Pillar: Risk and Resilience

Revolutionising the healthcare insurance landscape in Ethiopia

The problem

In rural Ethiopia, many families face significant financial barriers to accessing healthcare. Saglan Wajee General Hospital in Holeta Town, Oromia, is poised to change this narrative by becoming the country’s first full-fledged health insurance provider. Through the support of FSD Africa’s BimaLab Insurtech Accelerator Program, Saglan Wajee aims to offer affordable and comprehensive health insurance, transforming the local healthcare landscape for underserved communities. The hospital’s CEO, Dr. Yeraeifirae Sileshi (Dr. Raei), emphasises the importance of insurance in ensuring that quality healthcare is accessible to all, regardless of financial status.

The solution

BimaLab provided Saglan Wajee with essential venture-building support, including exposure to successful insurance companies like Jubilee and AAR in Kenya. This program facilitated critical connections, particularly with the National Bank of Ethiopia, which had not issued health insurance licenses for 14 years following the failure of an earlier initiative. After participating in BimaLab, Saglan Wajee was granted a license, enabling it to launch its insurance product, Efoy.

Initially introduced as Efoy 1.0, this micro-health insurance product was designed for low- and middle-income families, covering a broad range of medical services with minimal financial burden.The impact of Efoy has been profound. In its first year, the product attracted over 1,200 customers. By upgrading to Efoy 2.0, Saglan Wajee has expanded its coverage, offering segmented services for chronic patients, families, and individuals.

The impact

Café owner Nurae Gutu Chala and her family were among the early adopters, paying as little as 400 birr (4 USD) per child annually. Despite premium increases to 960 birr (9.5 USD) per child, Nurae’s family continues to renew their policy, appreciating the additional services such as MRI and medication coverage. The upgraded Efoy 2.0 has already reached 900 new clients, demonstrating significant growth and increased community trust.

Dr. Raei’s vision for Saglan Wajee is deeply personal, rooted in his experiences studying and working in China and Ethiopia. Inspired by China’s health insurance model, which covers 95% of patients, he returned to Ethiopia determined to address the glaring disparities in healthcare access. Through BimaLab, Dr. Raei gained valuable mentorship and insights, enabling him to build a sustainable insurance model. Looking ahead, Saglan Wajee plans to expand its insurance network, integrating 130 health facilities and launching a new branch in Addis Ababa. Dr. Raei’s ultimate goal is to establish Saglan Wajee as a leading competitor in the regional insurance market, driving a revolution in healthcare access across Ethiopia.

Flood Insurance: Safeguarding Lives and Livelihoods in Kenya

When torrential rains swept through Kenya between October and December 2023, Tana River County bore the brunt of the devastation. Over 546,000 Kenyans were displaced, 170 lives were tragically lost, and entire communities were left grappling with the aftermath of unrelenting floods. Among these were 300 families in Tana River who, for the first time, received financial relief through an innovative flood insurance programme.