Sustainable solution to primary health care problems in rural India

Kolkata, IndiaKolkata, India

Year Founded:

Organization type:

nonprofit/ngo/citizen sector

Budget:

$100,000 - $250,000

Website:

http://www.ruralhealthcarefoundation.com

Project Summary

Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

We provide primary health care to the downtrodden and poor people residing in remote villages.Poor people residing in these remote villages where we offer these facilities either have no access to such services or the services are not affordable. Our aim is to reach out to those people who cannot afford to spend money for quality healthcare, our model of work is designed to meet their ends.

About Project

Problem: What problem is this project trying to address?

In rural India people live in abject poverty and are not able to afford primary healthcare. The primary health centers set up by the government are mismanaged and are not able to deliver the expected results. 78% of Indian population stays in rural area with only 2% of human resources deployed in healthcare services. 80% of expense in health care is beyond the reach of villagers. Public health care delivery system is low quality & inefficient. In such a scenario our mission is to eradicate the lack of health care facilities in rural India through the deliverance of affordable quality health care by opening primary health care units in those remote villages where health care delivery system of the state is sparse.

Solution: What is the proposed solution? Please be specific!

To achieve our objective we have opened four centers at four different locations namely, Mayapur, Kusumgram, Swarupnagar, Namkhana. At each of these centers we have four departments running namely General Medical Department, Eye Department, Dental Department, Homeopathy department. The patients are charged Rs 50/- (90 cents) for which they are provided with medical checkup and also seven days free medicine.We have been successful in keeping our costs low by maintaining an efficient supply chain of generic and near expiry medicines. Besides catering to varied basic healthcare problems, our centers also arrange for cataract surgeries in association with Rotary Eye Hospitals. We are also in collaboration with Smile Train Foundation at CMRI, Kolkata for Cleft lip/palate surgeries

Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

Our vision is to open hundreds of units in the remotest corners of India. Our feasible vision includes the opening of 50 more centers in the next 10 years at various rural places in India. Our immediate vision comprises setting up 20 to 25 similar Health Centers to be opened in the backward areas of rural Bengal and a mobile hospital to give basic medical services at the door step of the poorest of poor. Our mission is to eradicate the lack of health care facilities in rural India through the deliverance of affordable quality health care by opening primary health care units in those remote villages where health care delivery system of the state is sparse.

Impact: What is the impact of the work to date? Also describe the projected future impact for the coming years.

In rural India the families are large and the economic condition is poor so when the sick get affordable healthcare near their home, the family as a whole get to save their hard earned money which is diverted to other expenditures like education and better nutrition for their children. Due to our presence even serious illness is diagnosed specially for women at an early stage which in turn saves them from going into the vicious cycle of apathy and misery. The presence of our centers has also resulted in local quacks closing down their shops which is beneficial to the rural residents both financially and in terms of their health. Because of the large footfall local retailers set up their shops to serve the visiting patients which in turn improves their economic condition. Local transporters also benefit because of the same reasons. We also add to the sale figures of pharmaceutical companies because of our medicine inventory. The direct beneficiaries of our facilities are the sick rural populace around our centers. We have treated more than 600000 patients so far in all our four centers. More than 25000 patients are treated every month. We also provide employment to the doctors and support staffs approximately 10 people per centers.

Sustainability

Financial Sustainability Plan: What is this solution’s plan to ensure financial sustainability?

In the short term we plan to open one new center every quarter thus opening up of a total of 12 centers in the next three years. In the next 5 years we want a total of 50 fully functional centers. Main Activities to replicate the model: -Identification of four such locations where the impact of opening up of a new center would be beneficial to a larger section of the rural poor. -Hiring and Training of doctors and support staff of running of the center. -Improvement in the supply chain of medicines The growth milestones would be to ensure that all the centers are operating at least at 90% of their capacity which is about 6000 patients per month.

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

The environmental conditions in which we operate, it is difficult to ensure the sustainability of the organisation and as a result of this we do not face any competition. The need for such services in rural India is huge and we would encourage the government to improve the management of its primary health care centers and also to any other individual or organisation who would help to make rural India a healthier place to live in. We do not have competition not because of choice but because of the circumstances under which our organisation operates.

Team

Founding Story

In a trip to Mayapur a lady beggar requested Arun to arrange a Cataract surgery for her. He arranged the surgery and in the next trip she offered him (2 cents) to buy sweets which she had begged. Arun saw God in her face and from that day he decided that he will dedicate his life to the poor and he gave up his successful construction business and started working for the health care for the poor.

Organization Name

Rural Health Care Foundation

About You

First Name

Anant

Last Name

Nevatia

Twitter URL

https://twitter.com/#!/rhcf2

Facebook URL

http://www.facebook.com/pages/Rural-Health-Care-Foundation/277888958904330

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Innovation

Explain what the "innovation" is about, e.g., is it the idea and/or the model you use to accomplish the idea, or your understanding of the target population, etc.?

The idea of providing a sustainable solution to the primary health care problems in rural India may seem challenging. Our innovation is not in the idea itself but in the implementation as well. We have four primary health centers running in rural areas where such quality services were not available previously either due to government failure to deliver such services or the existence of quacks more interested in minting money. Our centers have amply demonstrated that such services can be made affordable to the rural poor with the help of generic medicines and maintaining a supply chain of near expiry medicine. This model is sustainable and we are able to create a large social impact which is amply demonstrated by increasing number of footfalls in our centers over the years.

Describe how your innovation model is distinct from any other organization in your field?

Currently our centers are located in the remote villages of West Bengal and some of the villages where we operate have government primary health care center units but such centers are mismanaged and are always short on medicines.Apart from such centers the primary health services of such remote villages in rural India is left at the fate of unqualified quacks who do more harm to the health of rural India than good. Our organisation does not have any competition as such and the distinctness of our centers is making it possible for the rural population to have affordable and quality healthcare facilities within their reach.

What type of operating environment and internal organizational factors make your innovation successful?

We operate in an rural setting environment where the understanding of the needs of the rural poor become utmost important. The main aspect for the success of our model is the ability to keep our costs low and passing over the benefit to the rural poor as a result of which these services become affordable for them. It is in this regard that the internal organisation factors play a prominent role. The qualification and years of work experience and business background of the trustees is one of the major enabling factors in ensuring the sustainability of the organisation.

How do you make sure you constantly innovate in light of (potential) external challenges, or your growth plan?

The model as it stands today is the result of years of hard work and innovative changes made in the model over the period of time . The board of trustees are passionate to increase the number of centers over the next few years in order to widen the social impact. The urge to improve the primary health scenario of the rural India has constantly motivated us to innovate in order to create a model that is sustainable and replicable.
Our founder Mr Arun Nevatia has discontinued his successful businesses and devoted his entire time in the running of the organisation. With his help and support from our dedicated trustees and volunteers we are able to constantly innovate to meet various challenges head on.

Organization Country

, WB, Kolkata

Business Model

The systemic challenge you are trying to overcome (select one)

Bring accessible healthcare to communities in emerging markets

Health area (target market) where the need is [select only one]

Primary healthcare services

Categories along the health continuum you are covering [select all that apply]

Detection.

Stage that best applies to your solution [select only one]

Established (past the previous stages and has demonstrated success)

Core strategies of your business model [select all that apply]

Patient-centered design, Redesign of the public healthcare system for more efficiency (in terms of processes, structure etc.), New approaches to distribution of health products and services.

If other, specify here:

Most relevant tools you are using to implement the strategies outlined above [select only two]

New skills.

If other, specify here:

What is your value proposition?

Our value proposition is to address the basic need of primary health care services in rural areas. These services are non existent in rural areas and our main objective is to make such facilities affordable and available to the people residing at the bottom of the socioeconomic pyramid. We have identified a huge need for the rural healthcare facilities especially in remote areas where such facilities are non existent and not affordable. We propose to address this issue by opening of our centers at such locations with four departments Eye, Homeopathy, Dental and General Medicine. A nominal amount of Rs 50 (90 cents) is charged against which the patient is allowed a check up from a doctor and seven days medicine based on the medication prescribed by the doctor.

Who is your customer(s)?

Our beneficiaries (we do not believe in calling them customers) are the poor people residing at the bottom of the socioeconomic pyramid and dwelling in remote villages where the quality primary health care facilities are either non existent or not affordable. Over the years we find that following is the distribution of patients across department
General Medicine - 57%
Eye - 23%
Dental - 10%
Homeopathy - 10%

The age group of our patients is as follows:
0-5 years - 3%
5-12 years - 7%
12-60 years - 68%
Above 60 years - 22%

Gender wise break up:
Male - 33%
Female - 67%

What approaches to you use to reach your customers?

Before opening of any new center we advertise in the radius of 50 km about our upcoming center. The primary modes of our advertisement is distribution of hand bills and making announcement in and around the area . After a center is up and running we believe in more of word of mouth advertisement where in the patients who receive good treatment at our centers encourage their friends and relatives to visit our center and this is how our organisation has been growing year on year.

What are your primary activities?

We have 4 departments running simultaneously in each of our centers- General Medicine, Eye, Dental and Homeopathy. These services not only include the diagnostics of the patient but also providing of generic medicines. The Primary healthcare services offered through these centers are affordable to the poor which is amply demonstrated by the increasing footfalls in each of the center.

Besides catering to varied basic healthcare problems, our centers also arrange for cataract surgeries in association with Rotary Eye Hospitals. As of now approximately 5000 successful cataract surgeries have taken place. About 100 Cleft lip/palate surgeries for children have been conducted free of cost through Smile Train Foundation at CMRI, Kolkata.

What other challenges - individual, organizational, or environmental – are you currently facing or might hinder future success of your business, and how do you plan to overcome those?

The major challenges that we face is to get donation for starting of new centers. Also there have been few instances where we had started a center in a particular location but have to change later on in order to serve more people. We want to set up centers in location where the impact is maximum. Identification of such a location and getting a place on rent in such a location is a challenge.
As per the regulations there must be an MBBS doctor at each of the centers. We face certain challenges in finding such individuals, however, our experience suggests that the hiring of such an individual may take some time but eventually we are able to find the right person for the job.

Briefly describe your growth strategy going forward

Over the years we have made our model sustainable. We need donations only in the initial capital expenditure stage when we open a new center in a new location. The growth strategy is to raise funds for opening of new centers and making the operations sustainable.. Any surplus from any of the centers that accrue can be ploughed back into the working of the organisation.

What dimensions for growth are you currently targeting for your innovation [select all that apply]

New regions(s), New market(s)/country(ies).

What makes your business "ready" for growth?

The success of our four centers that are currently fully functional and having a huge social impact in rural areas amply corroborates that our model is sustainable and replicable. There is a need for these facilities in rural India and we believe that our model can help to serve this need and benefit millions of people living below the poverty line.

What are your key growth objectives?

Each center that we open in the rural area has an impact radius of around 50 km. In order to impact more lives and provide basic healthcare facilities to rural population residing at the bottom of the socioeconomic pyramid in each of the next three years we plan to set up a new center in every quarter thus spanning a total of 12 centers in three years each located in a different village.

Organization's Country of Operation

, WB, Kolkata

Social Impact

What methods for quantification of social impact are you applying (if at all)?

Quantitative Measures:
• Number of Patients Treated per day in each of the centers: Since its inception more than 600000 patients have been treated so far in all our centers. On an average more than 25000 patients are being treated every month in all our centers.

• Number of cataract and cleft lip/palate operation done: More than 4600 cataract operation have been done in association with Rotary Eye Hospital and over 150 cleft lip/palate operations have been performed in association with Smile Train Foundation.

• Number of spectacles sold at subsidized rates: Around 20000 spectacles have been provided to the needy at subsidized rates besides providing wheel chairs, artificial limbs, and blankets to the needy patients.

Could your solution work in other geographies or regions? If so, where?

Our model is replicable and can work in emerging markets where the primary health care services provided by the government is a failure. New centers such as ours can be opened in any rural area of all emerging and underdeveloped economies where the provision of such services is either sparse or non-existent. However to ensure that the model is sustainable the center should be opened in areas which are densely populated.

What is your projected impact over the next 1-3 years?

Over the next three years we would like to grow from four centers to twenty centers thus impacting the lives of millions of people living below the poverty line. The new centers would open in new villages thus making the primary health care facilities available to such remote places where such quality services are either not affordable or non existent. Currently we treat around 25000 patients per month at our centers, with twenty centers we can treat approximately 150,000 patients per month. Each center covers a radius of 50 kms and opening of 20 new centers will help us to a large extent in reaching out to those remote villages where such facilities are still non existent.

Sustainability

Elaborate on your current financing strategy

We meet our funding requirements through voluntary donations by various institutions and individuals who have belief in the good work that we are doing. In the past we have received voluntary donations from reputed organizations such as Lotus Trust, Mumbai and Birla Academy of Art And Culture, Kolkata. Recently we have collaborated with Giveindia.org through which we receive online voluntary donations albeit of smaller amounts. We have a sustainable model and the beneficiaries contribute around 78 - 80 % of our cost of operations. We need funding only for the capital expenditure at the time of opening up of a new center.

Share of revenue generation in total income of organization (in percent)

77.87

Direct sales to patients or other beneficiaries (in percent)

100

Of the possible sources of these sales listed below, check all that apply to your current strategy

Patients.

Licensing fees, e.g., for technology/franchise model (in percent)

Of the possible sources of these licensing opportunities listed below, check all that apply to your current strategy

Service contract with organizations, e.g., government, NGOs (in percent)

Of the possible sources of the service contracts listed below, check all that apply to your current strategy

Explain your revenue generation strategy in more detail

At each of our centers the patients are charged Rs 50/- (90 cents) for which they are provided the facilities of getting diagnostic from a doctor and seven days medicines as prescribed by the doctor. There are patients who are below the poverty line and cannot afford to pay Rs 50/-.(90 cents)

Share of philanthropy in total income of organization (in percent)

100%

Philanthrophy strategies you are using

Single strategy.

Explain your philanthropic approach in more detail

The facilities that we have made available to the rural villages have been set up with philanthropy at the heart of these activities. The nominal charge that is collected from the patient is to recover the cost of operations. The patients who are below the poverty line and are not able to pay the nominal amount are never refused treatment. The surplus if any generated is ploughed back to recover the deficit of other center. About 100 Cleft lip/palate surgeries for children have been conducted free of cost through Smile Train Foundation at CMRI, Kolkata. To facilitate poor, needy and physically challenged patients around 150 Wheelchairs have been distributed. In their aid, around 2000 blankets have also been distributed.

Expand on your selections; explain how you will sustain funding over the next 1-3 years.

As per the provisions of the proposed companies act which has been passed by the lower house of the parliament it is mandatory for prescribed companies to spend 2% of their net profit for corporate social responsibility (CSR). After this provision comes into effect it is estimated that around INR 273 million ( approx. 4.93 million USD) would be invested in these projects . Our organisation fulfills all the criteria to qualify for CSR activities. We believe that a substantial amount of this sum would be allocate to our organisation by various organisation. This would be in addition to the voluntary donations that we receive from individuals, organisations and Giveindia.org.

We are also exploring opportunities of collaborating with organisation wherein we can help them in rural marketing and charge them for our services. We have a large proportion of rural population visiting our centers, approximately 25000 patients per month and with the increase in number of centers this number is bound to increase many fold. The funds raised through these can be ploughed back for opening of new centers and running of operations.

Years in Operation

Operating 1-5 years

Has the organization received awards or honors? Please tell us about them

It is always a humbling experience when our work is appreciated by people and organisations. Some of the awards that we have received over a period of time are as follows:

1. AmeriCares India awarded the Certificate of Merit to our founder Mr. Arun Nevatia in recognition of outstanding contribution towards healthcare for society.

2. UN has selected the success story of Mr. Arun Nevatia for a publication of UN Volunteers.

3. RHCF was awarded the Social Enterprise Of The Year Award at the 3rd Annual India Leadership Conclave & Indian Affairs Business Leadership Awards 2012.

4. RISHAB JAIN (Leader - Youth Brigade) received YOUTH AWARD from Govt. Of India for his extra-ordinary contribution to Society from RHCF platform.

5. ARUN NEVATIA (Trustee - RHCF) finalist at INDIA VOLUNTEER AWARDS, 2011 initiated by APEEJAY GROUP.

6. ARUN NEVATIA (Trustee RHCF) received SALAAM BANGAL AWARD 2011 initiated by ABP GROUP.

7. Our Model was One of the Winning Entries at 3rd IDIYA CHALLENGE COMPETITION, 2011 organised by INDIAN SCHOOL OF BUSINESS, Hyderabad.

8. Won Mahindra Spark The Rise Award Season 2 Round 1 in Award Section.

9. We were invited to attend the Innovator-Investor Conference organised by World Health Care Congress in Washington, DC

10. We are also recipient of "Karmaveer Puraskaar" by iCONGO.