Plastic waste collection in communities to access healthcare with insurance
This article is based upon a learning circle call with a diverse group of partners serving communities to grow their wellbeing, and captures the main insights.
Soso Care is on a mission to collect waste and convert it into insurance to treat malaria and common illnesses. This medical insurance is providing access to a doctor and a network of hospitals and pharmacies in Nigeria – and you can pay with Cash or Trash. The impact is twofold: a cleaner environment and healthier people. In Nigeria, less than 5% of the population has any form of insurance – and less than 1% have health insurance – while under 5% of plastic waste is collected. This solution addresses both major societal challenges at the same time!
Insurance should be very simple, to reach & work in low-income communities
There is an urgent need for healthcare access as well as environmental intervention, however, the biggest issues are: low-income people in these communities do not trust insurance companies, and/or are not aware of the insurance benefits. What they want is income and what they know is barter. Therefore, a solution was piloted to bring these two together: to generate an income with trading waste (cash), while educating about the health insurance – offering an option to use the collected waste in return for health insurance. It’s all about making insurance simple.
Soso Care has figured out how to distribute their simple insurance product by informal workers to people who are not tech savvy and have limited education – it is explained to them by their peers. It’s simple in terms of choice of words, technology (a dial-in menu, without a need for a smartphone) and paid with recyclables. A key to success agent network is around the corner of where they live, and the agent is also one of them – available to them at any time of the day. There is an online app through which the insurance can be bought, but the off-line (agent network) channel is as important. This is the reason why Soso Care manages to reach informal sector workers, 90% of whom are first-time insurance buyers.
It is a long-term investment; it requires education and raising of awareness
We need to make insurance relatable to communities, for people to value it. What we want is for people to understand insurance, only then will they start to value it. How can we help every single Nigerian to understand that whenever they have malaria, they can walk into a pharmacy and get treatment. That’s why Soso Care for example calls it a health plan (instead of insurance). Once they’ve tried “the malaria”, they trust the product and then they come back and ask for a more complex product (insurance).
The same goes for recycling. Most of them, 75% has never recycled before. Once they start and learn what it can do for them, they start to come back. Here is where the trust is built and awareness is raised.
Insurance needs to be affordable – and this is more than pricing alone!
Paying the premium with cash or trash adds another meaning to the affordability. It’s not just affordable – price wise – it is within the realm of the community, where they live, work and walk. For example, the newest product Soso Care is currently launching will require around 120 cans (Coca-Cola or Cambia or anything similar) to get access to one-year medical insurance in any pharmacy in Nigeria. And affordability also relates to reach. Especially if/when you can pay with trash. People do not want to walk a long way to bring in recyclables. It needs to be within 1 or 2 minutes’ walk from your home.
Sustainability of a social insurance venture comes from different revenue streams
Soso Care as a social insurance venture becomes sustainable – while reaching the low-income people and communities – as a result of different revenue streams. Next to revenue from insurance sales (paid with cash or trash), there’s an income from plastic credits sold in Europe. Technology helps to sell through a network of agents, either based in the communities or from a pharmacy or another partner. These can be partners everywhere. The social insurance venture only works when the agent network works well. To assure this, Soso Care makes sure that the agents’ ‘business’ is also a good one. Growth of income for the agents is equally important, and there is a mark-up for agents, to generate a decent income from selling health insurance and recycling plastic waste. Agents are supported with the right technology, like the use of a digital wallet, and distribution support, like off takers for the recyclables.
How to motivate people to take health insurance: make it simple & give incentives
A complex insurance with an annual premium payment is not working for the low-income people in Nigeria, who have never bought an insurance before. So the challenge to overcome is how to make it a flexible and simple product. For example, some significant amount of 950,000,000 Nigerians actually has malaria every single year. “So, if we can design a perk that serves the need of nearly 1/4 of the population, that’s a good product for us.”, according to Nonso, founder and director of Soso Care. We need to make the insurance product simple, with monthly payments, and make sure that the entire process is right for them. In this way insurance covering the risk of getting malaria would tick all these boxes. It would require a lesser number of recyclables to be able to offset within a day.
Keep in mind that 80% of what people generate in their homes can actually be recycled. In this way, within a week the policy could be paid off. This would make the product simple, affordable, with a recycling process within reach – doable for the low-income people. In this way Soso Care encourages everyone with a small bag to collect one or two kilograms of waste, which can be collected in two to three days, and drop it at the nearest agent, who can then in return give them a medical insurance. It allows people to also get some money for food and other stuff. An agent takes a small portion (20-30%) for the insurance and pays the rest in cash, which they can use to buy whatever they want. Cash is an incentive for the people. Mind you: most of them don’t really come for the insurance, but for the cash. Only when they are sick and they use the insurance, then they change their minds about the insurance forever.
Stand with your customer – it’s the long-term behavior change you’re after
To stand by your customer is very important to make health insurance for low-income people a success. One of the things Soso Cares tries, is to build behavior change (positive health seeking behavior), which requires building trust in those communities. This is a long road. For this, a rapid and accurate claim process is key. Soso Care is regularly calling the claim line, randomly, to see how fast they’ll pick up the phone. And they make follow-up calls with customers to ask how the claim was processed and if they need any help. Only then will they renew and refer the product to friends. One key success factor to the growth of Soso Care has been word of mouth from their customers. It requires a strong level of education, investment and awareness.
Don’t rely on marketing, rely on the community
Part of the success and growth has been to go back to the community. Continuously asking your customers what can be improved. You cannot go on the radio and tell people to buy insurance. You need to build trust first. And they do not trust the product of insurance. Trust is built between people, in a relation, in exchanges between people. Ideally people from your own hood.
Community is not persé a neighborhood, village or suburb, it can be a group of employees of an employer too. Soso Care also offers the model to ‘collectives’ like for example medical insurance for the employees of a hotel in return of the hotel’s waste.
Another part of reliance on the community is to realise that you cannot offer insurance in isolation. You need a whole community (an eco-system) of partners to support the needs of your (low-income) customer base. For Soso Care it’s about financial inclusion – it’s about providing financial safety for people and it’s about making sure the environment is right. Soso Care has worked with government to reach women on welfare and other vulnerable groups. With a network of saving groups, supporting to create bank accounts and with savings in their wallets.
We hope you found the insights valuable and can take away key learnings. Our Learning Circle conversation was full of rich discussions, so we encourage you to watch the full recording. You can access it here: