By Andile Masuku
The intersection of tech-driven innovation and healthcare access in Africa has never felt more personal than it did at the iFHP Big Ideas Africa Workshop 2024 in Johannesburg last week.
Between managing updates about my elderly father's hospital admission at a nearby medical centre (following a near-fatal medical emergency initially misdiagnosed as food poisoning in Bulawayo) and processing the recent loss of a friend to stomach cancer, my conversations with Britam's Evah Kimani struck a particularly resonant chord.
As my wife Sithabiso simultaneously attended the ISPOR South Africa Chapter 13th Annual Conference across town—where discussions about health economics and access were in full swing—the WhatsApp notes we exchanged from our respective gatherings highlighted the urgency of Britam’s mission.
Kimani’s leadership in driving a platform and product development-focused “Partnerships and Digital” portfolio at Kenya’s largest insurer (with operations across six other African countries) isn’t just theoretical; it’s a crucial effort to address the severe healthcare access disparities impacting real lives across our continent daily.
In my third year engaging with this gathering of health insurance innovators and executives (though first as Head of Community at 54 Collective, then as an independent co-curator and media partner), these conversations felt weightier, more urgent – a powerful reminder that behind every discussion about digital transformation and financial inclusion lies a deeply human story of access, or the lack thereof.
In my conversation with Kimani, an interesting tension emerged between institutional ambition and market reality. As Kenya's most dominant insurer navigates the complex landscape of African healthcare access, their approach offers a window into the evolving dynamics of insurance innovation on the continent.
"When you're always on top, you have to keep watching yourself," Kimani noted, describing Britam's strategic posture. Yet rather than fortress-building, their response to market leadership warrants closer examination, particularly in how it diverges from typical incumbent behaviour in African financial services.
The company's engagement with tea farmers in Kenya presents an instructive case study. With approximately 700000 farmers under coverage, Kimani says Britam has been forced to fundamentally reconsider traditional insurance delivery mechanisms. The initiative reveals both the possibilities and limitations of institutional adaptation to African market realities.
Notably, Britam recognises the existing structures Africans have long used to mitigate risks. As Kimani puts it, “Africans have many traditional ways to manage risks.” From harambees—a Kiswahili term meaning “all pull together” and representing a broader cultural practice of community support, often through collective fundraising for events like weddings, funerals, or educational needs—to chamas, informal cooperatives where members pool resources for savings and investments, these traditional systems present both competition and opportunity for formal insurance providers.
This recognition has led to what Kimani terms "insurable moments" - the embedding of insurance into existing daily transactions. Whether integrating coverage into mobile data plans for motorcycle delivery riders or offering micro-insurance at device purchase points, the strategy appears calibrated to meet consumers where they are. However, questions remain about whether such adaptations represent genuine innovation or merely incremental improvement of existing models.
The implications extend beyond Kenya. With formal insurance penetration below 3% across most of Africa (excluding South Africa), the gap between institutional ambition and market reality remains stark. The challenge appears to be not merely about increasing coverage, but about questioning whether traditional insurance frameworks are appropriate for African contexts.
What makes Britam's transformation particularly noteworthy is their recognition of emerging risks that traditional insurance frameworks struggle to address. Kimani points to climate change impacts—floods and weather patterns previously unseen on the continent—as well as the mounting healthcare security challenges exposed by recent global health crises. These evolving risk landscapes demand more than just product innovation; they require fundamental rethinking of how insurance can function in rapidly changing African contexts.
The company's approach to health coverage is especially telling. Kimani acknowledged that with African governments struggling to provide universal health coverage, private sector innovation becomes increasingly crucial. Yet this innovation must grapple with complex realities: informal employment patterns, daily wage economies and the need to align payment structures with irregular income flows.
Their engagement with fintech partnerships and digital platforms reveals another layer of strategic thinking. Rather than viewing digital transformation as merely a way to improve efficiency, Britam sees it as a means to fundamentally reshape how insurance products are conceived and delivered. Their collaborations span telcos, fintechs and even global tech giants like Microsoft—all in service of creating what Kimani calls "solutions that are more holistic."
The launch of Betalab, their corporate accelerator programme, signals an intriguing institutional response. "We don't know what we don't know," Kimani candidly admitted, explaining their openness to startup partnerships. This institutional humility—coming from one of East Africa's legacy insurance heavies—raises questions about the role of incumbent institutions in driving systemic change.
Yet amid all this innovation, Britam maintains a pragmatic focus on business fundamentals. As Kimani puts it, "Ultimately everything we're doing is for profit." This isn't just about corporate sustainability—it's about proving that serving traditionally underserved markets can be commercially viable. The microinsurance business, she notes, isn't a charitable endeavour but a profitable enterprise that demonstrates the potential for alignment between social impact and commercial success.
As conversations about health economics and healthcare access continue across the continent, several questions linger: Can traditional insurers successfully navigate the path between incremental improvement and systemic reinvention? Will initiatives like Betalab drive genuine innovation, or will they bring only surface-level tweaks to existing models? To see these and other pressing questions answered in time, stay healthy and stay alive, dear reader.
Andile Masuku is Co-founder and Executive Producer at African Tech Roundup. Connect and engage with Andile on X (@MasukuAndile) and via LinkedIn.
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