jeevan expressed an unmet need for: (i) good quality primary care where they worked or where they lived and (ii) access to female physicians, especially for reproductive and gynaecological issues. This customer feedback triggered the quest for a primary healthcare delivery system in Pakistan and the realisation that more than half of the qualified, female doctors were not participating in the health system. doctHERs was the response to these unmet needs.
Why are you passionate about your project?
Growing up in the UK and coming of age in Pakistan, doctHERs' CoFounder, Asher observed a vast discrepancy: those with and without access to basic healthcare, and the devastating social consequences of this disparity. He narrates the story of how he witnessed a single health disaster ruin the hopes of his childhood friends in this TED Blog: https://blog.ted.com/working-for-the-health-of-the-many-how-asher-hasan-is-bringing-insurance-coverage-to-pakistans-low-income-workers/
Why are you well-positioned to deliver this project?
We are a diverse team of cross-sectoral experts - with over 60 cumulative years of experience in the following industries: pharmaceuticals, healthcare, finance, online education, AI technology, big data science, design thinking, gender-inclusion and women's entrepreneurship.
Over the past 5 years, we have taken our social business (doctHERs) to scale and profitability in Pakistan. We are now embarking on a major scale-up/amplification of the frontline health worker initiative to enable us to further amplify our impact across South Asia and North America.
Provide an example of your ability to overcome adversity.
As documented in this Forbes article, Asher's life changed after his father died in 1983. His mother moved him and his three sisters to Karachi, settling them in a spacious house near the grandparents, and then returned to the U.K. to tie up loose ends. That's when she suffered a nervous breakdown and spent the next three years in a hospital. Hasan and his siblings somehow made ends meet on an educational stipend that his father's bank provided them. "We went from living an affluent lifestyle to almost living on the poverty line," recalls Hasan. "The experience gave us the opportunity to see what it was like to be on the outside looking in."
Describe a past experience that demonstrates your leadership ability.
In order to provide transform the health system Pakistan via his first social venture (Naya Jeevan; http://www.naya-jeevan.com), Asher "left the biotech industry, took a quantum leap of faith and plunged full time into tackling this issue."
Asher further states: " I took a bunch of graduate students with me to Pakistan and India, and we did a fairly thorough, three-month landscape analysis of the health systems there to understand the nature of the beast. We looked at the public and private health care systems, the health ecosystem and various stakeholders. We paid special attention to the role of the private sector as payors. It was a fairly rigorous assessment of what the status quo was, what the unmet needs were. We interviewed a lot of our potential customers — low-income beneficiaries — to better understand their needs."
In other words, Asher left his medical career to pursue a systems-level change via his social business - something that requires both courage and leadership.
How long have you been working on your project?
Naya Jeevan - since 2007; doctHERs since 2013
Where are you headquartered?
Karachi, PakistanWhat type of organization is your project?
Hybrid of for-profit and nonprofitIf you selected Other, please explain here.
doctHERs was spun off as an independent, impact organisation in 2015 after having been incubated by its 'parent', Naya Jeevan between 2013 and 2015. Both organisations were founded by Dr. Asher Hasan.
If you have additional video content that explains your project, provide a YouTube or Vimeo link here:
Describe what makes your project innovative.
(i) Our project is humanity-centered:
(ii) Our project is gender-equal and culturally-appropriate: we use technology to match the underutilised capacity of female doctors (who would otherwise be excluded from the workforce) to the unmet needs of health-seekers.
One of the key target populations of our gender-inclusive employment approach are female frontline health workers. We recruit, capacitate, and equip these workers with laptops, tablets and smartphones. These trusted intermediaries are pivotal to our model as they help engender trust with health-seekers in a culture which prefers in-person human interaction over virtual communication. Accordingly, we are able to leverage both the exponential potential of technology and the power of the human touch.
What is your theory of change?
We believe that the re-integration of women into the workforce (output) by leveraging technology (an input) will yield increased economic empowerment for women (outcome) which will ultimately lead to increased returns for both society and participating corporate/business partners (Impact). This theory of change is based on compelling evidence cited by Dalberg (1) and the Cherie Blair Foundation (2) which reports that "female sales agents had superior customer service skills and processed customer queries more quickly than men"
1. Dalberg: "The business Case for Women's Economic Empowerment"; 2014
2. Cherie Blair Foundation: “Women Entrepreneurs in Mobile Retail Channels”; 2011
Select the key characteristics of the community you are impacting.
Which of the UN Sustainable Development Goals does your project address?
In which countries do you currently operate?
In which countries will you be operating within the next year?
How many people does your project currently serve? How many will it serve in one year? In five years?
- The current number of people we’re serving through our work: 1,150,000 (One Million, one hundred and fifty thousand)
- The number we’ll be serving in one year: 2 Million Lives
- The number we’ll be serving in five years: 25 Million lives (25 by '25)
What are your goals within the next year and within the next five years?
Our 1-year goals include:
- integration of other corporate partners into our last-mile retailer value chain program (e.g. Roche, Novartis, Telenor, etc)
- Direct Impact on 2 million women and girl-children across Pakistan
- Indirect Impact on 6 Million lives (families of women - including male members, i.e. husband, son, brother, father)
- 25% increase in monthly income of Guddi Baji (compared to baseline, time=0)
Our 5-year goals include:
- Replication/adaptation of our model by the Federal government of Pakistan as well as provincial governments
- Direct Impact on 20 million women and girl-children across Pakistan
- Indirect Impact on 100 Million lives (families of women - including male members, i.e. husband, son, brother, father)
- 100% increase in monthly income of Guddi Baji (compared to baseline, time=0)
What barriers currently exist for you to accomplish your goals in the next year and in the next five years?
- Deep local market knowledge: of the deep rural villages in which we will are delivering services
- Regulatory: clinical guidelines around telemedicine remain murky at best in South Asia in general so this is a potential risk that needs to be mitigated.
Our potential 5-year barriers include:
- Political: working in South Asia requires careful navigation of political waters. Some high-impact growth ventures have run afoul of the political powers that be so this is something we need to be cognisant of.
- Informal Worker Labour Unions: Although such unions do not exist at the present time, we need to be aware that this risk exists. )
How do you plan to overcome these barriers?
Ways to Overcome 1-year barriers include:
- Deep local market knowledge: we plan to mitigate this risk by collaborating with local tech-enabled women entrepreneurs (Guddi Bajis) and grassroots-level organisations (e.g. RSPN) in the health & wellness space.
- Regulatory: One way to mitigate this risk is to be part of the solution - i.e. to engage the government on formulating guidelines that enable innovation while enhancing quality of care and patient safety.
Ways to Overcome 5-year barriers include:
- Political: We need to ensure that we work in an apolitical manner and engage governments across the political spectrum.
- Informal Worker Labour Unions: One way to mitigate against this risk is by ensuring that all of our frontline workers are provided with employee benefits that are traditionally enjoyed by workers in the formal sector (e.g. health insurance, paid leave, etc)
What organizations do you currently partner with, if any? How are you working with them?
[1] We collaborate with large, multinational corporations (MNCs) such as Unilever, Nestle, Friesland Campina, etc and provide workers (and families including parents) in their value chains (i.e. suppliers, smallholder farmers, distributors, SME retailers, factory workers, etc) with access to a highly curated, continuity-of-care, health & wellness program. This program focuses on the 'missing middle' the low-income population that constitutes that largest segment of the population (~60% or 120 million lives) but who cannot rely on charity or on public sector healthcare (the urban/rural ultra-poor typically receive charitable care).
[2] in the Guddi Baji program, we are integrating additional corporate partners (e.g. Roche, Novartis, Philips, Pfizer, etc) into this urban center to last-mile village program that connects last-mile retailers (Guddi Bajis) to formal corporate value chains linked to Unilever's massive in-country distribution system.
[3] We collaborate with grassroots-level implementing partners (LSOs such as RSPN http://rspn.org/ and BRC, a rural market activation agency; https://brcpakistan.com/services/)
[4] We are members/fellows of the following bilateral and multilateral institutions (in collaboration with our parent company, Naya Jeevan): a) Aspen Network of Development Entrepreneurs, b) TED, c) WEF/Schwab Foundation, d) UNDP, e) Synergos, f) MIT SOLVE
[5] We are supported by the following donors & impact investors: a) Gray Matters Capital, b) UKAID, c) USAID Development Innovation Ventures, d) Grand Challenges Canada
What is your business model?
Our core business model is very straightforward: we charge corporate employers/sponsors a subscription fee for a monthly digital health & wellness plan of ~$5/person/month. Our COS (Cost of Sales) is $2.50/person/month, yielding a gross surplus of 50%. After deducting SGA (sales, general & administrative) operating expenses, we are able to generate a net profit margin at the unit economic level of ~15%-20%.
Corporations are willing to pay this amount both to mitigate against reputational risk (worker HSE regulations) as well as to incent their value chains ( distributors, retailers, etc) to perform better - our path to scale.
What is your path to financial sustainability?
We have 3 major revenue streams identified for 2020-22:
- Earned Income via SMART telemedicine clinics: $250,000 projected for 2020-21
- Health Service Delivery Contracts for Corporate Value Chains (suppliers, distributors, retailers, etc) - $1.5 Million projected for 2020-21
- Growth Capital - Series A - $2.5 Million
If you have raised funds for your project or are generating revenue, please provide details.
Seed:
- Gray Matters Capital: $120,000
- Naya Jeevan = $100,000
- Non-dilutive awards/competitions, etc: $230,000
Total: $450,000
Series A:
- Unilever: $800,000 (non-dilutive capital)
- Punjab Population Innovation Fund: $125,000 (non-dilutive capital)
- Philips: $150,000 (non-dilutive capital + in-kind)
- Pfizer: $100,000 (non-dilutive capital)
- Levi Strauss Foundation: $75,000 (non-dilutive capital)
- Tiger IT Foundation: $500,000 (equity/convertible debt)
- Gray Matters Capital: $120,000 (equity/debt)
- Naya Jeevan: $100,000 (debt)
- Grand Challenges Canada: $200,000 (non-dilutive capital)
Total (to date): $2.17 Million
If you seek to raise funds for your project, please provide details.
Series A: remaining bullet - $500K, close by December 2020 (preferably equity, $25 Million valuation)
What are your estimated expenses for 2020?
Expenses: $1.5 Million
Why are you applying for The Elevate Prize?
Although we've done it before - i.e. piloted and scaled Naya Jeevan, an "HMO for the marginalised" to profitability in Pakistan (over 300,000 health plan members enrolled over the past 7 years) - where the ELEVATE prize can really help doctHERs is by fast-tracking our path to global replication through collaborations/partnerships with other like-minded impact investors, donors and entrepreneurs who may be interested in replicating/adapting this model in their emerging market of choice (as well as the US/Canada where this model can be replicated with a special focus on migrant workers and First Nations people).
Perhaps there's a Moore's-like 'law of exponential replication' waiting to be discovered in the tech-enabled social enterprise arena!
In which of the following areas do you most need partners or support?
What organizations would you like to partner with, and how would you like to partner with them?
- Management Consulting Firms (Accenture, BCG, McKinsey)
- Digital Health Innovation companies (Google, HP, McKesson, etc)
- Software Integration Companies
Solution Team
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Dr Asher Hasan Co-Founder, doctHERs & Founder, Naya Jeevan
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Your bio:
A TED speaker, TED fellow and MIT SOLVER, Asher has previously served on the World Economic Forum Global Agenda Council for Social Innovation (2012-2014) and is a 2011 World Economic Forum/Schwab Foundation Asian Social Entrepreneur of the Year.
Prior to launching NAYA JEEVAN, Asher served in the capacity of Senior Director of US Medical Affairs for Amylin, a leading bio-pharmaceutical company in San Diego, CA.
Asher completed an MBA from New York University’s Stern School of Business and conducted preclinical research at Harvard Medical School & Massachusetts General Hospital, followed by training in General Surgery at Beth Israel Medical Center.
A voracious reader, Asher is also fond of hurtling down alpine ski slopes, bathing in the hot springs of Esalen and cruising in the Caribbean. Bali, Rio de Janeiro, Lake Bellagio and Istanbul are his favourite destinations for spiritual rejuvenation.