Soso Care: Turning trash into affordable health insurance for Nigeria’s underserved

The two pain points in Africa’s most populous nation have been the source of inspiration for Soso Care, a startup that is providing low cost health insurance to underserved communities by accepting cash or recyclables as premium, therefore enabling thousands of Nigerians to access medicare across over 1,000 hospitals.

The startup’s CEO, Nonso Opurum, spoke to FairPlanet about the inspiration behind linking trash to healthcare, the uptake and reception of the initiative among Nigerians, and their plans to scale the programme to the rest of Africa and Asia. 

FairPlanet: payment of health insurance with recyclable waste. That is a unique approach. Where did the idea come from and how has the experience been so far?

Nonso Opurum: Nigeria, like many other developing countries, faces two major problems. 

Every year, we worry about over 30 million tons of waste generated around the country, which includes over 20 billion plastic PET bottles. Less than 5 percent of them are collected and recycled. Lagos state alone, with a population of over 25 million, is estimated to produce about 14,000 metric tons of waste daily, which is equivalent to about 490 trailer loads of solid waste. This creates environmental problems, like pollution and public health issues, plus it affects marine lives since the waste gets dumped into rivers and oceans.

Again, we noticed that over 180 million Nigerians don’t have basic health insurance. This accounts for almost 90 percent of the 200 million people in the country. With over 100 million living below the poverty line and literacy levels being very low without a safety net, out of pocket health financing means more people are dragged into poverty every year from unexpected and catastrophic health spending. 

Because of low access to health inclusion, over 55,000 women lose their lives every year from pregnancy and thousands of children die from simple cases of malaria or cough, which are preventable with access to quality healthcare.

Both these problems are huge and catastrophic, although their market value is big.  As a company, we thought of how best we can solve these problems by using one of the problems to tackle the other, so we created SOSO CARE.

SOSO CARE is a low cost health insurtech, which accepts cash or recyclables as a premium to enable millions of people to access care across over 1,000 hospitals in Nigeria.

How exactly does the model work and how has been the reception among Nigerians?

We use a B2C model. By partnering with an insurance company, Hygeia HMO, to underwrite the insurance risk, a user accesses care by choosing a plan and paying online or by simply delivering recyclable materials like bottles, glass and plastics bags equivalent of $15 to our partner agents who sells the collected waste to big recycling companies as raw materials. 

The money generated from the sales is converted into a health fund to finance the annual premium to access healthcare across over 1,000 hospitals nationwide.

The reception has been great. Within 6 weeks of launching, 96 women signed up and started donating waste to us. 

Currently, over 21 percent of our users pay with their recyclables since it costs them nothing. In 2021, we expect the user growth from waste to exceed 500,000. 

Your startup seeks to tackle two unique and prevalent challenges in Africa and Nigeria: providing a low cost micro insurance platform to a population that has traditionally been uninsured, therefore promoting universal health care, while tackling waste menace.

How hard or easy has it been to implement the project and what would you consider as the highlights of the project?

We marked our first anniversary in November 2020. It has been both a tough and great experience. The biggest highlight is our mission. We are driven by the gap in health care financing in Africa due to poverty, and our mission is to bring millions of people who have never owned a health plan before into the fold of coverage - mostly the informal sector who account for over 95 percent of all out of pocket health financing.  

It is our mandate to insure at least 50 million Nigerians in a short time. For the first time, we now cover a 7-month old baby. Infant mortality is a great problem in Nigeria as a lot of children lose their lives before their fifth birthday. SOSO CARE serving as a safety net for parents is fulfilling for us. 

Your intervention has been feted and recognised by key global institutions, including UN Habitat, UNAIDS, World Bank. What do these recognitions mean to you and your company? 

When we founded SOSO CARE with our little savings, we wanted to solve these problems in our little capacity and measure impact. Today, the global support, mentoring and validations we have received from all our partners inspire us to see ourselves as a solution to a major problem. The recognitions and support have really helped us with more channels and partnerships. 

How has Covid-19 affected your business and the people you serve?

Covid-19 as a global pandemic has exposed the weakness and vulnerability of healthcare systems, especially in Africa, and created more awareness about our work and the need for health insurance. 

As a business we started with inpatient and outpatient care coverage, when Covid-19 disrupted normal living we added telemedicine in the plan. The idea was to deepen healthcare access to enable people to simply talk to a doctor anytime online for one year without visiting the hospital, thereby improving access to quality healthcare while reducing the spread of the virus. 

In your journey between conceptualising to actualisation of this idea, what would you say stood out as the biggest hurdle to the project? 

Like most businesses in Africa, funding was our biggest challenge. Good ideas and solutions die every day in Africa because of lack of financing. When we started, we struggled and fought to stay alive even when the odds were against us.  But I am grateful for the team and the global support we have continued to receive. 

In your pursuit to create homemade solutions to local problems, what is your perception of governments and the international community in supporting entrepreneurs? What more should be done?

More attention and intervention funds should be provided to support social enterprises and entrepreneurs working to solve key problems, just like the Bridge fund launched by [the] French Government under Digital Africa that has supported our work. 

How would you quantify your work to date in terms of impact on livelihoods and environmental conservation?

Both waste pollution and low access to healthcare are huge problems, although their market value is big. Every quarter we constantly measure our impact based on data obtained on hospital visitation and recyclables collected. The impact has remained huge. 

I remember at the peak of Covid-19, a user shared his experience on our plan that covered his wife’s appendectomy during the lockdown. He spoke of how the plan saved him from selling his car to finance the medical cover. He has referred over 20 more users to us, mostly his extended family and friends, and he believes health insurance is a must for his family for the rest of his life.  

We’ve also received feedback from a user who trekked almost a kilometer to the hospital to access care when he was sick and broke. In his testimony, he wondered how he would have survived and afforded drugs if he didn’t make the decision of subscribing to our plan. Such success stories give us the impetus to do more for our people. 

How do you intend to scale the operations of Soso Care? 

Our mission is to bring millions of people who never owned health insurance into the fold of cover using cash or recyclables as premium. We are hoping to raise money or attract grants to enable us to scale SOSO CARE across Africa and Asia where there is an urgent need for health intervention. 

In 2021, we expect our user growth to exceed 500,000. We are betting on partnership[s] with companies for recyclables. Companies see us as a value for exchanging their recyclable waste for the health insurance premium of people in their host communities as well as their customers. This way they provide access to quality healthcare for millions of people living in poverty in their host community, which works for the company’s CSR. 

By linking garbage to healthcare access we are killing two birds with one stone in addressing poor healthcare access, sanitation and environmental sustainability.

Image: King Baudouin Foundation (KBF) - Africa program.