Achieving Financial Sustainability: 4 Fundamental Questions for African Healthcare Companies

For many scaling companies, achieving ‘financial sustainability’ stands as a crucial milestone on the path to long-term success. But what exactly does financial sustainability entail, and how can companies achieve it?

At its core, financial sustainability refers to a company’s ability to operate without relying on external sources of capital such as grants, debt, or equity. Instead, sustainable businesses generate sufficient revenue from their operations to cover expenses and weather economic uncertainties without jeopardizing their long-term viability.

For many early-stage companies, achieving financial sustainability can be a daunting challenge. With limited resources and a myriad of competing priorities, understanding the key indicators of sustainability is essential for charting a course toward lasting success. Revenue, profitability, cash flows and working capital are some of the key indicators informing the financial sustainability of a company. Revenue indicates the demand for a company’s product/service, while profitability is the most basic indicator of a business’ performance. A financially sustainable company should either be able to maintain their revenue (where the company is already profitable) or demonstrate growth (creating a pathway to profitability). In either case, the company should be able to meet its operational costs using internally generated cash flows.

Cash flow is the amount of money that flows in and out of your business over a period of time, such as a month, a quarter, or a year. Cash flow is an indicator of your business’s liquidity and solvency, which are the ability to meet your short-term and long-term financial obligations, respectively. Working capital refers to the ability to repay short-term liabilities using short-term assets. A company’s working capital impacts the cash flow. A financially sustainable company will be able to cover all short-term liabilities using short-term assets, and positive cash flows, at least at the operational level.

Companies should consider several key questions to achieve financial sustainability.

#1 – Customer Base: Does the company have an addressable, growing market base or can the company create an addressable customer base?

A fundamental determinant of financial sustainability is a strong value offering to customers.

Prior to launching a product or service, companies should conduct comprehensive market research to identify customer requirements, pain points and gaps, and the steps needed to realize sales. It is essential to gauge the potential for growing demand among customers. Understanding the trajectory of customer demand allows companies to anticipate market shifts and position themselves for sustainable growth.

In cases where a readily addressable market is not available, companies need to explore the possibility of creating addressable market, which involves assessing the process, time, financial constraints, and risks associated with expanding market reach and generating demand. While this may pose challenges, it can also present lucrative opportunities for companies willing to innovate and carve out their niche.

When analyzing the market base, it is crucial to consider not only the presence of a gap but also other customer-associated risks. Factors such as affordability and awareness can significantly impact market penetration, particularly in industries like healthcare. By addressing these risks head-on, companies can enhance their market position and foster sustainable growth.

#2 – Strategic Growth: Is the company able to maintain its market share or grow its share?

A company that is able to grow its market share is more likely to be successful in achieving revenue growth, thereby more effectively move towards financial viability.

To develop a robust growth strategy, management teams should look at strategic growth options available to them, including pros, cons, risks, and financial considerations of each option. Growth initiatives should also be assessed in light of operational bottlenecks e.g., limited workforce, and technology constraints.

Companies must also recognize that not all growth initiatives support financial viability. Often, strategic growth opportunities have a long pathway to profitability, implying that existing activities need to absorb the burden until profitability is achieved. Therefore, it is important that the profitability of new initiatives along with the financing structure for the new initiative be analyzed in detail.

#3 – Capital Structures: What is the right capital structure for the company?

Companies have access to a myriad of capital forms – from grants to equity. Without the appropriate capital structure in place, companies may find themselves grappling with a host of financial strains. These strains can manifest in various forms, such as liquidity shortages, high interest expenses, or inadequate funding for expansion projects. The wrong capital structure can function as a significant impediment to growth and financial sustainability.

Fortunately, companies have access to a diverse array of capital forms, each with its own benefits and drawbacks. For instance, grants provide non-dilutive funding but may come with stringent eligibility criteria. In addition, equity financing offers flexibility but dilutes ownership stakes.

Achieving financial sustainability hinges on finding the optimal blend of capital that aligns with a company’s growth trajectory and risk appetite. This entails assessing factors such as cost of capital, leverage ratios, and funding requirements.

#4 – Operational Processes: Has the company implemented strong processes that minimize leakages and support growth?

Operational processes dictate how tasks are executed, resources are allocated, and risks are managed, all of which directly impact the bottom line. Streamlined processes and optimized workflows minimize waste and inefficiencies, resulting in cost savings and improved profitability. Furthermore, well-defined operational structures enable companies to scale their operations effectively, accommodating growth.

By regularly monitoring key financial metrics, companies can identify potential risks to their sustainability and take proactive steps to mitigate them. Whether it is implementing cost-saving measures, diversifying revenue streams, or optimizing pricing strategies, addressing these challenges head-on can help pave the way for long-term financial health and resilience.

The bottom-line.

While internal factors have a significant impact on financial sustainability, it is also important for companies to remain aware, and look to mitigate/balance out external risks faced by the company. Such risks include the economic conditions a company operates in and the regulatory landscape.

The health of a country’s economy is a critical factor influencing the financial viability of individual companies. A buoyant economy can propel a company to new heights, while a stagnant or declining economy can spell trouble for even the most robust businesses.

A robust economy characterized by steady growth and stability is likely to attract greater investor confidence, fostering a favorable investment climate for companies seeking capital to fuel their growth ambitions. Conversely, in an economic downturn characterized by sluggish GDP growth or recessionary conditions, companies may face significant headwinds.

By understanding and monitoring key economic indicators, companies can better assess their operating environment, anticipate potential challenges, and position themselves for success in an ever-evolving global marketplace. For example, companies operating in unstable economic conditions can look to diversify its presence through country expansion and partnerships in more stable countries.

In the complex landscape of business operations, compliance with laws and regulations stands as a fundamental pillar. When it comes to regulatory compliance, it is crucial to understand that different companies are subject to various sets of rules. These regulations are often enforced by different regulatory bodies, each with its own mandates and enforcement mechanisms. Consequently, navigating the regulatory landscape can be challenging, with requirements varying in complexity and stringency.

For companies, particularly early-stage ones, grappling with regulatory compliance can be daunting. Limited resources and workforce may pose significant obstacles, making it difficult to meet all the necessary obligations. Therefore, it is imperative for companies to assess their financial capabilities and allocate resources strategically to ensure compliance without unduly straining their operations.


Top Health Finance Takeaways from the 77th World Health Assembly

Late last month, government delegations, implementing partners, innovators, investors, and other stakeholders from around the world convened for the 77th World Health Assembly in Geneva, Switzerland, to address this year’s theme: All for Health, Health for All.

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