In an intensive care unit for COVID-19 patients where lives hang in the balance, doctors and nurses have to monitor patients’ vitals closely to ensure they are able to detect any form of distress. For countries like Uganda, where there is a strain in healthcare resources and a high patient-to-clinician ratio, doctors and nurses have to do more rounds and spend more time monitoring critically ill patients. This exposes them to a higher risk of infection.
As a solution, Villgro Kenya, an investor in health innovations, recently awarded $20,000 in grant funding to Neopenda, a medical device company focused on designing and implementing needs-base technologies for emerging markets. Their remote vital signs monitor is a device that will reduce the burden of clinicians and help them monitor more patients efficiently, while simultaneously reducing their risk of infection.
“At Villgro Kenya, we strongly feel that this innovation will change the way we administer care in the era of social distancing. Being able to remotely monitor disease progression in COVID patients could have a great outcome of reducing the risk exposure to healthcare workers who are at the frontline of this battle” – Wilfred – Co-Founder, Villgro Kenya.
The device, which started out as a neonatal vital sign monitor, was developed after founders Sona Shah and Teresa Cauvel, biomedical engineers from Columbia University, visited a hospital in Uganda and saw how nurses had a hard time monitoring admitted neonates.
“We wanted to understand the issue where clinicians and nurses are not able to know when a patient is in distress. This is because there are too many critically ill patients and not so many clinicians. So whenever there was distress, nobody knew and the newborns would end up dying from medical causes. So that led to the creation of the neo-natal device monitor called the Neo-guard,” said Sona.
Nurses and clinicians in remote areas of Uganda have used the device to monitor up to 20 patients at one time. Once all the patients are fitted with a wearable watch, their individual temperature, respiratory rate, pulse rate and oxygen saturation are displayed at a central dashboard. The low-cost device works effectively without internet or continuous power, which makes it well suited for low-income areas.
The company, which started with neonates, has always had a vision for expanding to pediatric and adult wards as well, and saw COVID-19 as an opportunity for them to move their scaling-up strategy forward.
“With our team capacity, we wanted to maintain focus, but when COVID came, most of the patients were adults and thus we adjusted the size of the band attached to the patient, recalibrated the device for different algorithms, because the natural adult vital signs are different ranges from neonate’s vital signs. So we had to do a couple of tweaks to expedite our development cycle,” Sona explained.
With advancements in its technology, the device can support the COVID-19 response in four primary ways. It can help identify suspected cases, as the common symptoms seen in positive patients, like elevated temperatures and low oxygen saturation, can be measured using the vital signs monitor.
Doctors and nurses can also triage an entire patient ward and be able to tell the severity of a single case, from which a clinician can determine an appropriate course of action. Once a patient is receiving treatment, the device can then inform the clinician on whether the patient is responding well to it or not. And, finally, data collected from the device will contribute to predictive analytics for population health, which will help inform trends within countries.
The team is currently looking to pilot their device in Uganda through their relationship with the Ministry of Health. Like many other medical devices, getting additional capital and the right investors has been a major challenge for Sona and her team. She welcomed the $20,000 COVID-19 Response Grant awarded to them by Villgro Kenya saying:
“I appreciate the efficiency of bringing the capital in. For a couple of other organizations it takes a couple of months of diligence for a small amount of the funding to come in, which would inhibit a lot of entrepreneurs. I appreciate the process Villgro Kenya took because that capital is very instrumental to small and large organizations alike.”
Medical devices require a multidisciplinary approach and partnerships across the sector are needed to ensure products like the Neopenda Vital Signs Monitor get to market.
Getting the right partnerships is a challenge for most medical device companies and, aside from funding, impact investors have a role to play in making the right connections.
Sona explained that, “One of the things we are doing with Villgro Kenya is developing a go-to-market strategy based on the COVID-19 response. So a better understanding of how we are responding and how to integrate within their national task force. Part of that is understanding the landscape, talking to other entrepreneurs that Villgro Kenya has connected us to that will enable us to work together to be part of the Ministry’s initiative.”
Speaking on how entrepreneurs can adapt to change brought about by the pandemic, Sona urged innovators and entrepreneurs to understand their role in the pandemic and leverage partnerships while engaging with users to ensure products released are relevant.
“With Neopenda, we accelerated our timelines and adapted our technology. For other companies, it may not be so straightforward to make the pivot to get into the fight but, for those who can adapt, relationships are crucial, especially in the markets venturing into partnerships.”
Frontline health workers continue to face the imminent risk of infection as they interact closely with patients. In Kenya alone, 84 healthcare staff were infected and this raises the concerns about their safety among key stakeholders. The vital signs monitor from Neopenda has the potential to save patient lives and reduce the chance of infections among frontline health workers long after this pandemic is over.
Over the last five years, it has been my great privilege to lead Villgro’s expansion effort in Kenya and East Africa. Villgro is one of the world’s leading business incubators, with 20 years of experience in supporting social entrepreneurs in India. Villgro’s definition of social entrepreneurship is a for-profit company that sustainably delivers value for the shareholders and social impact at the base of the economic pyramid through its products and/or value chain. A social enterprise should also be built for scaling up with venture capitalist (VC) backing. Prior to joining Villgro, I was a research scientist whose only claim to fame was a few initiatives that sought to commercialize research outputs. So, the terms “innovation, entrepreneurship, impact investment, VC” and other development-speak buzz words fueled my bold decision to go where no scientist had gone before (at least in my networks): to put these simple, common-sense concepts into practice in Kenya and East Africa.
Villgro Kenya opened its doors for business in April 2015. Armed with the Villgro incubation model (our “secret sauce”), a ready pipeline of Grand Challenges Canada-funded health innovations, key stakeholder partnerships, and backed by a young team that was full of energy and talent, we were ready to change the world!
The first lesson I learned working at Villgro was that “Plan A” never works. We set out as a business incubator to empower innovators through knowledge and business development services. We were met with veiled suspicion. We did not fit the “incubator” model. Villgro Kenya did not offer free space or wifi to innovators. Instead of “tech” or “youth”, the key buzz words that dominate Kenya’s innovation landscape, Villgro’s branding of “health”, “hardware” and “social entrepreneurship” seemed out-of-touch with the times and altogether not cool. Our target market, the entrepreneurs, did not mince words either. They wanted funding, not the rich menu of knowledge or incubation services that we offered.
The second lesson I learnt was grit and patience. This will be familiar to most entrepreneurs. It takes grit, perseverance and (in lieu of capital) partnerships to press on until the breakthrough! Slowly, the entrepreneurs started trickling in. It was not our impressive CVs or Villgro India’s enviable track record in supporting over 100 innovators to raise USD $25 million and create over 4,000 jobs. Rather, it was the introductions from friends and partners who vouched for us. We rolled up our sleeves and got to work. Our backers and partners, Villgro India and the Lemelson Foundation, were patient and accommodating as we struggled to find our feet. When we were hard on ourselves, they celebrated our little successes. More importantly, they reminded us that Rome was not built in a day. Through our partners, we were introduced to USAID’s Partnership to Accelerate Entrepreneurship (PACE) initiative that provided capacity building and grant seed capital to fund startups. With a stronger value proposition to entrepreneurs in place, we were finally in business, increasing the flow of quality startups applying for incubation!
My third lesson was about the importance of understanding the market. As we worked with startups, we learnt more about the health system and the market that it serves. In the health sector, need does not equate to demand. This is because Africa’s population lacks the purchasing power to reward private sector’s R&D investments with premium profits that drive the global pharmaceutical and medical device industry. Africa’s market – though not willing to bear the costs of “premium offerings” – is discerning and demands quality but cost-effective solutions. Imported solutions that are designed for the more affluent European and North American markets often fail due to high price points and expensive operational infrastructure requirements that further increase the costs of healthcare delivery. How can innovators employ frugal innovation in the design and development of solutions to achieve problem-solution fit? How can they employ social entrepreneurship business models in the production and delivery of health innovations to achieve product-market fit? We learnt quickly that the market is unforgiving, consisting of a donor-driven public health sector that lacks incentive for adopting innovations, as well as a private health sector that presents a fragmented market requiring considerable time and capital to gain traction.
The fourth and final lesson is that if “cash is king” it means the VC is the hidden customer! Realizing how much time and capital it takes to demonstrate a commercial proof of concept was humbling. The only way to reduce the time is to increase the capital. Enter the Argidius Foundation. They challenged us not to provide our services for free, but we didn’t want to charge cash-strapped entrepreneurs. Could we find a middle ground to make this partnership work? The short answer is yes, but we had to change our mindset from thinking like an entrepreneur (market focused) to thinking like an investor (ROI and investment cycle). We continued providing grant seed capital but also introduced equity investments as we de-risked the companies. We strengthened our due diligence and investment committee and noticed that our conversations with follow-on investors were beginning to yield fruit. Our incubation support also reflected a stronger commercial and investment mindset as we began to recalibrate our incubation goals to better align with the investors’ proof points. Before long, we were making our targets as our portfolio companies started to receive term sheets and successfully raise the necessary capital to start making significant inroads in the market.
Today, we celebrate five years of Villgro’s ongoing expansion in Kenya and the region. We are proud of the partnerships that have yielded the progress made so far. Villgro Kenya has proved that homegrown solutions and social enterprises in the health sector can rival the success of Fin Tech startups, if given a chance. Our portfolio companies have succeeded in generating more than USD 1 million in revenues and created 188 jobs in the formal economy, even as they sustainably delivered a health impact for the marginalized communities.
However, it is not all rosy. Clear disparities in the progress of African-founded startups still exist compared to expat-founded startups. The same disparity can be seen with startups offering services versus startups producing hardware or products, and academia or science-based startups versus tech or commercial-based startups. Moreover, even the hard-won gains now risk being wiped away by the COVID-19 pandemic as it threatens lives and upends the economy.
There is, therefore, a lot more work to do and even more at stake than before, which brings us to the fifth lesson: you can’t do it alone – it takes a village! This means looking beyond our own needs to building the ecosystem we operate in so as to create a more enabling environment for more innovators to succeed. “It takes a village” also means scaling Villgro’s replication across the continent by partnering with like-minded incubators and accelerators and sharing our “secret sauce”, the Villgro model of supporting and investing in social entrepreneurs across Africa.
Leading us into this new phase of growth is one of my co-founders, Wilfred Njagi, who will be taking over the helm as CEO as we begin the expansion of Villgro across Africa. Wilfred has been instrumental in the setting up of Villgro from the very start and graciously invited me to steer the boat in the early formative stages of our journey. Wilfred is a naturally gifted entrepreneur and leader, whose contributions to Villgro’s transformative story over the last six years cannot be gainsaid. I cannot think of a better person to lead the organization during this critical time in history as we address the COVID-19 threat. I am very thankful for the amazing friendship, partnership, and support that we have developed along the way and I invite you to join me in welcoming and supporting Wilfred in his new role as CEO as he drives us to greater heights. Thank you!
Sincerely,
Robert Karanja
Co-Founder & Director, Villgro Kenya
Since 2015, Villgro Kenya has been successfully supporting entrepreneurs and innovators in the health and life science sectors. During this period the organization has received hundreds of applications and provided approximately $1M in early-stage seed funding across 20 companies in Kenya, Uganda, and Ethiopia. With the onset of Covid-19 and the growing demand from health-focused entrepreneurs across the continent, Villgro will now be expanding its services across Africa.
As the organization prepares for the next stage of growth and impact, the team is excited to announce some internal changes that will allow the organization to capitalize on the opportunities that are emerging.
Beginning July 1st, Dr. Robert Karanja will “pass the CEO baton” to Mr. Wilfred Njagi, who is currently a co-founder and Chief Operating Officer of Villgro Kenya. Dr. Karanja has very successfully led the expansion effort of Villgro into Kenya and will now become Chief Research Officer (CRO) and will be leveraging his deep roots in academia, research, and impact investment to catalyze these sectors towards increasing opportunities to entrepreneurs and innovators across the continent.
Dr. Karanja has shared his thoughts and lessons learned during his tenure as CEO of Villgro Kenya. Wilfred Njagi has been with Villgro Kenya since the inception, prior to which he spent a year as a Fellow with Villgro Innovations Foundation in India. Mr. Njagi has deep roots and experience in the social enterprise ecosystem having also spent 10 years in Tech startups, Business Development, Social Entrepreneurship, Impact Investing & Incubation support.
“The Villgro Africa team is young, dynamic, and committed to providing more opportunities for African entrepreneurs and innovators. This expansion has been growing organically as the team is already supporting early-stage companies in Uganda, Ethiopia, Tanzania, and Kenya. It is truly inspiring to formalize this with the planned launch of Villgro Africa and see even greater impact throughout the continent“ says Rob Beyer, Co-founder and Executive Chairman of Villgro Kenya.
As Villgro plans the expansion efforts across the continent they will be welcoming collaborators who share a vision of enhancing the livelihoods of those at the base of the economic pyramid through a vibrant entrepreneurial ecosystem. Villgro Africa will provide access to the proven Villgro Incubation model and expertise as they endeavor to work with local incubators, innovation hubs, challenge funds, and research bodies that strengthen capacities within individual countries.
“For more information and/or to explore collaborations please contact [email protected].
Ethiopia has been touted as a frontier market in health innovation technologies as more young innovators continue to come up with local solutions for health challenges in the country. Villgro Kenya first ventured into the region when it supported Simbona Africa’s locally manufactured Neonatal Jaundice Treatment unit. Recently, the team manufactured a locally assembled UVC Room Sterilizer which was awarded a $15,000 COVID-19 response grant from Villgro Kenya to help ramp up their production.
The UVC apparatus is fitted with UVC lamps (8 watts) that emit high-intensity ultraviolet light that is able to kill microorganisms and pathogens found on surfaces in the room. It has the ability to disinfect up to 40 square meters of a room at any given time. According to the Centre for Disease Control (CDC), the entire UV spectrum can kill or inactivate many microorganisms, but UVC energy provides the most germicidal effect. This is considered a breakthrough in the fight against the novel coronavirus as the rays are able to kill all known viruses.
The UVC room sterilizer is intended for use in hospital rooms, wards, and medical equipment where the virus is most likely to spread. To ensure the safety of the people operating it, the apparatus is placed in an empty room and switched on for 5-10 minutes before anyone is allowed to come back in. Habtamu Abafoge, Simbona Africa’s founder, says they have put the safety of the staff first by training and giving a manual that outlines how to use the apparatus efficiently. This speaks to their role in the ecosystem as they are also helping the government come up with protocols for upcoming innovative medical devices.
“Locally produced medical devices have been out of the scope for Ethiopia and Simbona has paved the way for the government to adopt standards for WHO Class II Medical Devices. One such case is when the International Ethiopian Standard Agency adopted the International Electrotechnical Commission Standards to give approval certificates for the phototherapy units and baby warmers. This innovation went through the Ethiopian Radiation Protection Authority,” said Habtamu Abafoge.
For innovative startups like Simbona Africa, the pandemic presented an opportunity to think on their feet and come up with solutions for their region due to the global shortage of devices and equipment. Experience has come in handy for the team and they have not faced a big challenge developing this product, as UVC apparatuses do not require clinical trials.
Habtamu, who has a biomedical engineering background, said they have already produced 14 units which they have sold mainly to the Ministry of Health and they hope to increase their production to at least 40 apparatus to help contain the virus in Ethiopia.
“Since we made the post on our website and Facebook page we have received calls from hotels, homes, businesses, and schools requesting for the machines, however, our location at Jimma poses a geographical challenge and we are currently in talks with the Ministry of Health and Medical Distributors to help deliver our product,” he explained.
With the right partners, they hope to scale across East Africa to ensure the device reaches more countries and helps them fight the disease. The COVID-19 Response Solutions grant they received from Villgro Kenya will go a long way in helping them scale their production and unlock networks with relevant authorities within the region. “We are seeing exciting new innovations and strong talent flowing from Ethiopia, we are keen to support the growth of this team and sector in the country,” says Rob Beyer, a co-founder of Villgro Kenya.
Habtamu welcomed the grant saying, “We welcome Villgro Kenya’s financial support as it will help bridge the demand gap we are currently facing. The partnership will also be key in unlocking networks in the Ministry of innovation and Technology and the Ministry of Health due to its status as a regional Impact Investor for Innovations. We have plans to scale to East Africa due to the regional demand which has been brought about by the pandemic.”
Innovators like Habtamu continue to show the importance of a vibrant innovation ecosystem in opening economies and providing local solutions to health challenges faced in their communities. He credits the progress to the Government of Ethiopia, which has been a positive partner that is open to receiving ideas that have the potential to impact the people positively. As the East African region is gradually lifting curfews the UVC room sterilizer will help complement the COVID-19 preventive measures as countries strive to adapt to the new normal.
In Kenya, just like many other Sub-Saharan African countries, pregnant mothers face the grim reality of losing their babies due to a lack of proper transportation to health facilities. Salome, a 27-year-old mother is one such case. On the 23rd of May at around midnight she started experiencing labour pains and her water broke at home. Having lost her first baby, she was determined to deliver her second baby safely so she dialed 1196 and Wheels for Life sent a taxi to take her to Huruma Nursing Home.
At Huruma Nursing Home, Salome’s labour was progressing poorly, Dr. “Jane” from Wheels for Life made a call to Rescue.co at 2.04 am requesting an ambulance to transfer Salome to Pumwani Maternity Hospital. The ambulance was dispatched four minutes later and completed her transfer in 17 minutes. Rescue.co had notified Pumwani of Salome’s condition and when she arrived she underwent an emergency cesarean section which saved both their lives.
Speaking after her delivery, Salome credited the Wheels for Life initiative for her health and that of her baby, saying, “Were it not for this initiative, I would have walked to the hospital and am not sure the baby and I would have been fine. God bless the work of your hands that you may continue to help those in need.”
The Wheels for Life initiative is a collaboration between Rescue.co, the Ministry of Health Kenya, AMREF, Bolt, Pharmaccess Foundation, Kenya Healthcare Federation, and Telesky that seeks to get expectant mothers to the hospital during curfew hours. As part of the initiative, a call centre managed by TeleSky has been set up that routes emergency calls to volunteer physicians. Calls that require an ambulance are directed to Rescue.co’s dispatch centre while those that can be handled by a taxi are dispatched to a Bolt taxi.
The recent COVID-19 pandemic has exacerbated the challenges women face to deliver their children. In Makueni County alone, there has been an increase in maternal mortality by a factor of 14, with four deaths in one-week post-curfew versus 15 deaths in the previous year. The high numbers in mortality rates can be attributed to poor transportation and health facilities being reassigned for COVID-19 response, with some major public hospitals converting their maternity wards into Infectious Disease Units.
Since the Wheels for Life initiative began on April 28th, 2020, the team has fielded 3,714 calls, dispatched 198 taxis, and 60 ambulances. All of the women who have used this service have survived, and dozens of babies have been born. The calls have ranged in severity, with the most extreme ones being related to cord prolapses, hypertension, reduced fetal movement and distress, preterm labor, and severe bleeding pre and post-delivery. Their fast response rates have helped save the lives of an average of 8 mothers every night.
Caitlin Dolkart, Rescue.co Co-founder said the partnership with Villgro Kenya has given them the necessary support they need to continue saving lives.
“We are thrilled to be working with Villgro to extend our Rescue.co services to those most in need. The grant will provide us funding to serve over 150 more mothers, and welcome 150 more babies into this world. This is one of those obvious solutions with unbelievable clear impact, and we will also use this funding to galvanise funding support from donors, the private sector, and the government.”
While the effects of the coronavirus pandemic are sure to remain with us for a long time, measures like the Wheels for Life initiative promise mothers the hope that regardless of the new normal they have a partner during their journey.