Health Remittances: Optimizing Resources from the African Diaspora for Health

Remittances are an essential source of income for families around the world. An estimated 800 million people globally rely on remittances for their essential needs. Remittances also comprise 3% or more of GDP for a total of 19 African countries (African Business Magazine). Healthcare, along with daily expenditures, housing, and education, is one of the primary uses for remittances, but there are no formal channels to organize remittances for health.

Just launched, Remit4Health hopes to change that by providing innovative health solutions that will make care more accessible, affordable, and effective. Starting in Kenya, the company enables the diaspora to better leverage their financial resources to purchase affordable, comprehensive coverage plans for their loved one’s back home. In addition, plans are accompanied by health navigators who will support members throughout their health journey. Remit4Health also offers a medication wallet for those only seeking access to high-quality medication.

Dr. Kebba Jobarteh, the founder and CEO of Remit4Health, has an impressive professional and educational background with expertise in designing, implementing, and scaling national public health programs in emerging markets. As Care and Treatment Branch Chief for the U.S. Centers for Disease Control and Prevention in Mozambique and Director of Pediatrics at Partners in Health in Malawi, he established a strong track record of bringing innovative solutions from seed to scale. Dr. Jobarteh earned an MD from Yale Medical School, an MPH from Harvard School of Public Health, and an AB in Politics from Princeton University.

1. Why did you start Remit4Health?

Jobarteh: I am a member of the diaspora, born in Kenya to a father from Gambia and a mother from Argentina. I have lived all over the world and currently reside in Mozambique. Part of the social contract of being a member of the diaspora is sending money home; if you are financially secure you send remittances back to your family.

The health of their families back home is something that people in diaspora always worry about, especially for those loved ones living in an area where care is not reliable. Consequently, of the six hundred billion dollars the diaspora sent home every year in remittances, 10-15% goes to healthcare, which is an enormous amount of money. Questions remain, however, as to the efficiency and quality of the care those remittances pay for.

Last year, I sent money home for the healthcare for my grandmother. Despite the fact that I am a doctor, I couldn’t assess the quality of care she was getting or look into available alternatives. And so I sent money and I worried. And that was all I could do. There is no organized channel for health remittances. I hope with Remit4Health, we can change the way healthcare is provided and accessed.

2. What are the challenges in using traditional or agnostic channels for health remittances?

Jobarteh: With the current way that remittances are handled for health, there is no guarantee of good care or improved health. There are many reasons for this, but perverse incentives are at the heart of the problem. For example, family members of the diaspora back home often do not spend remittances on preventive care or treatment before there is an urgent need. This is because people tend to discount the future need and spend money on current needs, which is why they postpone seeking care until they have no choice. But if we instead directly channel remittances to prepay for coverage, we can break the unvirtuous cycle of delayed care seeking. Those with prepaid coverage will have better incentives to seek preventative care and earlier medical interventions, which will result in better outcomes and overall improved health.

Right now, despite the considerable buying power of the diaspora’s remittances, that money is not having much of an organized or systematic effect on health systems back home. In many of those systems, including those in East Africa, remittances fall into a maelstrom of misaligned motives. I believe that if we properly channel remittances and target health coverage, we can shift the system.

3. How can Remit4Health impact healthcare?

Jobarteh: We hope to improve health outcomes for our members but also to change the dynamics of healthcare. If done right, Remit4Health can better align incentives for providers, payers and patients.

Also, as we scale, we hope to impact the health system to better serve all, including those who are not the direct beneficiaries of remittances. The math of healthcare is simply supply and demand. If we are able to get more prepaid care, more people coming in for care earlier, but still with the same fixed costs, the cost barrier to entry should go down for all. If we can scale and hit the sweet spot with capacity, by increasing the volume while focusing on prepaid capitation model, we can reduce the administrative inefficiencies and free clinical time for patients. So we aren’t trying to simply reimagine remittances but the health system more broadly.

4. What is unique about your approach?

Jobarteh: We are the first company to focus on channeling remittances to health. The other unique aspect of our business is that we offer health navigators who will help people figure out how to get into care and access the services they need. Our navigators can help with things like signing up for national health services where available as well as serving as a point of first contact for those we cover. Having high quality services is great, but it’s not enough if people can’t or do not know how to access their care. That’s why we believe our Health Navigators are critical to our model.

5. What factors make a good market for a health remittance business?

Jobarteh: A few things need to be in place for health remittances to work well. First, there needs to be a large diaspora community with resources to pay for prepaid coverage back home. Within the country of origin, there needs to be a health system where quality care is available. The presence of national health insurance is also important as it supports some of health needs and can decrease the overall cost.

We are starting in Kenya, which has a large diaspora community abroad, quality care available and national health insurance. However, we believe our model will work in dozens or even hundreds of locations. We intend to grow quickly throughout Sub-Saharan Africa and then to Latin America. However, we are very aware that each location will have its own set of challenges and opportunities.

6. What is the hardest part about founding a company?

Jobarteh: Getting started! There are so many ways you can tweak a theory, so just launching is difficult but essential.

7. Is there anything that has surprised you to date about this work?

Jobarteh: People are incredibly collaborative. I have been pleasantly surprised by how forthcoming people are and their willingness to share. I have also been surprised by how emotive this issue is for members of the diaspora and how energized they are to solve the problem.

8. What excites you about Remit4Health?

Jobarteh: I love the fact that we are working to change the way healthcare is provided and accessed. And I love that our model revolves around African players, African resources, and an African solution. We are not driven by aid or donors but by a business built by and for Africans to solve African problems. That’s why I believe strongly that by leveraging and organizing the resources and excess capacity, we can have a real impact on the health system and make progress towards universal health coverage.