Simplifying finance in a complex environment

The Project

We took this non-profit back to basics – introducing best practice accounting, while taking steps to minimise tax liability.


The Client

Noora Health works with public hospitals in Southeast Asia, where patient numbers are stretching capacity to the limit. Their mission is to free up resources by training family members in the care of their loved ones, making them a core part of the healthcare delivery team.

The key is education. They turn wards and waiting rooms into classrooms, where they teach aftercare techniques for specific conditions – including how to spot signs of complications.

Their training is fun and interactive, often using video to explain complex medical matters in a simple, relatable way. They also re-enforce training through mobile applications, to improve recovery and reduce the need for readmissions.

To date, they’ve trained over 500,000 patients and family members across 120+ hospitals, reducing complications by 70% and 30-day readmissions by 24%.


The Problem

As with any early stage non-profit, Noora’s leaders were focused on impact goals – not finance. So they were living with systems and processes that hampered their efficiency.

For example:

  • Their Chart of Accounts was poorly aligned to the business, so expense tracking and reporting became a major issue
  • They needed a bespoke budgeting and forecasting model, tailored to their vision
  • Donor proposals needed more consistent and detailed information
  • As the company grew, their finance teams struggled to adapt to a changing brief

All this made it difficult to plan ahead, raise new funds and make informed decisions.

In addition money was moving through the business from multiple sources with different tax implications. It was time to tidy things up, by expanding – but also simplifying – the company structure.


The Solution

First, we led the integration of their finance and accounting teams: introducing the skills and systems to adapt to a new – and evolving – scope of work. As part of this, we engaged an Indian accounting firm to manage local books and auditing, which took some of the pressure off their main accounts team in the Philippines.

With this in hand, we were able to focus on specific tasks – starting with their Chart of Accounts. Directors needed a closer view of the business, but reporting was incomplete and inaccurate. So we introduced new classifications for expenses and receipts, and introduced a formal tagging process to eliminate previous errors.

We then went back to basics, creating a new budget from scratch, along with a Budget Vs Actual template that fed into a forecasting model.

From there, we turned to donor proposals. Having worked extensively in the non-profit health space, we’ve had the chance to analyse the fundraising process and interview donors to gauge their criteria. So we were able to pre-empt concerns and mine for relevant data, then present it in a way that models past successes.

Throughout this time, we were also working to simplify their structure and minimize tax liability.

The organization is US-domiciled but has operations in Southeast Asia, with a 501(c)(3) federal tax exemption. Working across multiple currencies and with partners abroad, taxation had become a minefield. We helped Noora reduce liability and take sensible steps to limit taxes in the interim.

This step gave us the breathing space to review and consolidate the corporate structure.

As of now, the company is going through audits in multiple countries, and has set up local entities where necessary. It’s a complex structure that will need to be revisited as approvals come through, so they can continue to direct money in the most transparent, tax-efficient way.


The Result:

Our work is ongoing. Already though, it’s led to significant growth – and higher impact.

It stems from a tighter finance system, and a confident CEO who feels fully supported and able to make more informed decisions.

So as we work towards a simpler structure, they’ll be in a position to grow sustainably and scale operations.

“James and his team came in when we were still relatively early-stage and running in start-up mode. We weren’t in a position to hire a full-time CFO, but needed more sophisticated support than our accountant alone was able to provide as our business became more complex.
James and his team transformed our finance processes and gave us assurance that we have best-in-class financials and systems in place – for today and as our business grows.
Finally, James and his team always provide personalized attention and at no point have we felt like just another of many clients. Overall, I can’t recommend bringing James and his team on more, and suggest doing it sooner than you think you need to.”

Edith Elliott /

CEO & Co-Founder, Noora Health