Almouneer - A Vision for Egypt

Interning at Almouneer has given me an opportunity to learn about a scaling a social-impact solution sustainably in an emerging market.

Almouneer is a clinic chain that focuses on chronic eye diseases, especially diabetes-related eye disease in Egypt.

It aims to eliminate diabetes-related blindness, which is the leading cause of blindness in Egypt and the Middle East by providing easy access, low-cost clinics that provide specialised treatment.

Applying for the internship I knew the business, the founders and the strategy well since Almouneer had been the business that was explored by our batch during “Master Strategy Day” at INSEAD in February as a part of the Introduction to Strategy course work. As a result, I understood their goals of scaling to 42 clinics and the challenges well and had an understanding of how I could contribute to their growth by improving operations. I was also excited by the opportunity to work with the two female founders- Noha Khater and Rania Kadry who had inspired us during their visit to the INSEAD campus.

At the internship, Andrew Chen, 19D (Co-recipient of INSEAD Social Impact Award and Almouneer summer intern) and I were brought up to speed quickly by Noha and Rania on all the latest occurrences in the organisation. The key problem was scaling while having the right mix of high volume, low-profit patients (supported by the NGO arm - Almouneer Control) and high-profit patients for the business. The hurdles to scaling were 1) lack of financing and 2) lack of expertise (operations and sales) and management capabilities. The founders were understandably hesitant to invest in management talent without having a clear financing strategy and 360° plan.

Our first week was spent in meetings with different consultants and partners. This gave us the outsiders view of the business and the market. The founders involved us in all meetings including consultant meetings to improve the in-house software for EMRs and CRM, meetings with VC funds interested in investing in the business, recruitment meetings for the NGO arm and meetings with possible partners to set up verticals in the service.

In terms of growth opportunities, the group (with four existing clinics) was looking to expand to one more owned clinic through internal financing and manage 2 clinics from established doctors who wanted to outsource clinic management on revenue sharing basis. This was their goal for 2019.

As a result of these meetings, we were able to identify key deliverables for our internship which we delivered over the next four weeks. The main Projects and deliverables were as follows–

• Set up operational processes and suggest operational improvements to reduce cost: Though rudimentary processes had been set up. They weren’t being communicated to the staff in an activity-based manner allocated to functions. There were no processes or checklists for clinic opening and set up.

We delivered an operational model and time-line to set up brand new or acquired clinics using a multi-functional SWAT team. We also created patient flow charts and written processes for administration staff such as nurses etc. to follow in order to have a clear allocation of responsibilities. We also helped to recruit a new employee in charge of operations for the organisation. We calculated and delivered key KPIs for utilisation of expensive equipment, a key Capex expenditure for Almouneer.

• Develop a pitch deck and business plan for fundraising: Though there was a lot of interest from different funds, there had been no internal attempt at creating a financial model, growth plan, funding requirement, competitive edge and strategy document to show investors financial and operational KPIs.

We were able to deliver a pitch deck with the company description, business plan, execution plan, financials and send it to interested VCs.

We were also able to evaluate and amend term sheets received from VCs using this financial model and business plan.

• Patent Agreement with an established local University: The company had commissioned research into enhancing drug delivery. The agreement with the university was not finalised with respect to intellectual property and royalty rights.

We had a meeting with the Director of technology transfer at the University and negotiated an agreement that is acceptable to both parties with ownership and commercialisation rights belonging to Almouneer.

• Sales and Marketing Strategy and Planning: There was no advance budgeting system for marketing and sales strategy planning.

We created and implemented a quarterly marketing planning and budgeting system with the marketing team and organisation of accounts and visit plan for the sales team with appropriate KPIs. We were also involved in recruiting new sales professionals for the company.

The internship at Almouneer has been rewarding for me as it gave me the opportunity to shadow entrepreneurs at closely and get first-hand knowledge of an emerging market as well as see the direct impact of the business in the lives of the patients.

My key takeaway was learning the importance of networks and strong partnerships for a new business. Both Noha and Rania have strong networks in the start-up ecosystem, medical and technical sectors in Egypt. This has helped them in all aspects of growing the business such as finding partners, mentorship and in fundraising. It has been interesting to see how they sustain and derive value for Almouneer from this asset.

I am truly grateful to the INSEAD Social Impact Award that has helped me to pursue the internship. As a result of this positive experience, I have a better understanding of sustainable social impact investing in healthcare which I look forward to developing further.