Social Challenge and Innovative Solution
In Senegal, mortality related to pregnancy, childbirth and post-partum is the first cause of death among women of child-bearing age. 25% of women have no medical follow-up in the 41 days following childbirth. Existing solutions in Senegal for the health of women and children are either very expensive (particularly private clinics), or affordable but insufficient and do not respect hygiene norms. Neither of these solutions offers total care for the mother and child. The improvement of the health services in this sector is one of the main priorities of the Senegalese state.
Founded in 2012 by Khadidiatou Nakoulima, NEST provides a complete monitoring of woman and children thanks to a paediatric and maternity hospital. NEST offers high-quality health services at a reasonable price, primarily aimed at middle classes. Accessible 24/7, NEST puts a particular emphasis on seeing and listening to patients, and allows young women of child-breeding age to be followed until the birth, and a follow-up of their children until they are 15 years old.
This model, inspired by the Indian private chain of maternity hospitals Lifespring Hospital, is particularly relevant in Senegal, where local medical offer is shared between expensive private clinics and public infrastructures suffering from a lack of technical means and standards. NEST embodies a gap-filling role within this market.
Key Social Impact Figures
Investing for Impact
How it started
In 2012 Khadidiatou Nakoulima met I&P at a meeting on social entrepreneurship organised by BNP Paribas and soon after presented her project to Jérémy Hajdenberg, Investment Director at I&P.
She was 24 when she started working on this project. Several members of her family worked in the medical field (her father is a renowned paediatrician in Senegal), and she clearly remembered the stories of these women who had lost confidence in the Senegalese medical system, because of a lack of attention or resources. These stories served as a guideline and key driver for action for NEST: through the establishment of this medical network, the objective is to ensure a complete monitoring of the women and young children, during and after pregnancy.
I&P decided to support NEST because of the pressing necessity of a solution to mortality related to pregnancy in Senegal and this at an affordable price. The project was innovative and would have a strong social impact, based on a successful model in India. I&P also knew that they would be working with high-level entrepreneurs. Since then, the fund has been actively involved in the implementation of the NEST’s strategy: feasibility study, market analysis and health sector requirements.
In 2012 I&P invested in NEST, taking a minority share (36.6%). The other shareholders are mainly members of the Nakoulima family, as well as Dr. Abdoulaye Diop, who is associated to the project since the beginning. I&P also support NEST in raising additional funds to develop the market potential of the clinic and to finance the medical care to the most vulnerable patients.
In parallel to the private equity investment, I&P provided grants for two technical assistance programmes. The first one (€9,300) was to set up internal procedures, optimise the management information system, and change the legal status. The second one (€8,500), initiated in 2017, aims to update sanitary procedures and provide further training on marking issues notably.
|Result (for 2016)
|Improved access to health care for middle to low income women
|# of women and children’s visits at the clinic
|3,700 women and 2,000 children in 2016
|# of babies born at the clinic
|More than 300 of babies born at the clinic in 2016
|Awareness raised about family planning and reproductive health
|# of information sessions organised
|52 of information session in 2016
|# of full-time employees and number of women employed
|26 full-time employees, including 20 women employees (77%)
|Improved employment conditions
|Average and minimum wage compared to the national minimum legal wage
FCFA 100,000 minimum wage (2 times higher than legal minimum)
Average wage of NEST employee is 4 times higher (200,000 FCFA) than minimum legal wage in Senegal
NEST is also deeply involved in advocacy campaigns on women’s and children’s health issues. It publishes detailed articles on its Facebook page, which has over 42,000 followers. This is a key pillar of NEST social impact, and it is led by the Dr. Aboudlaye Diop, a gynaecologist at NEST, who has been involved in the project since the beginning.
Once a year, I&P collects a set of impact metrics, including cross-portfolio metrics (number of jobs created, wages, health insurance, suppliers…) and specific metrics relating to NEST’s activities (number of births in the clinic, number of patients, number of information sessions…)
In 2015 I&P carried out an in-depth impact study on NEST as part of the study and video project “Small is Powerful”. The idea was to measure and represent the impacts of African SMEs on their ecosystem. A small documentary on this impact study is available online.
NEST is working on a new strategic plan for 2017-2020 with the project of opening two new maternity clinics and transforming the existing one into an outpatient clinic by 2020.
In terms of exit, I&P has not decided when exactly yet but certainly after 2018. The VPO will be looking for partnerships that will help NEST extend further its offer of health services, especially to the low-income population.