My path to building two healthcare startups, and how Nigeria can gain from ‘brain drain’ — Chekker Co-founder

Ifedamola Adefisoye is the co-founder and chief technology officer at the healthcare start-up, Chekker. He previously founded another healthcare start-up.

He speaks with freelance journalist, Tony Ademiluyi, about his latest healthcare start-up, his technological diagnosis of the challenges in the Nigerian healthcare sector, the vision for his start-up, and the expansion plans for it beyond the shores of Nigeria.

Below are the excerpts:

What was your motivation for becoming an IT Professional? Was it a case of talent or were you motivated by its current global demand?

I am very good at innovative thinking and thereby solving real problems. I hit a deadlock because I could not really implement the solution to those problems myself, so I started learning to code. It was a case of talent for me.

How did your educational background at all levels prepare you for the challenging world of IT?

Well, my educational background as well as early exposure to the world of IT really helped me. I was part of some very great organizations in school like ENACTUS, and Google Developers, so the training and orientation I got there really helped me.

Why did you choose to become an IT entrepreneur and how did your upbringing prepare you for entrepreneurship?

The push started when I lost my dad some 10 years ago, things became ugly, I then realised I needed to stand up for my family as the first child, I started blogging back then in the year 2011, then I got more interested in coding. I was then doing amazing stuff like building solutions to problems around my immediate environment.

Why the choice of co-founding a healthcare start-up?

The choice of founding a health startup dates back to 2016 when I and my co-founder Victor Emaye attended a hackathon in Delta State Nigeria at DSI Hub, Asaba, hosted in partnership with the Delta State government. We initially went with a solution I built that allows patients to easily communicate with the doctor. We named it ‘Swift Aid’, That idea came about due to the crowd at my university health centre then; you don’t get to see the doctor as and when needed. We didn’t get to present it at that hackathon but I developed a software named Emergency Response System which was built to aid national security within 72 hours of the hackathon. We got the third position and the drive to turn Swift Aid into a healthcare company started from there.

There are two fintech unicorns in Nigeria and one in ed tech but none in health tech. How can we have a health tech unicorn in the nearest future?

We can see that the IT market in Nigeria is growing and attracting lots of investment. There are lots of smart people solving different problems in healthcare now. If you look at healthcare in Nigeria, the idea of digitalisation didn’t start early enough like other sectors. Fintech as an example. I believe my company is doing something really big in healthcare, and I can say we are going to be a healthcare unicorn in Africa because the problem we are solving is really unique and health is a thing that concerns everybody.

In 2019, you co-founded Medipal Healthcare. Tell us why you co-founded it, the experience you had with it, and why you exited.

The Swift Aid software I built in the university is what transitioned to Medipal healthcare, it is a Robust Electronic Medical Record software for hospitals and I can tell you that it is one of the top EMRs in Nigeria. So Medipal Healthcare let me realise that there are many more problems to solve in the African healthcare sector. From Medipal Healthcare, we birthed Chekker which is taking the stress of people going to queue at the laboratories. I needed to focus on the new baby Chekker because I have grown Medipal Healthcare to a considerable stage alongside my co-founder, so we have a strong team managing Medipal Healthcare now.

You co-founded Chekker in December 2021. What challenges are you solving with it and how has the journey been in the last year?

In Africa, people often experience delays in accessing laboratory services due to long queues at the laboratory or road traffic congestion. This is where Chekker comes in, we take away this stress. We come to your house or office to take your sample to the laboratory and you get your result within 72 hours.

The journey is not smooth because it’s a new innovation, but people are seeing possibilities of convenience and a faster way to get tested without leaving their homes.

Why aren’t local and foreign investors investing huge sums of money in Nigerian healthcare start-ups unlike their counterparts in the fintech and edtech space? Flutterwave raised $250 million in Series D funding earlier this year and Paystack was acquired for $200 million in 2020. Why can’t the same be replicated in the healthcare start-up space?

Nigeria’s public spending on health care amounts to just 3.75% of its $495 billion GDP, according to the latest available figures from the World Bank. So, it’s a huge market but there are some challenges. One of the major challenges in the healthcare sector in Nigeria is that people are not aware of the current health issues they have. Since most Nigerians rely heavily on medical opinions from unqualified individuals, such as authoritative family members, patients do not feel empowered to learn more about their health and they are not actively engaged in the decision-making process of improving their well-being. So, you see this is a problem that hindered growth of some healthcare startups unlike other sectors for example fintech. Everybody spends money but for health, people tend to care less until the situation is worse.

Nigeria attracted $195 million in healthcare investment in five years between 2015 – 2020, which has now increased, so we should brace for more funding in healthcare in the coming years.

Has Chekker raised any funds from investors and if yes how much and how easy was the fundraising process?

Yes, we have raised some undisclosable funds from investors. The fundraising process is never smooth, but if you are solving a real problem, and you have some good traction, investors will be interested in what you are doing.

What is the expansion vision of Chekker within Nigeria and beyond the shores of the country?

IA: As I speak to you, we have a presence in over 3 states in Nigeria and we are going to extend to more states in the coming months. Also, our goal is to seek expansion to other African countries.

Many emerging economies like South Africa, Egypt, Ghana, Kenya, and Uganda have a far more robust health infrastructure than Nigeria with the power supply being more stable there. Are you planning to expand to these countries and what prospects do you foresee in terms of funding and revenue?

Yes, we are making good progress in expanding our services across Africa, and unbelievably those countries are on our core starting line because they are top leading economies on the African continent. The numbers we would be able to reach and the revenue growth will push us to that unicorn status and definitely attract more investors to our brand.

Do you think it is possible and realistic for Nigerians to have universal healthcare coverage like the citizens of the UK our erstwhile colonial masters who have it through the National Health Service (NHS)?

Yes, it is possible, Nigeria is a great country and a wealthy one. Improved funding for health and good governance is what takes us to that level of having universal healthcare coverage.

After the failed Bay of Pigs Invasion by the United States under then President John Kennedy, an embargo on sugar was slammed on Cuba under the then leadership of Fidel Castro. Castro responded by investing heavily in training medical doctors and exporting them abroad, which is now their major source of revenue having long replaced sugar. The world saw how good they were during the covid 19 pandemic. Nigeria has the third highest number of medical doctors in the UK after India and Pakistan. Do you advise the federal government to adopt the Castro model given the dwindling oil revenues and the shift from fossil fuels globally as a source of revenue?

This is already happening in the tech ecosystem and I believe the same will happen someday in healthcare, our government has now embraced the digital economy and has even made steps to start supporting SMEs, by giving financial support, reducing taxing, and even offering training facilitated by NITDA in partnership with Microsoft, Google, etc. This will be beneficial to the economy and place Nigeria top again as a giant of Africa.

What is the best way to curb the brain drain in the healthcare sector as health workers are leaving the country in droves?

The issue of brain drain is not only in health, but healthcare is something we should never jeopardise. The ratio of doctors to patients in Nigeria now is 1:9,083. Our government needs to do more in terms of ensuring good remuneration and welfare packages for our health providers. Most states don’t pay salaries timely, some even pay salaries in part, this will definitely discourage these health workers from staying, and they will look elsewhere for better remuneration.

The US has a global influence because of its status as the world’s most prosperous nation. Do you prefer its healthcare system of limited government role, being a capitalist nation, thereby giving excessive powers to healthcare insurance companies or the British system of more government involvement in the healthcare sector via the NHS which was set up in 1948 after the Second World War which prioritizes optimal health for all Brits through heavy government spending in that sector?

The NHS system set up after the world war was developed to help people access health despite the economic crunch. Maintaining that system in the same way decades after may not be the best way to go.

For the US system with limited government power in healthcare, it helps the private sector ensure quality services are being provided. The Government would just need to put in regulatory measures to ensure standards are being met in the private sector. Limited government spending also leaves room to develop other sectors of the economy which indirectly affect the health of citizens.

That may be a good approach to healthcare systems, taking a holistic approach to other factors that affect health, investing in them to reduce the diseases that may arise from their unavailability, and eventually building a healthy nation through that.

For example, someone gets an accident from an explosion from his generator, while it is a good thing for such individuals to have access to healthcare at that time, it is also a wise investment for the government to ensure there is the adequate power supply to avoid or reduce the use of generators which has numerous health hazards.

In view of the dwindling government resources which was clearly seen in the failure of the Nigerian oil sector to immensely benefit from the windfall occasioned by the Russian-Ukrainian war, is a socialist approach to healthcare by the government – direct involvement in it realistic and sustainable?

Sincerely speaking, it is not realistic for now, but there are possibilities of this happening in the future. Nigeria is a developing country. Even some developed countries have since abandoned the socialist approach to healthcare. Fears of the specter of communism, unmanageable costs, and raising taxes make people debate on this. Just like we have FREE education, I believe FREE or Subsidized Healthcare should also be a priority of our government.

Does increased budgetary spending in the healthcare sector have a direct impact on you as an entrepreneur? If yes, how?

Yes. When the government increases budget spending for the healthcare sector, it means our clients will be able to pay more for the services we render.

What is your advice to aspiring healthcare start-up entrepreneurs in Nigeria?

My advice for aspiring healthcare start-up entrepreneurs is to keep building, don’t ever give up at any time, success might not come as fast as you hoped, but you need to keep building for the next billion users.

What is your advice to local and foreign investors who may wish to invest in Nigeria’s healthcare sector? What low-hanging fruits do you posit to them in view of the daunting challenges in Africa’s largest market?

Healthcare is one of the sectors to invest in, it doesn’t apply to a class of people, healthcare is for everyone. According to an independent report, Nigeria’s leading healthcare companies earned N44.043 billion as revenue in the half of 2022, outpacing their earnings in the corresponding period of 2021 of N30.385 billion.

Thank you for your time and attention; I wish you the best in your future endeavors and God willing, there will be a follow-up interview in the future after you must have either greatly scaled or become another unicorn.

Amen, thanks so much for the privilege.