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Strictly private and confidential |For discussion only
1
Investment Proposal
Medikea
12 March 2025
Deal Lead: Christian Muneza, Sharon Batamuriza, James Fraser
Materials:
Data Room
Recommendation
Key Deal Informa.on
Industry Health Founders Elvis Silayo (CEO),
Munir Said (CTO), Denis
Ruhinda (exiting)
Sub-Industry Clinical Network &
Telehealth
HQ Tanzania
Stage Pre-seed Key Operational
Metrics
• 2025 Revenue: $637K
• 2025 Gross Margin:
51%
• CAGR: 47.8%
• Number of live
clinics: 2
• Upcoming Clinics: 2
• New Clinic Breakeven
Period: 6-8 months
• Number of FTE: 44
Fundraising Target $200,000-$300,000 Key Impact Metrics
• Patients served:
60,000
• Women served:
32,618
Post-Money Valuation $5,000,000 Key Investors Impacc, Madica,
Catalyst
Instrument Equity Fundraised to date $700,000
Madiro Fitness:
Medikea (the Company) aligns with Madiro’s thesis as the Company addresses a clear access gap by
combining digital consultations, diagnostics, pharmacy services, and centralized records into a single,
Medikea
Tanzania
Strictly private and confidential |For discussion only
2
practical model for underserved patients. Medikea would expand Madiro’s impact footprint into a new
geography, one that has a particularly low insurance penetration and that is below the Continent’s
average on key health access indicators.
Key Risks:
• Regional Expansion: This is a business that notoriously favors incumbents and is hard to expand cross-
borders. This is due to significant differences in healthcare and regulatory systems across countries
and high upfront costs before a brand builds reputation. Regional expansion in this business has been
via acquisitions of an already established network rather than set up from scratch.
On the flip side, this means that if Medikea builds depth into its home market, it becomes an
interesting acquisition target for a larger player that wants to expand to Tanzania.
• Operational Complexity: As the network of clinics expand, the founder effect is stretched thin and it
becomes more likely that clinical practices vary across sites, leading to inconsistent patient outcomes
and potential malpractices.
Medikea will need to aggressively invest in professional development and have recurrent trainings to
build and maintain the same quality and standard across all its clinics.
• Funding Challenges & Growth Plateau: Unfortunately, the pool of funds that invest in physical
healthcare infrastructures is rather limited due to skepticism on scalability potential, and this lack of
capital forces companies into a premature growth plateau.
It’s imperative that the Company starts building connections with growth-stage funds that have
appetite for physical infrastructures such as Africa50 and AfricInvest and even possibly small and mid-
cap PE funds but also start thinking ahead of 4me of possible alternatives to equity financing.
Continued financial discipline that ensures positive net margins and a well-reputable network of clinics
may make them acractive to debt financiers, for example.
Madiro Value Crea.on:
• Board Formation & Oversight: As the Company expands, the complexity of decision-making increases.
Madiro can draw from its network and experience investing in health ventures across the Continent
to help set up both the BoD and an advisory board that comprises experts in clinical care, regulatory
affairs, and health management. As part of the Board, Madiro can champion operational excellence
within the existing network of clinics before new ones are launched; this will be key to ensure the
Company has a solid foundation and won’t struggle to maintain its quality as it expands.
• Senior Management Recruitment: Close to the above, Madiro can help with finding a replacement
for the exiting COO or filling other necessary roles critical to the Company’s growth.
• Evidence Generation and M&E for Scaling: Help Medikea build the impact-measurement framework
needed to prove Medikea’s clinical outcomes to future investors.
• Growth-stage Financing: Guiding the Company in future financing strategies (equity, debt) and helping
it build a network of future financiers ahead of 4me.
• PorPolio Synergies: Madiro can facilitate intros with existing porfolio companies for learning and
sharing experiences and exploring potential collaborations.
Strictly private and confidential |For discussion only
3
Due Diligence Summary
Problem
Quality healthcare in Africa is scarce, expensive, inaccessible, and fragmented in non-urban centers. While
digital health promised to integrate a fragmented healthcare system, it simply cannot work without
prerequisite investments in physical healthcare infrastructures that make healthcare services widely
accessible and affordable. Africa, and Tanzania in particular, has a dismal shortage of clinics; well run,
equipped, and standardized clinics; well-trained physicians; and few specialty services offering.
The table below gives a side-to-side comparison of Tanzania and Sub-Saharan Africa versus Europe to
illustrate the extreme structural scarcity that needs to be addressed.
Indicator
Europe Sub-Saharan Africa Tanzania
Health facilities per
10,000 people
5 2.2 1.9
Physicians per 10,000
people
40 2.5 1.52
Nurses per 10,000
people
85 11 6.9
Hospital beds per
1,000 people
5.1 1.2 0.44
Solu.on
Medikea is building a hybrid healthcare delivery model that combines in-person clinical services and in-
app digital health services.
• In-person Clinical Care: Medikea clinics provide integrated care from consultation, diagnostics, and
pharmacy. Beyond general medicine, Medikea clinics offer services across the following specialty
services:
o Pediatrics
o OBGYN
o Dermatology
o Diabetes
o Hypertension
In 12-18 months, they plan to have added the following specialty services:
o Cardiology
o Gastroenterology
o Dental Care
Strictly private and confidential |For discussion only
4
• In-app Digital Health Services: Medikea’s app allow patients to have a seamless digital healthcare
journey.
The app offers the following services:
o Booking an appointment, either online or in-person.
o Online consultation
o Messaging for questions and follow ups
o Lab results
o Prescriptions
Product-Problem Mapping
Product Problem How the product addresses the problem
Hybrid Care Model
(Telemedicine +
Physical Clinics)
High Customer Acquisition
Cost (CAC), Low trust, and
unsustainable unit
economics of purely digital
plaPorms.
Purely digital apps in Africa fail due to limited clinical utility
and low trust/patients’ habit and preference for seeing the
doctor in person. Purely telemedicine solutions have an
impossible unit economics predicament given the high costs
of clients’ acquisitions (which omen relies on expensive digital
channels and constant engagement to create mass cultural
change and antude towards online consultation) and the
structurally limited revenue as their only service is
consultation. The hybrid model removes the need to do
massive upfront investments in changing population antudes
towards online consultation and instead builds on the already
existing market preference, acting as a high trust anchor that
drive local patient acquisition organically while moving
routine follow ups to convenient digital channels and keeping
the online consultation option available for the population
segment that is comfortable with/prefers it.
The hybrid model also captures a bigger share of the patient’s
wallet, allowing for more sustainable unit economics.
Integrated Pharmacy
and Diagnostic
Services
Fragmented supply chain &
3-4x retail markup
Medicines across Africa pass through multiple small-scale
wholesalers, each adding a markup. By the 4me a medicine
reaches a patient, the markup is more than 100% and, in many
cases, a multiple, making the cost of care punitive for most of
the population.
Medikea solves for this as it directly imports or purchases
from national distributors, skipping sub-national middlemen,
allowing it to price medicines cheaper than traditional private
pharmacies while still capturing a 50-60% margin.
Integrated Digital
Health Record (DHR)
Diagnostic Redundancy Patients across Africa omen visit multiple clinics for the same
issue because data isn’t shared, leading to repe44ve,
expensive tests, and lack of a coordinated approach to care.
Strictly private and confidential |For discussion only
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Medikea’s patients’ digital profile reduces clinical waste and
enables the Company to manage chronic diseases through
continuous monitoring rather than isolated acute visits
Insurance
Integration & HMO
Low Liquidity & High Out of
Pocket (OOP) Spending
Only 15% of Tanzanians have medical insurance. Medikea was
the first company to get insurers to cover virtual care, and
they partner with the National Health Insurance Fund, the
largest medical insurer in the country. Further to this,
Medikea plans to become an HMO, contributing to increasing
Tanzania’s insured population and reducing OOP spending.
Impact
• For the B2C Market
o Local communities that get easier access to specialty services and high-quality general
medicine
o Patients with chronic conditions that get to have virtual care (check in and follow ups)
without back-and-forth clinical visits
o Uninsured and underinsured people, often without formal jobs to enjoy corporate-
sponsored health benefits
o Budget and time-conscious consumers who need care from doctors they can trust, at prices
they can afford, conveniently
• For the B2B Market
o Uninsured MSME’s who are not served by traditional insurance companies
o Insurance companies who want to use telemedicine services to reduce the cost of claims
while delivering top notch customer experience to their clients
o Corporates who want to use telemedicine to offer innovative wellness services to their
employers, e.g. mental health, diet and nutrition and other related employee assistance
programs.
Theory of Change (To C):
Medikea’s ToC is built on the belief that if patients are anchored in coordinated primary care, specialists
are availed, and incentives are aligned towards prevention, we can ensure early diagnosis, lower costs,
and improve long-term health outcomes at scale.
Medikea’s ToC works in five steps:
1. Anchor Patients in Structured Primary Care: Make primary care the entry point into the system — not
tertiary hospitals.
2. Digitally Coordinate the Patient Journey: Integrate EMRs and referral systems to eliminate
fragmentation across clinics, specialists, diagnostics, and pharmacy.
3. Detect Chronic Disease Earlier: Proactive screening and longitudinal tracking to reduce late-stage
presentation.
4. Align Incentives Toward Prevention: Reduce reactive fee-for-service dependency through
subscriptions, corporate programs, and insurance integration (including NHIF)
Strictly private and confidential |For discussion only
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• Impact metrics: The Company doesn’t track impact metrics yet beyond the number of patients
served (60,000). This is something that Madiro can help them with post-investment.
• Impact at scale: In the short run (12-18 months), Medikea seeks to have served 100, 000+ patients,
expanded to 3 more clinics, launched 10 specialty care services, and launched a health insurance
product.
Ultimately, Medikea’s vision is to transform healthcare by enabling a seamless access to quality healthcare,
a unified digital health profile enabling patients to own and access their medical history, making healthcare
more affordable, and supporting drug development on the continent by partnering with Big Pharma to
leverage patients’ data for clinical trials.
Overall, these will lead to outcomes such as:
● Fewer preventable diseases
● Lower out-of-pocket spending
● Less pressure on tertiary hospitals
Market
Economic Tailwinds:
• Total healthcare Spend: Tanzania’s current health expenditure is approximately $4.1bn, representing
3.36% of GDP. While the per capital spend is modest at $49-52, the sheer volume of a 66.6 million
population growing at 2.9%-3.2% annually creates a massive, non-cyclical floor for healthcare services
• Urbanization: Tanzania is one of fastest urbanizing nations in Africa, with a 38% urbanization rate in
2023. Smartphone penetration in cities such as Dar es Salaam, Arusha, and Mwanza is at 60%. Urban
patients are higher Lifetime Value and represent a segment that is more likely to pay for convenience
and opt into digital services.
• Supply Scarcity Moat: With only 1.9 healthcare facilities and 1.52 physicians per 10,000 people, there
is zero price war risk. Demand so far outstrips supply that the primary challenge is not finding patients
but increasing access and efficiency.
Regulatory Tailwinds:
• Universal Health Insurance (UHI) Act: The government officially commenced the mandatory “Bima ya
Afya kwa Wote” scheme in early 2026. This represents a significant opportunity for health insurance
players and will open a bigger market as the more people are insured, the more they seek healthcare
services on a 4mely and regular basis instead of waiting for when it is too late or go to traditional
healers or informal drug vendors.
• National Health Sector Strategic Plan (HSSP V): The government targets to move 46% of curative
services to the private sector.
Overall, Medikea is not just one more clinic services provider but a necessary infrastructure in a market
that is massively under-built, and as scarce and inefficient the healthcare system currently is, it will only
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7
get worse if more solutions like Medikea do not emerge to deal with growing challenges in NCDs,
urbanization, and population growth.
Te a m
Medikea founders, particularly the CEO, have on the ground experience and an intimate understanding
of the realities of Tanzania’s healthcare system. Below is a snapshot of their experience:
Elvis Sirayo
Co-founder, CEO
Elvis is a medical doctor and former primary care clinician at a leading tertiary
hospital in Tanzania, where he treated and managed over 12,000 patients. His
frontline experience gives him deep insight into patient pain points and health
system gaps. Beyond medicine, Elvis is a self-taught Product Manager, uniquely
blending clinical expertise with technology and user-centered design. This hybrid skill
set enables him to build digital and physical health solutions that are intuitive for
patients and efficient for clinicians.
Munir Said
Co-founder, CTO
Munir is a seasoned software engineer with deep experience building secure,
scalable systems. At Nexis Africa, he developed backend systems for banks and
financial institutions, gaining strong expertise in high-reliability infrastructure. He
later joined Tuya Global—one of China’s fastest-growing unicorns—where he built
IoT and cloud development platforms used by hardware companies worldwide.
Munir brings world-class technical leadership to Medikea’s digital ecosystem.
The Company currently has no board. Madiro should assist in board formation—both BoD and advisory.
Moving forward, it will also be critical to explore how to strengthen management to ensure it’s able to
meet the growing financial & admin and clinical care complexities of an expanding clinical network.
Note on Co-founder, Desire Ruhinda, Exit:
The Co-founder and COO, Desire Ruhinda, decided to exit the Company, and Medikea’s investors—Madica
and Catalyst Fund—have been supporting the founders in mediating the exit process. As of today, the exit
framework has been agreed upon by both parties and is in contracting under the following terms:
• Total Buyout Price: $100,000
• Guaranteed Payment: $50,000 to be paid upfront within the first 3 months. $30k upfront, and
$20k by April 30th.
• Share Surrender: Desire agrees to surrender 100% of his shares.
Strictly private and confidential |For discussion only
8
o Note: There is a proposal to hold 50% of these shares in escrow until the final
payment is cleared. The shareholder is responsible for any legal fees associated with
this escrow arrangement. Alternatively, if the second (contingent) payment is not
triggered, 50% of the shares may be subscribed at nominal value.
• Operational Handover: Resignation and handover of all company accounts and software access
must be completed immediately. This is a standalone requirement and is not contingent on the
payment schedule.
• Resignation. Desire agrees to resign after he recieves first payment but is happy to sign agreement
stating these terms and that being tied to his resignation.
• Contingent Payment ($50,000): The remaining balance is subject to company performance.
Specifically, it is payable only if Medikea successfully raises a minimum of $1,000,000 USD
within 24 months of the agreement date.
The buyout costs will be personally incurred by the CEO, Elvis, and not the Company.
Financials
The Company has had impressive growth since starting operations, growing revenue by more than 2x in
2024 and 1.5x in 2025. As seen in the graph, diagnostics and medicines are the leading sources of revenue.
This validates our conviction that digital-only solutions are not only not enough to address inadequate
healthcare but are also not enough for a company to be financially promising. Also important to note
are the margins across product lines. Again, diagnostics and medicine sales lead. Again, we see that by
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9
offering a hybrid model, Medikea has been able to escape the structural margins leakage that has plagued
telemedicine plaforms across the continent. Beyond this, the high margins on diagnostics and medicines
sales show Medikea’s advantage of being vertically integrated. By importing/purchasing from national
distributors and then directly stocking its pharmacies and selling to end consumers (patients), Medikea
has been able to capture margins that would have been taken by middlemen. By owning in-house labs,
the Company has also been able to capture margins that would have otherwise been lost if they were
outsourcing such services.
In 2026, Medikea projects to 3-4x their revenue. This is a function of all their 4 clinics being live by April
2026, and as per Company’s estimate, each clinic bringing in a minimum of $50K per month. Proceeds of
the current round will be imperative in enabling this as they will go towards fully equipping and staffing
clinics. On average, their clinics have capacity to receive 4000 patients a month and require a staff of
around 15 full 4me employees which comprises 3 doctors, 4 nurses, 3 lab technicians, 3 pharmacists, 1
clinic manager, and 1 finance manager. Other operations such as tech, procurement, pharmacovigilance
and quality assurance, HR, and marketing are centralized, which allow the Company to enjoy economies
of scale as they expand their network of clinics.
Projections for 2027 and 2028 are functions of increasing specialty services offered from 5 to 10, existing
clinics serving at near full capacity, and launch of new clinics. These projections are still speculative, and
the Company will be remodeling over 4me.
The Company is also planning to launch an HMO product afer its Seed fundraises. The HMO will cover
individuals and MSMEs that are not served by traditional insurance players, and people covered under the
HMO will be able to use that cover across Medikea’s network of clinics and partners. This will make the
Company even more vertically integrated and fully meet patients’ needs. The Company has communicated
that it takes 3-6 months to get an HMO license in Tanzania, and that the capital required by the Central
Bank is $600K, of which 50% goes towards the deposit requirement and 50% goes towards operation. The
HMO product isn’t included in the model above pending more certainty on launch 4melines.
It is important to note that the high margins projected are revelatory of that the Company may be
capturing all the margins gained by skipping middlemen and not necessarily passing some of them to
patients through lower pricing. In any case, the high margins give the Company enough breathing space
and means to invest in more clinics, becer services, and becer equipment, for example, and maintains the
optionality to lower prices if and when it is the right strategy.
Funding
The Company has raised $700,000 across 3 pre-seed rounds. The current largest investors are Impacc that
invested $250,000 in the pre-seed round 3, and Madica and Catalyst that invested $200,000 each in pre-
seed round 2.
As noted above, Co-founder Desire Ruhinda is in the process of being bought out by Co-founder Elvis
Silayo.
Strictly private and confidential |For discussion only
10
Fundraise Target Instrument Use of Funds
$200,000-$300,000 SAFE • Hiring top talent for key positions (Finance, HR,
Marketing, Product Management, Business
Development)
• Hiring Core Specialists (Pediatrician, Obstetrics &
Gynaecologists, Physician)
• Operational excellence (Rolling out operational SaaS for
Business intelligence, streamlining processes, boosting
team productivity and efficiency)
• Growth and Marketing
• Employees development programs
Exit
A 5 years NPV and IRR calculation based on the Company’s current financial model, a $200K investment,
and a 15% discount rate provides a $685K NPV and a 76% IRR. This calculation should not be given any
weight, however, as the current financial models are bound to change and the long-term financial
projections of such an early stage startup are too uncertain for any reliable forward-looking figure to be
extrapolated.
Medikea represents a compelling investment given the still very underserved market it’s entering, and its
approach to combining digital and clinical services to offer integrated care.
Most likely exit opportunities include a trade sale to a large hospital group looking for established players
with existing infrastructure and digital-first patient base and a secondary buyout to a late-stage fund.
Strictly private and confidential |For discussion only
11
Due Diligence Questionnaire
Medikea, Inc
Note to the organization:
This questionnaire and the information contained within are for discussion only and will be for the exclusive use of
Madiro and Medikea, Inc. No part of this document will be copied, photocopied or duplicated in any form by any
means, or redistributed without the prior written consent of Madiro and Medikea, Inc. Information contained in this
document is not all-inclusive, and no one other than Madiro should use this information or place any reliance on this
document for any purpose.
Guide to completing the questionnaire:
● Complete all sections that are applicable to your organization at this stage.
● If an answer to a question has already been addressed in your supporting documentation, please indicate
where it can be found in the Dropbox data room.
● Do answer this questionnaire as completely and in as much detail as possible.
Summary
Information on the organization
Summary of organization
Headquarters 5th Floor, Noble Centre, Victoria, Dar Es Salaam, Tanzania
Type of innovation, technology or
social enterprise
Tech-enabled healthcare solution
Information on geography
Country(ies) of registration Delaware US, and Tanzania
Current country/region/city of
operation
Tanzania
Planned country/region/city for
expansion
Uganda, Zambia, Ethiopia
What is your approach towards
localizing day-to-day operations
and decision making on the
continent?
[For organizations based outside of Africa]
Information on finance & funding
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Total funding raised / available and
source of funding (personal,
friends, family, angels, investors)
$700,000
Funding requirements (12-18
months)
$1,000,000
Use of the funding required - Hiring top talent for key positions (Finance, HR,
Marketing, Product Management, Business
Development)
- Hiring Core Specialists (Pediatrician, Obstetrics &
Gynaecologists, Physician)
- Operational excellence (Rolling out operational SaaS for
Business intelligence, streamlining processes, boosting
team productivity and efficiency)
- Growth and Marketing
- Employees development programs
Human Resources
Information on the organization
Company headcount by
location/function/department
Total headcount 44
Headcount growth over time
Board makeup (highlight relevant
skillsets)
No board yet
Advisors (highlight relevant
skillsets)
Ex-Startup founders (Operations), VC Partner (Fundraising), Specialist
Doctors (health services), Ministry of Health (Policy, Regulation, and local
network)
Diversity makeup of the team
Management team
Only include team members with key management functions. Include as many as you need.
Team member 1: ELVIS SILAYO
Role
CEO
Tenure
Since company founding 2022
Full time/part
time/contractor/other
Full time
Highlight relevant experience and
background
Elvis is a medical doctor and former primary care clinician at a leading
tertiary hospital in Tanzania, where he treated and managed over 12,000
patients. His frontline experience gives him deep insight into patient pain
points and health system gaps. Beyond medicine, Elvis is a self-taught
Product Manager, uniquely blending clinical expertise with technology and
Strictly private and confidential |For discussion only
13
user-centered design. This hybrid skill set enables him to build digital and
physical health solutions that are intuitive for patients and efficient for
clinicians.
Team member 2: MUNIR SAID
Role
CTO
Tenure
Since company founding 2022
Full time/part
time/contractor/other
Full time
Highlight relevant
experience and
background
Munir is a seasoned software engineer with deep experience building secure,
scalable systems. At Nexis Africa, he developed backend systems for banks and
financial institutions, gaining strong expertise in high-reliability infrastructure. He
later joined Tuya Global—one of China’s fastest-growing unicorns—where he built
IoT and cloud development platforms used by hardware companies worldwide.
Munir brings world-class technical leadership to Medikea’s digital ecosystem.
Team member 3: DESIRE RUHINDA
Role COO
Tenure Since founding 2022
Full time/part
time/contractor/other
Full time
Highlight relevant experience and
background
Desire is a medical doctor, researcher in non-communicable diseases, and
a Master of Philosophy in Innovation graduate from the University of Cape
Town. He specializes in health behavior change and is an active advocate
for NCD prevention and management. Desire brings strong expertise in
public health, population insights, and patient engagement strategies—
ensuring Medikea’s care models are evidence-based, empathetic, and
impactful.
The problem
● What is the problem you are trying to solve? How severe is the problem? What are the adverse effects of
this problem not being solved?
Medikea is solving fragmented, low-trust, and inaccessible healthcare in Africa.
Today, patients face three core challenges:
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14
1) Fragmentation of Care - Primary care, specialists, diagnostics, pharmacies, and follow-ups operate in
silos. Patients must move between multiple facilities, repeat medical history multiple times, coordinate
their own care, there is no integrated system that manages the patient journey end-to-end.
2) Poor Access to well-equipped facilities & Specialists - Well-equipped facilities and Specialist care are
concentrated in major cities, leaving 70% of Rural and peri-urban populations lacking access, Waiting times
are long, Informal or underqualified providers often fill the gap. Quality care exists, but it is not equitably
accessible.
3) High Out-of-Pocket Costs - Over 90%+ of healthcare in many African markets is paid out-of-pocket.
This leads to patients delaying seeking care early, opting to self-medicate, or skip follow-ups due to costs.
This has leads to long term catastrophic health spending when conditions worsen.
2. How Severe Is the Problem?
Africa carries ~24% of global disease burden but has ~3% of global health workers.
Chronic diseases are rising rapidly (hypertension, diabetes, cancer).
Public hospitals are overwhelmed with primary-care cases.
This is a system-level failure, not an isolated inefficiency.
Adverse Effects If Not Solved
Preventable strokes, kidney failure, maternal deaths
Increased poverty due to medical bills
Overburdened tertiary hospitals
Reduced workforce productivity
Declining life expectancy gains
This is both a public health crisis and an economic development constraint.
Africa carries ~24% of global disease burden but has ~3% of global health workers.
Most care is still paper-based and uncoordinated.
Patients often wait hours for consultations that last minutes.
Chronic diseases (hypertension, diabetes) are rising rapidly.
Specialist-to-population ratios are critically low.
In many markets, healthcare quality is a function of geography and income — not the patient's needs. This
is not just a health system inefficiency problem. It is a life expectancy and economic productivity problem.
3. What Happens If This Problem Is Not Solved?
If nothing changes, the consequences are severe:
1) Rising Chronic Disease Crisis and Preventable deaths - Late diagnosis of hypertension, diabetes, cancer,
which leads to health complications Increased stroke, kidney failure, heart disease or at worst case loss of
Strictly private and confidential |For discussion only
15
lives. WHO proved that by scaling up primary health care interventions across low and middle-income
countries could save 60 million lives and increase average life expectancy by 3.7 years by 2030
2) Financial Catastrophe for Families - Households fall into poverty due to medical bills. According to World
Health Organization, over 500 million people in Africa are at risk of falling into poverty due to out-of-pocket
health spending of 10% or more of their household budget
3) Overburdened Public Hospitals - Tertiary centers and Specialists treating primary care cases, leading to
long queues, clinician burnout and Reduced quality of care overall
4) Loss of Productivity
Working-age adults suffer preventable complications, Businesses face absenteeism, National GDP impact
increases, Healthcare inefficiency compounds economic inequality.
● How many people are affected by the targeted health issue each year in the region where you operate (or
plan to operate)? What are the consequences for these people?
Primary Market: Tanzania ~ 67 million
Expansion Market: East Africa ~ 300 million
In Tanzania (~67M population)
~60 million people live in underserved regions (peri-urban and rural) with no reliable access to quality
healthcare services and specialists.
~ 90% of the population are uninsured or underinsured, pay out-of-pocket for healthcare and at risk of high
hospital bills or ignoring seeking care to avoid costs.
Millions lack structured primary care follow-up
● How do these health issues affect low-income people compared with middle and high-income people in
East Africa? Is it more prevalent in certain demographics than others?
Low-Income Populations
● Delay care due to cost
● Higher reliance on informal providers or self medication
● Higher rates of undiagnosed disease
● More catastrophic health expenditure
● Worse outcomes
Fragmentation hurts them most because they lack resources to navigate it.
Middle- and High Income Populations
● Access private clinics but still fragmented
● Pay repeatedly across disconnected providers
● Lack continuity and data coordination
They pay more — but don’t necessarily receive integrated care, and Fragmentation becomes inconvenient
rather than catastrophic.
The solution
● Describe the solution/product/service you have developed/are in the process of developing. Outline the
key features and benefits of the solution from the perspective of the user described above.
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Medikea is building a tech-enabled, integrated healthcare system that combines virtual and in-person care
to deliver accessible, affordable, and high-quality primary and specialized services under one coordinated
platform.
Key User Benefits
● One coordinated care journey
● Faster access to trusted network of GPs and specialists
● Affordable diagnostics and pharmacy
● What are the drawbacks of the solution from a user perspective when compared with existing alternatives?
● Requires behavior change (through community education and engagement)
● Requires basic digital familiarity (for our telemedicine solution)
● Our solution may initially appear to be perceived to be expensive and built for middle and high
income people while in reality it is designed to be affordable even for low income.
● Physical visit still required for some services
● What infrastructure is necessary for your solution? (Ex. Testing equipment, cold chain/storage, power, etc.)
● User mobile app
● Physical clinic space
● Diagnostic equipment and reagents supply chain
● EMR platform
● Internet connectivity
● Power backup
● Pharmacy supply chain
● Licensed clinicians
● Referral network partnerships
● What makes your approach novel? What is being done here for the first time? When completed what will
your product be able to do that no one else has done?
While most players are digitizing a broken healthcare system, Medikea is rebuilding the system from the
ground up. We are creating a vertically integrated healthcare model that combines care delivery,
technology, and risk management under one coordinated operating system, designed to make healthcare
more efficient, lower cost, and prevention-driven. When fully built, Medikea will deliver longitudinal,
coordinated, risk-aligned healthcare at scale in East Africa – something no existing provider currently
offers.
● What intellectual property do you anticipate that this innovation will generate if any?
In future, Medikea’s defensibility will be based on integrated system architecture, proprietary care models,
and data network effects.
We anticipate generating IP in the following areas:
1. Proprietary Care Pathways for Product lines: Standardized, data-informed condition specific product line
i.e chronic disease program. These pathways become structured, algorithmic, and continuously improved
through outcomes data.
2. Healthcare Operating System: Our vertically integrated platform (primary care + specialists + diagnostics
+ risk layer) becomes a proprietary healthcare operating architecture tailored to emerging markets.
3. Clinical + Cost Data Layer: Longitudinal patient data across levels of care will enable Predictive risk
modeling, Cost optimization algorithms, Preventive intervention triggers. The data becomes a
compounding strategic asset.
4. Brand + Trust Equity: In healthcare, trust is infrastructure. Brand defensibility becomes a major intangible
moat.
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● How easy would it be for others to develop a solution that would deliver similar features while not violating
any IP that you expect to have? Are there any other barriers to stop someone from competing with you?
Why hasn’t anyone done this before?
On the surface, components are easy to copy: Clinics can be built, Apps can be developed, Specialists can
be contracted. But replicating the integrated system is significantly harder. What makes Medikea
defensible is not features — it is orchestration. To replicate Medikea, a competitor would need to
simultaneously:
● Build physical clinic infrastructure
● Recruit high-quality clinicians
● Integrate specialist networks
● Develop scalable health-tech infrastructure
● Align incentives with insurers or risk pools
● Acquire enough patient volume to generate meaningful data
● Build brand trust in a sensitive sector
This is a multi-layered execution challenge.
Value proposition, customers & beneficiaries
● Who are the company’s target beneficiaries/customers/ users? List all potential beneficiaries/customers/
users of the solution.
For the B2C Market
● Uninsured and underinsured people. Often without formal jobs to enjoy corporate-sponsored
health benefits.
● Budget and time-conscious consumers who need care from doctors they can trust, at prices they
can afford, conveniently.
For the B2B Market
● Uninsured MSME’s who are not served by traditional insurance companies
● Insurance companies who want to use our telemedicine services to reduce the cost of claims
while delivering top notch customer experience to their clients
● Corporates who want to use telemedicine to offer innovative wellness services to their employers
e.g mental health, diet and nutrition and other related employee assistance programs.
● What is the total addressable market? What is the market growth projection?
Our target market is in Tanzania, where the total available market (TAM) for out-patient expenditure is $10
billion, based on the 40 million annual hospital visits. The serviceable available market (SAM) represents
70% of outpatient visits that can be effectively addressed through virtual or in-person primary care,
amounting to $7 billion.
In Tanzania healthcare spending increases at ~6–10% CAGR.
● What have you done to understand your customers and beneficiaries well? How much time have you spent
speaking to them? Who have you spoken to and what research have you done?
● As a doctor myself, I have treated over 10,000+ patients, giving me first hand experience of
clinicians pain points, how the current health system works, and its inefficiencies.
● Ongoing customer interviews during our product development process
● After visits anonymous reviews and ratings by patients
● Strategic partner meetings (Insurance companies, employers, hospitals, suppliers)
● Specialist engagement
● Market analysis
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● Has the solution (product or service) been tested with a sample set of potential customers/beneficiaries? If
so, where did you test the solution, with how many people and what was the impact?
Since 2023, we have served over 60,000 patients.
● What is the value proposition for each of the beneficiaries and customers listed? Specifically, does it
address the various problems/pain points you have stated in the earlier sections?
● Competitive landscape: What is your competitive advantage? Who or what is currently providing solutions
to this problem? How effective are these solutions? Why do these existing solutions need to change or be
improved upon? What are the barriers to entry?
Current solutions:
● Public hospitals → Overcrowded, low trust, low quality
● Private hospitals and clinics → Fragmented, Expensive, Limited to their geographical location,
Outdated tech, inconvenient
● Telemedicine apps → Limited to online consultations only, No physical integration for labs and
medicine delivery, High CAC, High churn, Low consumer trust.
Medikea Advantage:
Hybrid integration: Virtual and in-person care, giving patients convenient
Technology-enabled care: Boosting patient engagement, experience, and retention
Trusted GP and Specialist network: Brand positioned as infrastructure
Positive unit economics: In house labs and pharmacy ensuring affordability with profitable margins
Scalability & impact
● Is this business designed to grow large? Do the owners have the desire and capability to support this
growth?
Yes — Medikea is intentionally architectured for scale. The model scales across three reinforcing layers:
1. Physical Infrastructure (Hub-and-Spoke Clinics)
● Standardized primary care clinics
● Centralized specialist network
● Replicable operating playbooks
2. Technology Layer (Low Marginal Cost Expansion)
● Unified EMR
● Coordinated referral engine
● Longitudinal patient tracking
● Technology scales with minimal incremental cost, improving margins over time.
3. Risk & Payment Layer (Future launch)
As patient volume grows:
● Subscription models become viable
● Corporate contracts expand
● Insurance alignment strengthens
● Preventive care economics improve
● Scale improves both unit economics and clinical outcomes.
● What are some of the challenges you anticipate for scale?
● Talent acquisition - Scarcity of high-performing talent that fit startup culture
● Regulatory and cultural differences across countries when scaling beyond Tanzania
● What role do government sales have to play in your business’ ability to reach scale?
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Government partnerships are strategic accelerators, not the foundation of our business model.
Medikea is designed to scale initially through:
● Direct-to-consumer patients
● Corporate partnerships
● Private insurance
● Subscription-based primary care
However, government alignment significantly expands reach and impact.
NHIF Partnership Opportunity – Already Secured
We have successfully closed an NHIF partnership for our Dar es Salaam clinic. This allows us to serve
members of the National Health Insurance Fund (NHIF) – representing approximately 4 million insured
Tanzanians.
Through this partnership:
● NHIF members can access our integrated primary and speciality care services
● We reduce out-of-pocket barriers for insured patients
● We increase patient acquisition efficiency
● We strengthen our institutional credibility
We expect to expand the partnership to our Telemedicine services and other clinics.
● What is your theory of change and ultimate impact goal?
Theory of Change
Healthcare in East Africa is fragmented, reactive, and hospital-centric. This leads to late diagnosis,
preventable complications, catastrophic spending, and productivity loss.
Medikea’s theory of change is built on one core belief:
If we anchor patients in coordinated primary care, digitally connect specialists, and align incentives toward
prevention, we can reduce complications, lower costs, and improve long-term health outcomes at scale.
Our change pathway works in five steps:
1. Anchor Patients in Structured Primary Care
We make primary care the intelligent entry point into the system — not tertiary hospitals.
2. Digitally Coordinate the Patient Journey
Integrated EMRs and referral systems eliminate fragmentation across clinics, specialists, diagnostics, and
pharmacy.
3. Detect Chronic Disease Earlier
Proactive screening and longitudinal tracking reduce late-stage presentation.
4. Align Incentives Toward Prevention
Through subscriptions, corporate programs, and insurance integration (including NHIF), we reduce reactive
fee-for-service dependency.
5. Reduce Financial Shock and System Congestion
Better-managed patients mean:
● Fewer preventable strokes and kidney failures
● Lower out-of-pocket spending
● Less pressure on tertiary hospitals
● Higher workforce productivity
Scale compounds these effects.
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Ultimate Impact Goal: Build Africa’s most trusted, integrated healthcare system that shifts care from
reactive to preventive – improving life expectancy, reducing catastrophic health spending, and
strengthening economic productivity.
● How will you track and identify the impact on patients? Provide sample metrics to indicate social impact.
Medikea measures impact through structured clinical, financial, and access metrics captured within our
integrated digital system.
1. Clinical Outcomes
% of hypertensive patients with ...
