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ImpactAssets 50: A Global Landscape of Impact Investment Fund Managers
The ImpactAssets 50 (IA 50) is the first open-source, publicly published database of experienced private debt and equity impact investment fund managers.
https://www.impactassets.org/impactassets-50

ImpactAssets 50

An Annual Showcase of Impact Investment Fund Managers

Medical Credit Fund

Total Assets Under Management: Less than $25M
Asset Class: Private Debt - Absolute Return / Notes
Small/Medium Business Development
Microfinance/Insurance & Financial Services
Global Health

Firm Overview

Category: Private Debt - SME Finance (Emerging)
Medical Credit Fund (MCF) was established by PharmAccess International as a not-for-profit foundation under Netherlands' law in 2009. PharmAccess, one of the pioneers of HIV/AIDS treatment in Africa, has a digital agenda dedicated to making health markets work for the poor. It mobilizes public and private resources for the benefit of doctors and patients through loans (MCF), benchmarking standards for quality and business improvement (SafeCare), health insurance, private investments (Investment Fund for Health in Africa) and impact/operational research. This approach is accelerated through a digital platform for healthcare financing and delivery (called M-TIBA in Kenya) that connects patients, healthcare providers and payers, and gives individuals access to a mobile health wallet containing entitlements that can only be used for healthcare. By helping private healthcare companies to obtain capital, and by providing technical assistance to strengthen and upgrade their operations, MCF drives a critical component of this integrated approach.
Firm Headquarters: Western Europe
Years of Operation: 5 – 9 years
Total Assets Under Management:
Less than $25M
Total Number of Investors: Between 5 – 25
% of Capital from Top 3 Investors: 25% – 49%
Investment Thesis:
The MCF helps Sub-Saharan Africa meet its growing demand for quality medical services, tying its loans to a quality and business improvement program to ensure its funds result in higher quality healthcare and stronger health enterprises     
Investment Overview:
In most African countries, the public sector is unable to meet the growing demand for healthcare. Therefore, 50% of the people turn to the private sector, which is dominated by SMEs. However, SMEs have limited access to financing, which prohibits them from scaling. MCF was established to support health SMEs obtain capital and technical assistance to improve their quality, decrease investment risk, and achieve scale. The SMEs include clinics, health centers and hospitals, pharmaceutical and equipment suppliers and other health related enterprises.  MCF provides local currency loans of up to 2.5 million USD with local financial partners. The loans are accompanied by an extensive technical assistance program using SafeCare to evaluate, improve and certify the incremental increases in quality of services of healthcare providers. In response to market needs, MCF launched innovative financial products, including a "cash-advance" product based on mobile payment turnover and receivable finance using insurance claims.

Investment Example

Anton Memorial Clinic is located in Alajo, a densely populated suburb of Accra. It provides primary healthcare services, laboratory services, maternal and child care, family planning, and minor surgery.    The clinic has obtained the first MCF loan in 2012 and a follow-up loan in 2014. The proceeds were used to renovate and expand the clinic, and purchase furniture and equipment (an ultrasound). The clinic currently has 10 beds with a 77% occupancy rate, 66 staff and sees 4,000 patients per month. It has also benefited from several tranches of MCF's receivable finance product, using insurance claims to provide liquidity while NHIS payments are delayed. The MCF's loans and the accompanying quality improvement program have helped to improve its layout, sanitation, organization & structure and equipment. The clinic's SafeCare score increased from 30% at baseline to 64% two years later (from Level 1 to Level 2).

Leadership and Team

Cumulative Leadership Experience in Investing:
30 years or more
Cumulative Impact Experience of Top Three Firm Leaders:
20 – 29 years
Arjan Poels – Managing Director More Info

Bart Schaap – Finance Director More Info

Bart Schaap came to the MCF as Director of Finance. He is a monetary economist and worked in the financial sector as risk manager and credit finance specialist in both developed and emerging markets.

Evelyn Gitonga – Director Medical Credit Fund East Africa More Info

Evelyn Gitonga is a career banker with over 10 years banking experience. She joined the Medical Credit Fund in 2013 as a Senior Business Analyst.  In January 2016, she was promoted to Director for East Africa, where she is responsible for overseeing all loans in Kenya (representing more than 50% of the MCF portfolio), the supervision, training and guidance of business analysts and technical partners, liaising with Partner Banks, and building the East African loan book.  Prior to this, she worked at Sidian Bank in different capacities and by the time of exit was Head of Micro Finance and Acting Head of Credit risk. By the time she left to join the Medical Credit Fund, she was managing over 200 staff with a portfolio of over $50million. She has a vast experience in Senior Management (overall banking), Banking, Portfolio Management, Micro finance, Retail/SME lending, Loan recovery and Credit Risk Analysis.

Percentage of Investment Professionals who are Women and/or Under-Represented Groups in Firm's Geographic Focus:
25% to less than 50%
Percentage of Management Team who are Women and/or Under-Represented Groups in Firm's Geographic Focus:
25% to less than 50%

Financial Performance

Target Financial Returns Relative to Benchmark:
Near-market Rates
Actual Performance Relative to Target Financial Returns in the Past Three Years:
In line with initial target returns
Financial Reporting Frequency to Investors or Donors
Quarterly

Impact Performance

Percentage of Total Assets Under
Management that are Impact Investments:
100%
Primary Impact Outcomes:
Increasing access to financial services
Increasing access to healthcare services and improving health
Value-added Services Offered:
Business and legal training
Financial literacy training
Other: Healthcare quality improvement support

Investments systematically target companies where social and/or environmental impact is integral to the product/service being created:
The Medical Credit Fund's primary objective is to increase the delivery of affordable quality healthcare services, particularly to underserved populations, by enhancing access to capital and reducing the investment risk. All of its borrowers – health facilities, diagnostic centers, pharmaceutical and medical supply distributors - must serve this goal.  The MCF's due diligence process specifically assesses the social impact of its potential borrowers, including the populations they serve.    To reduce the risk of these types of loans, the Medical Credit Fund provides debt financing in combination with technical support - the two programs are interlinked: the Technical Assistance (TA) program and the Finance program. In addition, the selected healthcare facilities will participate in a medical and business quality improvement program which strengthens their business case and debt servicing capacity, and reduces their credit and medical risk.

Investments systematically include social and environmental sustainability practices in the due diligence process:
Healthcare facilities that borrow from the MCF enter a quality improvement program using the internationally recognized SafeCare standards (www.safe-care.org). The standards were developed in collaboration with the Joint Commission International (JCI) of the U.S.A and the Council for Health Service Accreditation of Southern Africa (COHSASA). The SafeCare Standards require providers to adhere to local law and regulation. Additionally, management must strive to reduce and control hazards and risks, prevent accidents and injuries and maintain a safe environment. The providers also have to plan for occupational health and safety programs, fire safety, emergencies, hazardous materials and security.

Impact Tracking and Monitoring

Impact is Tracked:
Yes
Social and/or Environmental Impact is Reported to Investors and Donors:
Yes – to the public
Third Party Validations:
Participant on steering committees or leadership roles within impact industry associations
Publisher or contributor to industry white paper or other research in impact investing

Learn More

Key Contact Name: Arjan Poels
Phone: +31 (0) 20 2103921
Mailing Address:
AHTC, Tower C4, Paasheuvelweg 25, 1105 BP Amsterdam, the Netherlands

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Impact investments are investments made into organizations and funds that generate measurable social and environmental impact as well as financial returns.