Does Africa Need More Health Startups — Or Just Stronger Health Systems?

In 2020, a young woman in Northern Nigeria faced a serious complication during childbirth. Her local clinic lacked a functioning ultrasound machine, and the nearest equipped facility was hours away. She didn’t make it.

It’s in heartbreaking stories like these that we find the true cost of weak health systems — fragile infrastructure, under-equipped facilities, and inaccessible services. But these same stories have also sparked a wave of innovation. Across Africa, a new generation of health startups is rising with promises of better access, faster care, and smarter solutions. But as innovation explodes, we must ask the uncomfortable question: Do we really need more health startups — or do we need better health systems first?

The Growth of Health Innovation in Africa Africa’s digital health market was valued at $3.8 million in 2023 and is projected to grow at a staggering 23.4% CAGR through 2030. Startups like MyDawa (e-pharmacy and telehealth in Kenya), Rology (remote radiology across underserved hospitals), and WellaHealth (Health Insurance in Nigeria) are reshaping care delivery. In fact, according to Salient Advisory, more than 60% of Africa’s current health startups were launched in the past five years, many spurred by the COVID-19 crisis.

But alongside this explosion of innovation lies a sobering reality.

You Can’t “Appify” a Broken System

What happens when a telemedicine startup connects patients with doctors — but the internet is unstable, health records are still paper-based, and no lab or pharmacy is within reach?

These innovations, while promising, are often layered on top of weak systems. Many startups become stuck between doing good and staying alive — struggling to scale in contexts where infrastructure, policies, and financing are still catching up.

Take wearables for example. Continuous glucose monitors (CGMs) are revolutionizing diabetes care in the West. But in Nigeria, even with a strong product and willing users, a CGM startup failed to gain traction. Why? No reimbursement structure, high device costs, and a fragmented supply chain. In short: wrong context, wrong system readiness.

Not Just More — But Smarter, Aligned Innovation This doesn’t mean innovation isn’t needed. It’s essential. But the goal shouldn’t be more startups. The goal should be better-aligned innovation. Solutions that work with — not around — the realities of African health systems.

For example:

Rwanda’s Health Intelligence Center (2024) launched a nationwide platform to integrate health data and improve system-wide decision-making. It didn’t start with fancy tools. It began with policy, infrastructure, and standardization.

In South Africa, MomConnect only succeeded once integrated into public health programs and delivered through free SMS, not an app.

In Ethiopia, successful EMR rollouts aligned with national health strategies, ensuring administrative buy-in and long-term sustainability.

So, What’s Really Missing? It’s not always the technology. Often, it’s:

• Policy and regulation to set standards and protect users
• Funding models that go beyond seed money and include insurance buy-in
• Digital literacy for both providers and patients
• Incentives aligned with public health — not just VC excitement
• Infrastructure, from reliable electricity to supply chains and workforce capacity

What About the People?

One final point: not all patients are users, and not all users are buyers. In many cases, it’s parents buying healthcare apps for their children, or adult children supporting elderly relatives. Patients still matter. But successful innovation must serve both the user experience and the buyer logic — whether that’s governments, hospitals, or insurers.

Final Thoughts

The rise of health startups in Africa is inspiring. But for these innovations to truly transform lives, they must grow in partnership with stronger systems — not in place of them.

Let’s continue to build. But let’s also fix what’s broken. Because in the end, health isn’t just a market opportunity. It’s a human right.

Written By Wanjiku Ngigi