Access Afya Scaling Services and Segments for Healthcare in Kenya

The case describes the journey of Access Afya, which was founded in 2012 with a mission to provide access to affordable, high-quality health care for unserved communities in Kenya through a hybrid offering (digital and physical facilities) – its own clinics, Curafa™ franchise health centres (in urban and peri-urban areas), and mDaktari, its online clinic. These were an alternative to existing public clinics, ‘illegal’ clinics, and expensive private clinics targeted at people on higher incomes. The case discusses the ecosystem it developed for primary healthcare that aimed to be sustainable and scalable. To expand further through its Curafa™ franchise, the team required a go-to-market strategy to ensure quality was maintained and looked to serve a more mixed market than Tier 1 (people in ‘informal settlements’ earning less than US$60 per month).1 Tiers 2 and 3 presented greater opportunities to scale, but also more competition. Tier 1: 10,000 KES Tier 2: 10,000-20,000 KES (monthly earnings of US$100-200) Tier 3: 20,000-30,000 KES (monthly earnings of US$200+) (N.B. exchange rates are volatile; these were correct at the time the case study was written).

The case prompts discussion of the pros and cons of expanding primary care services from Tier 1 to Tiers 2 and 3. How can this be achieved without undermining the company’s mission – in this case serving the low-income population, especially people living in informal settlements. What would be the optimal customer mix across the three tiers? Expansion into other geographies can also be discussed – how low-cost healthcare delivery organizations can take a business model beyond the founding city/country. To which regions? What should be the go-to-market strategy?