What are SDGs?
Sustainable Development Goals or SDGs are a set of 17 goals and 169 targets adopted unanimously by 193 Heads of State and other top leaders as an extension to the MDGs or Millennium Development Goals that ran from 2000-2015.
With almost 17.6% of the World’s population living in India, the socio-economic development of 1.4 billion Indians will contribute significantly to global development. The key question is what will help India fulfill her SDGs in the next 15 years? There are 2 key players in this journey who have the ability to be the game changers- Government and Social Entrepreneurs.
While the Government can foster change from the top through right policy making, resource mobilization and effective governance, social entrepreneurs through their market-led, innovation & impact based interventions can bring about change from grounds-up. A report by Intellicap states that Healthcare, Housing, Education, Livelihood and Water and Sanitation are the leading sectors in which the social good brands in India operate.
This 4-part series will focus on how social entrepreneurs can contribute towards India achieving her SDGs in Healthcare, Education, Livelihood Creation and Water & Sanitation and highlight a few enterprises that are bringing innovative solutions to these areas.
Current Shortfalls in Healthcare in India
India’s human development index (HDI) at 0.6 is a far cry from the likes of Norway at 0.944, which is considered the best in the world. This reflects the lack of healthy, long and good quality of life for the average Indian. There is a multiplicity of factors responsible for this phenomenon. One of the biggest factors is the poor state of healthcare facilities & services available to the ordinary Indian. Indian government spends only 4% of its GDP (compared to 18% by the US) on healthcare. This has led to grossly inadequate delivery infrastructure and acute shortage of doctors & nurses- per capita expenditure on healthcare services and infrastructure in India stands at just $58 as compared to $8895 by the US. It’s no wonder that probability of deaths between 15-60 yrs of age in India stands at approximately 24% for males and 15% for females. Clearly, such high rates of mortality in the productive age group deprives our nation of its precious human capital required for economic growth. Further, only 5% of Indians are covered by health insurance. Thus for the vast majority of the populace, a serious illness in the family leads to a bankruptcy and further poverty.
Bottoms-up Approach to Healthcare by Social Enterprises
Daunting nature of challenges in the Indian healthcare sector necessitates ground up efforts of social enterprises and social good organizations to complement governmental programs. Here are some good examples of organized, scalable and innovative initiatives in healthcare delivery that may prove to be game changers.
Swades Foundation, through their health care workers called Swaraksha Mitras, is taking healthcare to the BOP population. Swades connects rural communities of Maharashtra to the nearby multi specialty hospitals and regularly takes the citizens for their health treatments and surgeries(eg: cataract, open heart) free of cost.
Nanohealth, based in Hyderabad, on the other hand uses a for-profit, subscription-based service driven model to take the reach of healthcare to the doorstep of its BOP customers. They achieve this through a network of women community health workers called Saathis. Saathis have been trained to carry out health diagnosis using a basic medical kit and to refer patients to doctors who charge them a highly discounted fees. Once a BOP customer enrolls in NanoHealth’s plan, Saathis monitor their health regularly through home visits.
Both these organizations represent a new way of delivering basic healthcare to the masses. They have created an army of trained health workers that operates at grassroots of the society. This simple approach of connecting the needy with existing healthcare infrastructure ensures not only improved productivity of assets but also greater diagnosis and better insight into the health status of the BOP. While this is one part of the solution the other part lies in creating new infrastructure like hospitals and primary health centers that can deliver good quality and affordable healthcare to the populace.
Narayana Hrudhyalaya is a great example of delivering affordable specialty healthcare to millions of people. They are a network of hospitals, heart centers and primary healthcare centers spread across southern and eastern parts of India. They perform heart surgeries at half the price charged at corporate run hospitals for people from financially poor backgrounds and make sure no one is turned down for lack of ability to afford a surgery. Narayana is able to achieve this through economies of scale ( 30 heart surgeries a day) and process innovation. Their business model, perfected over last 15 years, represents positive impact on healthcare on a huge scale.
Doctors for You, founded in 2007, is a humanitarian organization based on the principle of ‘Health for all’. Formed as a network of passionate doctors, medical students and social workers they harness concerted efforts of these professionals to provide medical care to most vulnerable communities and people affected by natural disasters or emergency situations.
India needs fresh thinking, innovative approach and scalable models of healthcare services. Providing basic diagnosis and primary healthcare to the under-served through community workers, bringing down costs of specialty healthcare for millions through scale of operations and building organizational capacity to take healthcare to medical emergencies are some of the prominent ways. Government will do its job but it is the social entrepreneurs that will affect change on the ground in a major way in next 15 years. If both of them work in tandem, achieving India’s SDGs in healthcare by 2030 will not be difficult.