S1 Episoe 4 - Sophie Smith - FemTech CEO Reinvents Personalised Healthcare For Women

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On establishing Nabta Health:

I got chatting to the organizer of a diabetes conference in Kuwait and a month later, he sent me a whole lot of stats on women's health in the region. There's been a lot of medical information floating around so I knew the stats were not good. So when he said do you want to do something in women's health together, it made me realise that I've been looking maybe unconsciously for the company that I really wanted to run. And when I say I really wanted to run, I mean, the thing that you obsess about the thing that occupies your thoughts in the quiet moments, that you have the space that you're happy in, in many ways happiest. It doesn't take away from how you feel about your family and any other kind of priorities in your life, but it's really a space where you want to be.

And as soon as he asked, I knew that Nabta was that company and I said give me a few months, let me handle my existing business interests and in the end we started to work on that.

On the main resistance to HRT over the years:

A lot of the language around women's health has not been particularly positive. Everything from miscarriage, which implies that the baby was somehow miscarried, to termination for medical reasons, to geriatric pregnancy, a lot of the terminology that we have that relate to women's health, have a degree of finger pointing or a suggestion of failure, somehow, on the woman's part and present these negative overtones. We still live in a world where being a woman is not as easy as it could or should be.

Hormone replacement therapy, even the term sounds like you're interfering with a process that should be natural, as though those hormones should be there, but they're not, so you have HRT. And for some reason, you as a woman are lacking, because you don't have those hormones. Hormone enhancement therapy might be a better phrase.

On whether there is still a stigma in the UAE and the countries around hormones and menopause? 

There's a lot of stigma surrounding menopause. Even the word menopause in Arabic translates into age of despair. Most women don't understand that you can enter perimenopause in your 30s. So many symptoms of perimenopause aren't picked up because people assume that you hit menopause in your late 50s.


On advances in femtech

The general movement towards outcome oriented innovation is a really exciting thing.

When we founded Nabta in October 2017, most of the FemTech that we saw were period tracking apps and typically addressing reproductive health. When you look at healthtech, you look at innovation across three levels. The very bottom level is education - platforms that have subscriptions to videos and other learning resources.

Then you have access to things that grant more access, for instance, I would put period tracking apps in that category - access to information about your cycle, access to doctors through virtual consultations. 

And then you have outcome oriented innovation, which is about really changing the way that we support when we diagnose and treat disease.And we manage health and wellness as an ongoing basis. 

Back in 2017, we were doing something a little different and then over the last 5 ½ years, we've seen a lot more innovation, across different categories of women's health and we started to see companies that are operating more like healthcare companies, rather than tech companies, where they are focusing on the continuum of care, and managing people along clinical pathways in the same way that you would in a hospital. 

On diet and health 

A lot of people develop PCOS within a couple of years of landing in the Gulf. I was diagnosed with this and it took me completely by surprise. The very first thing I did was I got rid of everything in white in our house. We didn't have white bread anywhere, no white pasta, no white rice, everything, the hidden sugars are what really get to you.

And I also bought my meals forward because my metabolism slows down a lot, everyone's a little bit different but most of us have a degree of a circadian rhythm to us, meaning we digest food less well when it's dark and I really noticed that I struggled to digest food late at night. And just those two things by themselves have made a world of difference. 

In your overall health, it's the little things that make a big difference. if you drink more water, if you get enough sleep, if you move enough, if you don't have too many refined carbohydrates is the stuff that people find boring in many ways. They want a quick or interesting fix and, actually, the basic things do work for the majority of the population.

On exciting advances at Nabta 

One of the things that I'm most excited about is our hybrid healthcare model that we wanted to have back in 2018 taking shape. Pre COVID, people thought virtual consultations weren’t going to take off, home testing wasn't going to happen, people were very skeptical. But thanks to Covid, people realized it could. People also realize the value of personal relationships and interactions. So we came out of the pandemic, with a renewed sense of we need this hybrid model.

We acquired our first clinic in May and so now we have the full hybrid model here in the UAE. And I'm excited about addressing some of the imbalances in terms of access to care, the UAE is a predominantly insurance led market. But all insurances are not made equal. So we're introducing a very low cost membership care system, specifically targeting low income women. We'll give them access to a minimum of three annual health checks for breast cancer, pap smear and then a general metabolic health test and access to monthly drop in clinics, coffee consultations, classes and courses that are focused on nutrition and mental health that are often left out and they’ll also get a year's supply of eco friendly period products. What this means is that the lowest income women in the UAE will end up with some of the best health care.

On her top tip on how to deal with perimenopause symptoms

Fiber is my top tip, not just for perimenopausal women, but if you have any hormonal issues. People ask for weight loss solutions and if you aim for your recommended daily intake of fiber, you will find it very hard to eat stuff that is bad for you because fiber is very filling. It does everything good for you in terms of regulating your bowel movements, reducing the rate at which you can digest sugars, all hormone management, having a good diet and a healthy gut.