A clinic for low-income communities

A clinic for low-income communities

Ratan Tata funded Swasth India, a non-profit social enterprise, founded by Sundeep Kapila and Ankur Pegu, works towards preventive and primary healthcare for the low-income population in the country. In the next five years, it aims to serve over 30 million lives across 5-7 cities in India through a network of over 300 primary health centers

POORNIMA KAVLEKAR

THE BURGEONING PROBLEM

WHO estimates 32 million to 60 million people in India go from above poverty line to below poverty line due to a health shock. Swasth India, a non-profit social enterprise, aims to prevent this from happening by offering primary, secondary and tertiary care for the low income population.

THE SOLUTION?

The organisation operates a network of self-sustaining primary-preventive health centers. Each center has a 250 square feet facility located in the community and has a primary care physician, a dentist, three physician assistants and one or two outreach community health workers. “All of these services are provided at half the market price and in such a way that the center becomes cash flow positive after one year of operation,” says Sundeep Kapila, co-founder of Swasth India. The organisation does not provide secondary and tertiary care services but has created a preferred network of like-minded hospitals and nursing homes to provide the same. It currently operates in Mumbai with 16 centers. “We plan to expand across Mumbai first and then outside Mumbai,” he adds.

The organisation is faced with two key challenges: one, identifying and setting up centres in a location accessible by the community and two, in building scalable systems and processes.

QUALITY OF SERVICES

To ensure high quality of care, the organisation extensively uses data for continuous monitoring and objective supervision. “Our customers have a unique ID and their entire medical history is recorded and audited to ensure that proper care is provided,” states Kapila. The centre also has a 24-hour patient help line number for queries, suggestions and complaints. Additionally, it surveys five per cent to 10 per cent of its patients within a week to get their feedback. Lastly, it also offers continuous training to ensure professional development of the medical staff (in terms of improving medical knowledge, and familiarising with various systems and processes).

Innovative processes  

“The reason we have been able to develop a self-sustainable model at a price point which is half the market price is because we have innovated at multiple levels to reduce cost of healthcare delivery by 40 per cent,” says Kapila. For instance, its one-stop shop format not only offers significant convenience for patients to access all services at one location, but also makes the cost structure lean. Moreover, it focuses on health improvement and not just disease treatment. “We hold campaigns on how to prevent infectious diseases and ensure early detection and management of chronic conditions like diabetes and hypertension,” states Kapila.

Swasth India also uses technology extensively in customer management and in internal processes. Its customers can get their lab report through an SMS or email, and the doctor sees the past records in every visit.

FUNDING ?

In his personal capacity, Ratan Tata has invested Rs 2 crore in the company.  Before this, the organisation was funded by friends and like-minded individuals. It used those funds to develop and demonstrate that a self-sustainable model of operating primary health centers for the urban poor exists. “With Mr Tata’s funding, we were able to scale our proof of concept from five units to a healthy 15 units, increase the scale of impact, and demonstrate that the systems are scalable,” states Kapila.

Swasth India currently operate 16 centers with a membership of over 70,000 families. It has handled over 250,000 patient visits and reduced the out-of-pocket expenditure of the urban poor by over Rs 4 crore. “This is less than the total investment we have received in this project. This demonstrates that the direct social impact of our work is more than 100 per cent. In addition, the social impact is perpetual without the need for any other investment, as each center becomes cash flow positive within 12 months,” says a proud Kapila.

FUTURE GROWTH

In the next three to five years, Kapila sees Swasth India serving over 30 million lives across five to seven cities in India, through a network of 300 primary health centers. “We have proven that with an initial investment of only Rs 20 per life, we can deliver quality primary care to the urban poor with significant reductions in out-of-pocket expenditure and through a self-sustainable model,” says Kapila. The organisation needs capital and more importantly high calibre individuals to get behind this and expand the presence of these centers across India. “We also need to develop a Version Two of our software platform to meet our needs as we scale across India. We need best HR practices to ensure that we are able to attract and retain the best talent,” concludes he.

Poornima Kavlekar has been associated with The Smart CEO since the time of launch and is the Consulting Editor of the magazine. She has been writing for almost 20 years on a cross section of topics including stocks and personal finance and now, on entrepreneurship and growth enterprises. She is a trained Yoga Teacher, an avid endurance Cyclist and a Veena player.