On Febuary 25th, ACCESS Health and bKash co-hosted a roundtable discussion with healthcare organizations in Dhaka on the finance challenges that patients face in accessing care, and how digital finance can be part of a solution.

The discussion was far-reaching and led to a few insights:

  1. Healthcare organizations often think of insurance as the primary, and sometimes only, solution to health financing challenges. When discussing healthcare financing challenges broadly, insurance emerges and re-emerges as a solution, despite very low uptake and trust in insurance in Bangladesh. Roundtable participants said that when people see the word “insurance,” they immediately think of life insurance, which means talking about death and people don’t want to do that. So they write off the idea of insurance before considering it
  2. When faced with specific health financing and accessibility challenges, which in this instance was maternity and newborn care, the ideation process and conversations veer toward creativity and are expansive in solutions-finding.
  3. Translating health financing challenges into problem statements for the finance industry is a challenge but possible. What emerged through our roundtable discussion is that, while healthcare people speak in terms of therapeutic or disease areas, or as a set of healthcare challenges for a particular population (in this case pregnant low-income women), finance people see the opportunity in healthcare but need to speak in their own language. What we need to do at ACCESS Health is to collate epidemiological data across disease and therapeutic areas that face similar finance challenges and reframe those numbers as the number of people who need a particular type of financing solution, in order to quantify the market opportunity in financial terms. A roundtable participant suggested that we organize future discussions around target groups or healthcare challenges (e.g. maternity care, NCDs, primary care, etc.) as a next step.
  4. Having said that, finance solutions will still need to be integrated by healthcare challenge. Once a common digital finance platform is created or tailored for healthcare, it can become more powerful when combined with healthcare focus areas through packages of care. This brings a new proposal or query to light: how can digital finance present an opportunity for value based care models in the private sector?
  5. For the purposes of ACCESS Health’s Fintech for Health initiative, it is good to have high level conversations but implementation will require finding and working with local partners who are patient centered and agile enough to partner with ecosystem partners. This will most likely be a startup who acts as an aggregator with traditional healthcare organizations and fintech partners.
  6. Most of the development organizations are evolving their business models from donor funded and donor driven to sustainable business models that involve co-pays by the patient. These organizations are taking their expertise and research and turning it into a startup model, working with patients and catering care to what people are willing to pay for and the value that patients see in the products and services. It is an exciting time for development of the healthcare market in Bangladesh, as it is on the verge of reaching middle income status, donor funding is being scaled back, and the tech talent is continuing to grow.
  7. Finally, this roundtable discussion reaffirmed that the best motivation for us is working with people who are passionate about their work and see healthcare as a human right, delivering that care in ways that are sustainable.

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