ACCESS Health Southeast Asia Explores Fintech for Health in Bangladesh

Adrienne Mendenhall, Director of Business Development in Singapore and Tript Bhatia, Director, Startup Alliance visited Dhaka from January 19-22 to start Fintech for Health work in Bangladesh.

Over three days the group attended more than a dozen events. The trip started with meetings with healthcare nongovernmental organizations, including the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), CARE, Marie Stopes International, BRAC, and Shakti Foundation. The team also met with two digital health startups to round out discussions on priority health financing needs for lower income populations in Bangladesh.

Many of the discussions focused on the difficulty that women and their families have in saving for maternity care and the accompanying costs, including transportation. Nongovernmental organizations in Bangladesh have long focused on improving maternal and neonatal mortality through health messaging, including encouraging women to deliver in hospitals or at the very least with a skilled birth attendant. While the percentage of women delivering in healthcare facilities risen, half of births still take place at home. The reasons for this are multifold, including tradition, but also because of the costs involved in traveling to and delivering at a healthcare facility.

Tript participated in a workshop held by Women’s World Banking and funded by MetLife Foundation on financial inclusion for women garment factory workers. The government of Bangladesh mandated wage digitization in Bangladesh 5 years ago. 90% of garment workers will be brought under the digital wage system by 2021 as part of the government’s push to build a cashless society. Banks such as Dutch Bangla Bank are taking advantage and are looking to increase uptake and use of their mobile financial service, Rocket by these factory workers. During this workshop, Women’s World Banking shared their learnings from the pilot project that they launched with the bank with a readymade garment factory located on the outskirts of Dhaka. Specifically, they talked about the barriers to mobile account usage and how to address them.

The group also met with three fintech companies: Bkash, the first to market and furthest reaching digital finance company in Bangladesh; Nagad, a public private partnership led by the Bangladesh post office; and Pathao, a ride sharing platform backed by Go-Jek. It was impressive to see the investments and traction that digital finance companies have gained in a short few years. The healthcare organizations we met said that almost everyone, no matter how poor or where someone lives, uses mobile money. The sector has gained a far reach that makes it a desirable partner for most merchants, from nonprofit organizations to SMEs and multinational corporations.

Most healthcare organizations we met with are considering digital health financing models, including savings, lending, and insurance. There is significant mistrust of insurance in Bangladesh, with only 3-4% of the population holding insurance policies. For this reason, and combined with the messaging of maternity programs in Bangladesh, mobile health savings accounts are a likely starting point.

The Singapore team will be returning next month to lead a roundtable discussion between healthcare organizations and one of the digital finance companies, and probably multiple times after that when activities ramp up.