Health insurance is meant to protect people from financial ruin when illness strikes. But in many low- and middle-income countries, that protection barely exists. Out-of-pocket payments still account for the majority of healthcare spending, driving tens of millions into extreme poverty each year, according to the World Health Organisation.
The insurance gap is wider than we think
Across much of Africa and Asia, health insurance penetration is abysmally low. In Nigeria, only about 10% of the population is enrolled in any form of health insurance. In Kenya, that figure hovers around 26%, and even those covered often cannot afford to use it because of high co-payments.
The picture is even more alarming in South Asia. In Bangladesh, 73% of total health expenditure was out-of-pocket in 2021, as publicised by the Bangladesh Institute of Development Studies (BIDS). In 2022 alone, this pushed about 6.13 million people(3.7% of the population) below the poverty line. Sri Lanka, often cited as a stronger health system in the region, still reports minimal insurance penetration, with total premiums (life and non-life combined) representing just 1.8% of GDP, according to Verified Market Research.
What these numbers reveal is a fundamental weakness in health financing. Conventional insurance and state provision have left huge gaps. But innovation is showing that another path is possible, one that looks less like bureaucracy and more like free, real-time insurance for the poorest. This tech-driven system is not a replacement for universal health coverage but offers emergency lifelines for those who would otherwise die waiting.
From red tape to real time
Helpster Charity has pioneered a model that bridges urgent care and donor support without the usual administrative delays. Working in Nigeria, Kenya, Bangladesh, Cambodia and Sri Lanka, it identifies patients facing life-threatening conditions who cannot afford treatment. Trained volunteers and hospitals submit cases digitally, which are then verified through medical records and thorough poverty and urgency assessments.
Not every case is approved. In fact, around 40% of applications are declined because they do not meet urgency or poverty thresholds. This strict admission process ensures that only those most in need are admitted, creating confidence among both hospitals and donors.
Once approved, funds are released directly to hospitals. Patients are admitted without worrying about payment. On average, each intervention costs around 200 US dollars, a sum that would otherwise devastate a poor household but is manageable when distributed across donors. Crucially, Helpster caps support at a set maximum amount and prioritises only life-saving or life-changing cases. This ensures resources go further and impact is maximised, with every intervention designed to prevent needless death or long-term disability.
Transparency as currency
One of the most persistent challenges in global aid is trust. Donors often feel disconnected from where their money goes. Helpster’s model addresses this head-on. Every approved case is logged, every hospital payment recorded and outcomes tracked. Donors see exactly how their contributions are used.
This transparency is not a side feature. It is what turns sporadic giving into sustained support. By knowing that their funds are covering real treatments for real patients, contributors stay engaged. For hospitals, the direct payment system reduces delays and ensures accountability. For families, it means survival without debt.
Scaling the solution
The challenge now is scale. Saving hundreds of lives is powerful but Helpster’s ambition is larger: to save 1,000 lives every month across 10 countries within five years. Achieving that requires not just technology but partnerships with governments and the private sector.
Think of it as a missing layer in the healthcare ecosystem. Insurance protects those who can afford premiums. Government schemes aim for universal coverage but struggle with reach. Donor aid tackles systemic needs but often moves too slowly. Free, tech-driven models fill the urgent gap in between, ensuring that poverty is not a death sentence by providing emergency cover.
A rethink of compassion
The humanitarian sector has long operated on the assumption that change must be slow. But technology is rewriting those rules. If an app can summon a ride in five minutes, why should it take months for aid to reach a child with pneumonia in Kenya or a mother in obstructed labour in Bangladesh?
The poorest families cannot wait for reform cycles or budget approvals. They need treatment today. Systems that act like free insurance- fast, transparent and scalable- show that it is possible.
Helpster has already saved over 2,000 lives through this approach. That number may be small compared to the scale of the crisis but it proves another way is possible. The challenge now is scaling it fast enough to match the urgency of families who cannot afford to wait.
