Africa’s healthtech sector is flourishing, driven by innovative startups that are enhancing healthcare access, quality and affordability through advanced technologies.
Many of these companies are capitalizing on key trends like AI-powered diagnostics, the growth of telemedicine, local manufacturing, blockchain as well as robust investment support.
Telemedicine platforms are bridging urban-rural chasms, with adoption rates climbing to 40% in underserved areas, while blockchain innovations secure patient data amid rising cyber threats.
Still, regulatory silos stifle seamless integration, demanding unified policies to unlock the full potential of this market poised to redefine healthcare equity.
One company that is using blockchain technology to connect underserved communities is South Africa’s HealthStash, a purpose-bound health payment rail specifically for workers in formal employment excluded from medical aid schemes.
Founded in 2025, HealthStash is South Africa’s first regulated health payment system for the 11 million formal workers excluded from medical aid schemes, connecting employer funding, patient needs and provider payments in real-time.
The platform enables a closed-loop economy where employers load R300-R800 ($18.75-$50) monthly into employee health wallets, which can then be spent via HealthStash’s HealthPay system.
Connecting Africa Associate Editor Matshepo Sehloho spoke to HealthStash Founder Ngeli Mrasi about how the technology works and his plans for the company in the future.
Matshepo Sehloho (MS): What key healthcare gap in South Africa inspired the creation of HealthStash?
Ngeli Mrasi (NM): The core inspiration was the liquidity gap in the “forgotten economy.” While official stats cite roughly R40 billion (US$2.5 billion) in direct out-of-pocket spend annually, the total private health expenditure of the uninsured market, those excluded from medical aid, is estimated at over R130 billion ($8.1 billion).
This money moves through inefficient channels: cash, slow EFTs, or expensive “savings” products that don’t fit the survival economics of low-to-middle-income workers.
The gap wasn’t a lack of doctors; it was a lack of a financial rail that moves money fast enough and cheaply enough for real-time healthcare.
MS: How would you describe HealthStash’s core mission in one sentence?
NM: Our mission was to build the first “financial operating system” for South Africa’s excluded health economy, connecting employer funding, patient needs and provider payments in real-time.
MS: What makes your solution different from other health‑tech platforms in country?
NM: Most platforms are either trying to be insurance [companies] or just digital booking tools.
We are a payment rail. We power the transaction itself using the Stellar Blockchain for three-second settlement and “Purpose-Bound Money” (HealthCoin).
We don’t just “manage” health data; we ensure the value intended for healthcare reaches the provider without leakage. We are also South African Reserve Bank (SARB) Draft Notice 4.1.1 compliant, operating as a registered closed-loop system.
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HealthStash connects employer funding, patient needs and provider payments in real-time. (Source: Image by DCStudioFreepik)
MS: How do you see HealthStash evolving in next three to five years?
NM: I see us evolving from just being a small business benefit tool into the underlying infrastructure for the informal economy.
I see us integrating with bargaining councils and stokvels [informal, community-based savings clubs], becoming the bridge that automatically redirects patients from failing public clinics to stocked private pharmacies instantly when stockouts occur.
MS: What problem does your platform solve for South Africans today?
NM: We solve the “cash vs. care” dilemma. If a worker is sick today, they either lose a day’s wage queuing at a public clinic, or they pay cash they don’t have at a private pharmacy.
We solve the “liquidity timing” problem, which is getting the money to the point of care exactly when it’s needed via a mobile wallet.
MS: Can you walk us through how HealthStash works from a user’s perspective?
NM: HealthStash is designed to be invisible. Using our hybrid pricing model to keep costs low, an employer funds a digital wallet.
The user then receives an SMS/WhatsApp notification when their balance is active. When they visit a pharmacy, they simply verify their ID.
The “HealthCoin” is transferred to the pharmacy instantly via the blockchain. No paperwork, no claims forms, no waiting weeks for reimbursement.
MS: What technologies or innovations power your platform?
NM: We are blockchain-first. We use the Stellar Distributed Ledger to mint our “HealthCoin,” ensuring every transaction is immutable, traceable and settles in roughly three seconds.
We also utilize a mobile-first stack (USSD/WhatsApp integration) to bypass data barriers for users who cannot afford high data costs.
MS: How do you ensure the accuracy, security and reliability of the health data you manage?
NM: We separate the financial from the clinical. We don’t store sensitive medical records like diagnoses on the blockchain; we store the financial ledger.
We use purpose-bound smart contracts, which means the money is cryptographically locked to health categories for example, pharmacies or general practitioners.
This prevents fraud and ensures strict compliance with POPIA [South Africa’s Protection of Personal Information Act] and SARB regulations for closed-loop systems.
MS: How tailored is the platform to local health challenges, infrastructure and user habits?
NM: It is built for the “loadshedding” economy. Our systems are designed to work offline-first and sync when connectivity returns.
Our pricing model is also hyper-local, we moved away from a flat corporate fee to a hybrid pricing tier (shared cost), making it accessible to security guards and retail workers who traditional fintechs often ignore.
MS: What user behavior trends have you observed since launch?
NM: We are seeing a rapid shift from savings to access. Users don’t want to save R300 per month for a someday emergency.
They want R300 available today if their child has a fever. They value liquidity over insurance. They also prefer a closed-loop wallet because it protects their health money from being used for other household expenses.
MS: How does HealthStash improve healthcare accessibility or affordability?
NM: We remove the friction cost and by processing payments instantly via blockchain; we cut the administrative overhead associated with medical aids.
We also enable bulk purchasing power by aggregating SME spend, effectively giving small companies the buying power of a large corporate, which allows us to negotiate better rates for medication.
