Our growth potential: Nairobi vs. New York City

There is no single estimate in Kenya for the number of medical emergencies that require an ambulance. The main reason being that hospitals and ambulance providers are independently operated and while documentation does exist within each, the ability to collate the numbers across a number of operators is challenging. Further, demand is currently low and even if we could piece the numbers together, they would likely be grossly incomplete. Many deaths go undocumented, patients often use alternate transport to arrive at a facility like taxis or they do not seek care at all due to difficulty in accessing the services.

At Flare, we estimated the Nairobi and Kenyan market in a number of ways. We know the potential addressable market is large and Flare can provide an enormous impact, but you may be wondering, just how large.

What we know:

  • Between 3,000 - 13,000 Kenyan die in roadside accidents per year. If you take the lower estimate, that's 1 death every 4 hours. But, with the upper estimate that's over 1.5 deaths every hour.
  • There are 14,609 deaths due to strokes. Stroke victims must receive tPA, the life saving medication, within 60 minutes or less. This gives them the largest chance of survival and reduces neurological damage.
  • 9,163 deaths due to heart attacks and 200,000 new heart disease cases reported annually in Kenya. Defibrillation must be done after 10 minutes or very few will survive if the patient has gone into cardiac arrest.
  • 6,632 women die due to pregnancy related causes each year. Nairobi has the 3rd highest number of deaths after Mandera and Wajir counties.

From this bottom-up estimate, we could say at least 43,404 Kenyans per year require an ambulance. We think this estimate is likely very incomplete, however it does show the immediate impact we can have on roadside accidents, stroke and heart-attacks and complicated pregnancies.

But, what if the total number of emergencies in Nairobi and Kenya were on par with NYC?

We know that there are significant demographic, infrastructure and consumer behavior rifts between Nairobi and NYC, but just for illustrative purposes, we'll show you how large the market could be if it were to be similar sized to NYC and adjusted for population sizes, of course.

The population of NYC is 8.05M and the number of life-threatening emergencies are 448k and non-life-threatening emergencies are 576k for a total of 1.02M emergencies per year (2015). Both require ambulances, it's more a matter of segmenting the use of Advanced Life Support (ALS) ambulance and Basic Life Support (BLS)rides.

Take Nairobi, a population of 3.5M and using the same incident rates as NYC, this amounts to a total 445,349 emergencies per year of which 43% are life-threatening and 57% are non-life threatening. In Kenya, the number of emergencies would stand at 5.6M per year.

During our pilot in July 2016, we will start to confirm our many assumptions about the size of the market. Can we grow the market 100 fold? And how do we grow it in line with emergencies that truly require ambulances? Later this year, for the first time, we will have documented rates of emergencies and causes within Nairobi across many ambulance providers. During the next release stage of the app, we will be integrating with hospitals. This will certainly provide us greater data and insights into just how large we can grow in Kenya to expand emergencies services to all.

Stay tuned, as in future posts, we'll give you a greater glimpse into other ways we've sized the market by building up estimates from our ambulance partners and estimating the number of emergencies based on the WHO recommended number of ambulances per thousand individuals.

And now a few resources that were used to write this article:
Response time for Stroke Patients

Heart Disease in Kenya

Number of Heart Attacks and Strokes in Kenya

Response time for Heart Attacks

Maternal Mortality Rates in Kenya

NYC Emergency Statistics

Caitlin F Dolkart

Graduate from MIT Sloan School of Management (MBA) and a Legatum Fellow. Background in management consulting, impact investing and international development.

Nairobi, Kenya

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