Combining Entrepreneurship and Global Health to Provide Access to Health Care Delivery in Rural India

Policy Problem Statement

Health and wellbeing are not only of the highest importance to both the individual and to societies, they are also a fundamental human right. For as far as we can think, healthcare is a public good and therefore more a domain of the public sector rather than the private one. Governments and international institutions like the World Health Organization (WHO) have worked to integrate health and health care into their policies to ensure that health is regarded as a public good that must be achieved equitably and to the highest attainable level.

Currently, less than 35% of India’s population has access to health care. This means approximately two out of three residents in India do not have a medical facility to go to (clinic or primary health center) or a doctor to consult, much less are they able to get a prescription and buy medicines. Even the one out of three residents who have access to a medical facility are not seen by a trained medical professional. This is due to an acute shortage of trained staff and chronic absenteeism, since doctors get their salaries from the government and prefer to spend more time at their private clinics where they can charge for their services. Additionally, if the patient is lucky to see a doctor and get a prescription, chances are that the medical stores will be out of stock. The medicines are either not purchased and delivered to the stores or they are sold into the private market for a hefty profit.  This is the state of affairs when only 420 million people are afforded access to health care. However, more resources are needed to scale this up to 1.2 billion Indian citizens and a few million other residents.

Only 20% of India’s medical professionals serve in rural areas where 70% of the population resides. The bulk of primary healthcare is delivered by private providers trained through informal apprenticeships, who do not have a statutory medical qualification. Innovative, scalable strategies are needed for further training and regulating these providers. The challenge for equitable healthcare delivery in India is to clearly define goals and responsibilities, and secure investments for the development and use of new technologies, medical advances, and healthcare delivery. The national health care systems of many developing countries are ill equipped to provide healthcare to their burgeoning populations thereby necessitating the use of novel and innovative health care delivery models. Stable public-private partnerships and renewed political engagement with the understanding of health as a public good will be the basis for harnessing innovative power and scientific development, and will be crucial for translating new insights into advances for health.

As the founder and CEO of Sustainable Innovations, you understand the importance of using business solutions to provide universal access to health care, especially in rural villages in India. However, there are still many challenges that exist regarding the implementation of the Arogya model and the ability to make it sustainable. From my understanding, this model aims to train high-school educated young women from local, rural villages in Rajasthan to become social entrepreneurs and run their own health kiosk for patients to visit as well as make house visits in remote areas where people cannot access the clinic. One of the greatest challenges is ensuring the local villagers understand the business model and terms associated with running a business, especially if these concepts are foreign and do not incorporate cultural values and traditions. If they are not willing to take ownership of this business, proper treatment and care will not be given to community members and the healthcare system will not be sustained. Workers must be open to new business concepts and terms, and willing to go the extra mile to help those in need and fulfill the mission of Arogya Ghar while understanding this is a for-profit business for which they are responsible. Educated women able to treat the villagers who know them would make a great health worker and entrepreneur to run this business. Unfortunately, there has been difficulty in recruiting women to join this business because they are unfamiliar with the enterprise terms and this is an unusual job for women.

Additionally, healthcare is the government’s jurisdiction. They have committed that they will provide healthcare to everyone at no cost; however, there is an access gap because there is no treatment provided to people in rural villages. Working with the government is an essential aspect to ensuring the success of this grass-roots enterprise model, but on a smaller scale. The private sector is also involved to ensure flow of capital, management, and technology to villages. A partnership between the two groups has not been established, which is impeding progress on this project and will not allow this enterprise to be scaled to more villages around India.