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______________________________________________________________________ Samhita Social Ventures, B-305, Cello Triumph, I.B. Patel Road, Goregaon (East), Mumbai - 400 063

www.samhita.org [email protected] [email protected]

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Ideas in healthcare for CSR

Index 1. The need of the hour ............................................................................................................................... 3

2. Challenges in CSR in healthcare sector ............................................................................................. 5

2.1. Pressure of need for innovation .................................................................................................. 5

2.2. Solutions to chronic diseases ...................................................................................................... 5

2.3. Partnering with the government ................................................................................................. 6

3. What should companies do to have a successful CSR program? ............................................. 6

3.1. Public Private Partnerships is the way to go .............................................................................. 6

3.2. Innovate, innovate and innovate ................................................................................................. 7

3.3. Corporate collaborations ............................................................................................................. 8

4. Solutions and best practices ................................................................................................................. 8

4.1. Providing high quality primary health care to rural areas ....................................................... 8

4.2. Mobile health camps and community-based volunteering ....................................................... 9

4.3. Deworming pills distribution .................................................................................................... 10

4.4. Use of technology ....................................................................................................................... 11

4.5. Process innovation and affordable medical insurance ............................................................ 12

4.6. Awareness campaigns and community sensitization .............................................................. 13

5. How do you decide your CSR strategy? .......................................................................................... 14

6. Conclusion ................................................................................................................................................ 14



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Laxmi visits a doctor for what she assumes is a minor ailment. She has visited a number of doctors in the past through the public health system but has had no proper record of her past ailments. She now visits a doctor at a private hospital and to her shock; she is diagnosed with multiple issues that require high-cost treatment. Laxmi cannot afford this treatment and nor does she have access to a medical insurance that will pay for the expenditure. Laxmi is none other than the average rural Indian who runs from pillar to post to access one dosage of pills, one shot of a vaccine or one hour of the operation that could save her life. This story, unfortunately, is the reality for a significant proportion of the population in India, particularly in rural areas.

1. The need of the hour With respect to its health systems, India was ranked at the 112th position among 191 member nations according to the World Health Report 2000 published by the World Health Organization (WHO)1. Today, 46% of the Indian population is malnourished and 50% of its women are anemic. According to the WHO, the life expectancy at birth in India was 65 years while the global average was 70 years (2011 figures).2 UNICEF also estimated the Infant Mortality Rate (IMR) to be 47 deaths per 1,000 and adjusted Maternal Mortality Ratio was stated to be a staggering 200 per 1,00,000 live births3. Nearly 60 crore poor in rural and urban areas do not have access to quality healthcare that is affordable1. Government expenditure on health in India is also extremely low. According to the 2013 Economic Survey, the total expenditure on health in 2010 was estimated to be 4.1% of GDP. The report also highlighted that the public expenditure share alone was lower at 1.2% meaning that the private expenditure accounted for 70% of total healthcare spending. India’s public expenditure on health ranks much lower than many other developing countries and is, in fact, the lowest among the BRICS countries4.

1 WHO, Geneva (2000): Health systems: improving performance - http://www.who.int/whr/2000/en/whr00_en.pdf?ua=1 2 India Health Profile: WHO - http://www.who.int/gho/countries/ind.pdf 3 UNICEF, India Statistics - http://www.unicef.org/infobycountry/india_statistics.htm 4Ministry of Finance, Government of India: Human Development, Economic Survey 2012–13 - http://indiabudget.nic.in/es2012-13/echap-13.pdf

India: Healthcare or health scare?

• Ranked 112/191 nations in health systems

• 46% of the population is malnourished • 50% of women are anemic • Infant Mortality Rate at 47 deaths per

1,000 • 60 crore poor do not have access to

quality healthcare • Public expenditure on healthcare at

1.2%

http://www.who.int/whr/2000/en/whr00_en.pdf?ua=1%20

http://www.who.int/gho/countries/ind.pdf

http://www.unicef.org/infobycountry/india_statistics.htm

http://indiabudget.nic.in/es2012-13/echap-13.pdf



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Ideas in healthcare for CSR A study conducted by the Institute of Health Informatics showed that access to healthcare facilities is also extremely skewed towards urban areas. Indians in urban areas, comprising 28% of the population, have access to 66% of total hospital beds, while Indians in rural areas, constituting 72% of the population, have access to the remaining available beds. This has made access to healthcare centers extremely tough. The study also revealed that despite the steep cost, more people in both rural and urban areas have been using private healthcare services even for in-patient services. 40% of respondents cited ‘long waiting time and absence of diagnostic equipment’ in the public healthcare centers as a major deterrent for approaching public health centers. Under the same survey, 38% respondents cited greater quality of treatment as a major reason for approaching private centers for in-patient services5. The public healthcare system therefore, is treated with distrust by the public and the alternative is often reserved for high-income groups.

As against this, the new Companies Act 2013 ushers a regulatory stance for companies with at least ₹5 crore net profit/₹500 crore net worth/₹1,000 crore turnover to divert 2% of their annual profits towards CSR activities. With a country in dire need of not only corporate finances but also strategic partnerships, substantial resources and personnel, health has emerged to be a priority sector in terms of potential for investments. With this premise, Samhita Social Ventures, in partnership with USAID, organized a conference named ‘CSR in Healthcare - Making it Work’. The conference was attended by representatives from over 25 companies and foundations and provided a platform for dialogue and discussion on various issues within this spectrum. The conference created an opportunity for major stakeholders

5 IMS Institute for Healthcare Infomatics (July 2013): Roadmap to Address Healthcare Access Barriers in India - http://www.imshealth.com/portal/site/ims/menuitem.d248e29c86589c9c30e81c033208c22a/?vgnextoid=da4cf7e1f83ff310VgnVCM10000076192ca2RCRD&vgnextchannel=437879d7f269e210VgnVCM10000071812ca2RCRD&vgnextfmt=default

Cost not an issue: Private healthcare scores over public healthcare

• Less waiting time

• Availability of diagnostic equipment

• Greater quality of treatment

As against this, the new Companies Act 2013 ushers a regulatory stance for companies with at least INR 5 crore net profit/INR 500 crore net worth/INR 1,000 crore turnover to divert 2% of their annual profits towards CSR activities.

72%

34%

28%

66%

As percentage of total population

Access to hospital beds

Urban

Rural

A raw deal for rural India

*Source: IMS Institute of Health Informatics

http://www.imshealth.com/portal/site/ims/menuitem.d248e29c86589c9c30e81c033208c22a/?vgnextoid=da4cf7e1f83ff310VgnVCM10000076192ca2RCRD&vgnextchannel=437879d7f269e210VgnVCM10000071812ca2RCRD&vgnextfmt=default





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Ideas in healthcare for CSR in the health sector to build awareness on the gaps that exist, disseminate knowledge of the existing models and above all, lay out clear guidelines on how CSR in India can contribute to this space. We had some extremely revered speakers and experienced healthcare professionals to set the tone for the conference. These included Mr. John Beed, Mission Director of USAID/India, Dr. Zeena Johar, President, IKP Centre for Technologies, Dr. Duru Shah, Founder, Gynaecworld, Dr. Paresh Parasnis, President, Piramal Foundation and Dr. Devi Shetty, Founder, Narayana Health. This paper documents information and learnings from the conference, namely the major issues in healthcare in India, what companies can do to impact the healthcare sector, some best practices from the field and a framework that companies can use to design their CSR programs. The document particularly highlights the big messages from the conference backed by preliminary secondary research. Inaccessibility of private healthcare along with the failings of the public healthcare system has made quality healthcare a commodity for high-income groups in India. This now needs to become the focal point of improving healthcare services- either through public healthcare reforms or by bringing in innovative ways to scale up affordable private healthcare. During the conference, Dr. Devi Shetty pointed out that India has the opportunity to be the first country to ‘disassociate healthcare from affluence’ where the corporate world definitely has a big role to play.

2. Challenges in CSR in healthcare sector

2.1. Pressure of need for innovation Innovation, as highlighted by the speakers, is an emerging trend in the development sector today. Given the depth and scale of the programs, the need to innovate has become paramount as highlighted by Mr. John Beed. However, as pointed out by other speakers including Dr. Zeena Johar, there is often a disconnect between innovation as a concept and the implementation of that idea owing to the situation on the ground. It is difficult to let innovation and sustainability move hand in hand. At the grassroots level, innovation does exist but facilities are not in place. Thus, even though the service delivery has been well thought of, there are lacunae in the implementation process.

2.2. Solutions to chronic diseases Through the panel discussion, the speakers also highlighted the need for significant investment in chronic diseases. As pointed out by Dr. Zeena Johar, India is the diabetes capital of the world.

‘’India has the opportunity to be the first country to ‘disassociate healthcare from affluence’ where the corporate world definitely has a big role to play’’

-Dr. Devi Shetty, Chairman and Founder, Narayana Health



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Ideas in healthcare for CSR According to the International Diabetes Federation, 4 crore people in India suffer from diabetes6. Despite this, many companies are keener to invest in primary and secondary healthcare as they seem to be more visible issues in the healthcare sector. Few are willing to solve chronic issues such as heart diseases, diabetes or cancer. More interventions are necessary in these specific areas that are deemed either too insignificant or too challenging.

2.3. Partnering with the government

The event also brought forth the point that companies are hesitant to entering into partnerships with the government and are particularly wary of finding themselves caught in bureaucratic processes. Governments, be it central, state or local, are willing to enter into Public Private Partnerships (PPPs) across development sectors. However, governments tend to lack strategic support during the implementation phase of the program. The perception is also that governments fail to perform while executing the program as the vices of administrative inefficiencies, bureaucratic delays, red-tapism and procrastination creep in. Another common belief is that a change in government always destabilizes partnerships resulting in a need to resume from scratch, which can be

exhausting as well as detrimental to the project. In addition, the federal nature of the administration adds another layer of complexity. Different parties announce disparate policies at the national and state levels making execution of programs challenging.

3. What should companies do to have a successful CSR program?

3.1. Public Private Partnerships is the way to go As pointed out by Mr. Paresh Parasnis, entering into partnerships with the government, state or central, is one of the easier ways for CSR initiatives to gain scale. There have been several successful initiatives that show the way. For instance, Piramal Foundation has partnered with six state governments under the National Rural Health Mission (NRHM) to set up the Health Management and Research Institute (HMRI).

6 The Indian Express (November 13, 2013): Diabetes hits young women due to sedentary lifestyle - http://archive.indianexpress.com/news/diabetes-hits-young-women-due-to-sedentary-lifestyle-study/1194531/

Risks of working with the government:

• Lack of strategic support during implementation

• Administrative inefficiencies • Bureaucratic delays • Red-tape • Procrastination

“The PPP route helps companies scale up CSR initiatives”

-Mr. Paresh Parasnis. Head, Piramal Foundation

http://archive.indianexpress.com/news/diabetes-hits-young-women-due-to-sedentary-lifestyle-study/1194531/



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HMRI’s flagship program is the Health Information Helpline – 104, that enables the general public to call with any medical queries, get counseling and ‘lodge any complaints against the public health facilities’7. The team has been trained to speak in the local language with set protocols. Partnering with the government has helped the foundation get close to 2.5 lakh calls a year. One of the greatest challenges of this partnership was to convince the government to distribute medicines for chronic diseases. But ultimately, it was a win-win situation as Piramal Foundation was able to scale up its model and the government was able to adopt accountability in their practices. Therefore, given the magnitude of the problem at hand, scale is absolutely necessary to create sustainable impact in the healthcare space. Government is perhaps one of the most effective mediums of gaining the scale that companies are looking for because of the reach and resources both central and state governments have under the ambit of their welfare schemes and programs.

3.2. Innovate, innovate and innovate Innovation was the major point highlighted at the ‘CSR in Healthcare’ conference. Innovation can cut across products and processes to create new healthcare systems. Of all plausible partners, a company with a CSR budget is best placed to innovate. Companies can afford to take financial risks and mitigate those risks by providing resources and expertise that are their core competence. This fact was reinforced at the conference by Mr. John Beed where he said, “What we think as ‘Tried and True’ in fact might not be ‘true’ and the companies must come with an open mind to invest in innovation”. More importantly, these innovations need to take place on the ground rather than in the laboratory - a gap that Dr. Zeena Johar, Founder of IKP Centre for Technology emphasized upon. The appetite for innovation will also depend on the extent of capital available with the company. That makes it imperative to invest in innovation earlier rather than later. Another major message that emerged from the conference was that companies should be cognizant of the thin line between innovation 7 HMRI (2014): Health Information Helpline - http://www.hmri.in/our-solutions/health-information-helpline.html

The PPP advantage

• HMRI set up by Piramal Foundation in partnership with 6 state governments

• Flagship Health Information Helpline (104) operational in 4 states

• Services provided to 2.8 crore callers till date

“What we think as ‘tried and true’ in fact might not be ‘true’ and the companies must come with an open mind to invest in innovation”

-Mr. John Beed, Mission Director – India, USAID

http://www.hmri.in/our-solutions/health-information-helpline.html



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Ideas in healthcare for CSR and reinventing the wheel. To avoid the latter, there is more need for companies to be aware of what their peers are doing. This can be facilitated by more such platforms that engender sharing, networking and recording of best practices.

3.3. Corporate collaborations Another avenue for successful collaboration is for companies to partner with other companies. Such collaborations have the power to create collective impact. Collective impact brings together the passion, resources and expertise of different organizations working on the same issue but from different perspectives. One of the most successful examples of collective

impact in India is KC Mahindra Education Trust’s Nanhi Kali program. For more information on the Nanhi Kali program and the analysis on the factors that have made it successful, please refer to the Tata Strategic study on the ‘Best Practices of CSR in the field of education in India’.8 One of the areas that could stem out of corporate collaborations is impact assessment. Although the methods employed for the same could be expensive, well designed assessments can enable organizations to undertake midcourse corrections that are necessary to further strengthen projects.

4. Solutions and best practices As a company looking to address causes of healthcare through its CSR, there are several options available. Programs can address economic bottlenecks of patients, unavailability of access to healthcare services (infrastructure or trained personnel), lack of

medical insurance, and much more. This section documents some programs and models that have worked successfully in India in the past.

4.1. Providing high quality primary health care to rural areas Only 28% of the population in India has access to good quality healthcare9. This gives rise to the need for increasing access at the level of primary healthcare. This is especially important in rural

8Tata Strategic Management Group (2010): Best practices of CSR in the field of education in India - http://www.tsmg.com/download/reports/CSR_in_the_field_of_Education.pdf 9The Economic Times (July 28, 2013) - Rural India's access to healthcare patchy- http://articles.economictimes.indiatimes.com/2013-07-22/news/40727949_1_rural-areas-providers-healthcare-informatics

Joining forces

• The Nanhi Kali program is jointly managed by the KC Mahindra Education Trust and Naandi Foundation

• Several Corporate partners sponsor large number of Nanhi Kalis

• Some of the key sponsors are Capgemini, HPCL, HDFC Bank, J&J and M&M

http://www.tsmg.com/download/reports/CSR_in_the_field_of_Education.pdf

http://articles.economictimes.indiatimes.com/2013-07-22/news/40727949_1_rural-areas-providers-healthcare-informatics

http://articles.economictimes.indiatimes.com/2013-07-22/news/40727949_1_rural-areas-providers-healthcare-informatics



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Ideas in healthcare for CSR areas where one has to deal with both lack of enough primary centers and lack of medical personnel. As pointed out by Dr. Zeena Johar, there are currently only 4 lakh doctors in India with a need for 12 lakh. 70-80% of doctors are concentrated in the urban areas. Creating incentives for qualified doctors to move to rural areas on a large scale is cumbersome. There is need for high quality and sustainable access to primary care in rural areas. The IKP Centre for Technologies for Public Health’s model for providing primary health care in rural areas leverages healthcare professional training, advances in technology, and financing models. The model provides training to AYUSH (Ayurveda, Yoga, Unani, Siddha and Homeopathy) trained doctors, integrating them into the mainstream public healthcare system. IKP runs a 6-month Bridge Training Program for AYUSH workers in collaboration with the University of Pennsylvania to provide them with adequate skills after identifying the gaps in skills and practice. A curriculum model is then designed with the objective of expanding the primary healthcare clinical decision making skills of AYUSH doctors10. Through this initiative, IKP runs seven clinics in Tamil Nadu.

4.2. Mobile health camps and community-based volunteering Something that is highly disregarded in the Indian health scenario is the extent of indirect expenses that an individual has to bear. For example, many people are forced to travel to get to the closest station to reach a health center. In such situations, setting up mobile health camps with pre-scheduled journey plans can be useful. 10 University of Pennsylvania (2013): Penn Nursing Impact Report - http://flipbook.nursing.upenn.edu/i/198393

12,00,000

4,00,000

The need

The reality

India: Where are the doctors?

Addressing rural India’s healthcare needs

• IKP Centre for Technologies in Public Health trains AYUSH practitioners to make up for the deficit of mainstream medical practitioners

• After identifying gaps in their knowledge and practice, they are trained in making primary clinical decisions

• They are integrated into the mainstream healthcare system

http://flipbook.nursing.upenn.edu/i/198393



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Ideas in healthcare for CSR The Piramal Foundation’s mobile health clinic is a successful example of this. These clinics have one doctor, a few pharmacists and registered volunteers from the village. This is an easy low-cost solution. Health camps can specifically be useful for ensuring that patients get access to quality preventive care and early diagnosis. Vaccine Preventable Diseases (VPDs) constitute over 5 lakh deaths in India annually. 11 However, this model will be truly impactful only if a systematic approach of maintaining records and linkages to secondary and tertiary healthcare are created. Also, regularity and continuity are key factors in ensuring the success of this model.

4.3. Deworming pills distribution Research has proved that distribution of deworming pills is particularly effective and has positive externalities. In many parts of the developing world, including India, existence of parasitic worms is extremely harmful, causing weakness, reduced nutrition levels and chronic gastric issues. This is far more pronounced for school-going children. An evaluation of a deworming initiative in Kenya showed that the incidence of intestine related infection dropped by 50% for the treatment group and also increased school attendance12. Deworming is one of the most cost-effective short-term solutions and this has now been adopted by the state governments of Delhi and Bihar. The state governments, through the Jawahar Aarogya Mission, are mandated to conduct health camps in government schools including eye and dental check-ups. The school is then entrusted with the responsibility of distributing iron tablets throughout the year. The school is a great medium to connect and bring in the community as it already has a captive audience in the form of students but these health camps need to be regular and monitored. However, the sustainability of this model is questioned because of the lack of continuity and linkages for secondary healthcare practices. Once the children are diagnosed, there needs to be a system in place to track the students even beyond the health camps. 11 Vashishtha, V. M. and Kumar, P. (2013): 50 years of Immunization in India: Progress and Future, Indian pediatrics, 50 (1), pp. 111—118 - http://www.indianpediatrics.net/jan2013/jan-111-118.htm 12 Poverty Action Lab (2014): Primary School Deworming in Kenya | The Abdul Latif Jameel Poverty Action Lab - http://www.povertyactionlab.org/evaluation/primary-school-deworming-kenya

Reaching out to rural India

• The Piramal Foundation’s HMRI venture deploys mobile health clinics equipped with medicine, technology and health workers

• This program has provided services to 1.2 crore people across 25,000 service points

http://www.indianpediatrics.net/jan2013/jan-111-118.htm

http://www.povertyactionlab.org/evaluation/primary-school-deworming-kenya



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Ideas in healthcare for CSR 4.4. Use of technology According to a PWC report, the role played by mobile technology in providing healthcare services is set to expand globally13. mHealth or Mobile Health has huge potential since usage of mobile phones across India has increased in the last few years and the potential for tapping this source of access and network is tremendous. mHealth can be a useful mechanism for both information delivery and monitoring. Use of mHealth for information services can be transformative for several lifestyle and chronic diseases. Moreover, this does not need to be restricted to urban areas. While it is acknowledged that the mHealth model in rural areas might need to be more complex to account for the charges, enabling a community base for this can solve the cost issue14. Global applications such as Ushahidi have been used to disseminate emergency alerts through mobile phone messages. Connecting online platforms to

mobile phones can also enable patients to specifically ask questions to doctors via SMS and receive an instant reply15. However, this information should also be connected to the closest primary health center (PHC) for the patient to visit the clinic/hospital during emergency. Apart from information dissemination, mHealth can also be a means of better service delivery, particularly

for community health workers. An experiment in Orissa showed that sending videos and messages in local languages to community workers enabled them to provide better advice to their patients and specifically helped pregnant women adopt better practices16. A third use of mHealth is monitoring and assimilating data. Most patients in rural areas do not have written or past records and often written data can be easily discarded. The IKP Centre for Technologies attempts to solve this issue by using an Android application to record data that is part of the National Management Information System initiative. Having a record of the patient’s current and past records can go a long way in accurately diagnosing a patient particularly during tertiary care. This type of application can also be used to track a doctor’s progress and becomes an effective form of monitoring.

13 PwC (2013): Health in India to be a 3000 crores INR opportunity by 2017 - http://www.pwc.in/press-releases/health-in-india.jhtml 14 Thomas, S. (2012): Affordable Mobile technology towards Preventive Health care: Rural India. IOSR Journal of Dental and Medical Sciences (JDMS), 3 (3) - http://iosrjournals.org/iosr-jdms/papers/Vol3-issue3/F0333236.pdf 15 Mascarenhas, A. (November 22, 2013): BBC releases policy briefing on 'Health on the move: Can mobile phone save lives?' - http://archive.indianexpress.com/news/bbc-releases-policy-briefing-on-health-on-the-move-can-mobile-phone-save-lives-/1198322/ 16Garai, A. (October 26, 2011): Role of mHealth in rural health in India and opportunities for collaboration. Background reading prepared for ICCP Technology Foresight Forum: Developments in Mobile Communication OECD Headquarters, Paris - http://www.oecd.org/site/stiffmob/49440234.pdf

Dialing for better health: The uses of mHealth

• Information delivery and monitoring

• Better service delivery

• Monitoring and assimilating data

http://www.pwc.in/press-releases/health-in-india.jhtml

http://www.pwc.in/press-releases/health-in-india.jhtml

http://iosrjournals.org/iosr-jdms/papers/Vol3-issue3/F0333236.pdf

http://archive.indianexpress.com/news/bbc-releases-policy-briefing-on-health-on-the-move-can-mobile-phone-save-lives-/1198322/

http://archive.indianexpress.com/news/bbc-releases-policy-briefing-on-health-on-the-move-can-mobile-phone-save-lives-/1198322/

http://www.oecd.org/site/stiffmob/49440234.pdf



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Ideas in healthcare for CSR Use of telemedicine to connect PHCs to bigger, more reputed hospitals is another form of technological intervention in healthcare. While the use of telemedicine in high-end hospitals already exists, extending this to areas that serve the bottom of the pyramid (BoP) is relatively new. It is important to emphasize that the design of telemedicine-related initiatives is important. The Piramal Foundation’s telemedicine initiative operates by connecting 10 PHCs in Maharashtra to a specialist in Hyderabad. The specialist helps to diagnose patients and the PHCs provide the medicines. One must keep in mind that while technology can aid in enabling better service delivery, information dissemination and monitoring, it cannot be delivered in isolation from other services and hence, the need for comprehensive integration.

4.5. Process innovation and affordable medical insurance

According to a PwC report, 80% of all healthcare expenditure in India in 2010 was out-of-pocket, 3% from insurance and the rest from the government17. While the central government under the Rashtriya Swasthya Bima Yojana has made it mandatory for all workers under the National Rural Employment Guarantee Act to get covered, less than half the population in India is covered or will be covered by 201518. Recently, the Maharashtra State Government, in partnership with the National Insurance Company (NIC) has launched the Rajiv Gandhi Jeevandayee Arogya Yojana that provides families with an annual income of less than INR 1 lakh access to free medical treatment up to INR 1.5 lakh19. However, this is now being implemented in phases and has not translated into an effective mechanism for the rest of the country. This lack of access to insurance serves as a detriment to accessing tertiary healthcare such as surgeries. This might serve as a severe blow to those suffering from chronic diseases.

17 PwC (November 22, 2010): India Pharma Inc: Capitalising on India’s Growth Potential - PwC-CII Pharma Summit Report - http://www.pwc.in/assets/pdfs/pharma/PwC-CII-pharma-Summit-Report-22Nov.pdf 18 Forgia. G and Nagpul. S (2012): Government-Sponsored Insurance in India: Are you covered? The World Bank. Directions in Development - http://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2012/08/30/000356161_20120830020253/Rendered/PDF/722380PUB0EPI008029020120Box367926B.pdf 19 The Hindu (December 19, 2011): Maharashtra launches health scheme for poor - http://www.thehindu.com/news/national/maharashtra-launches-health-scheme-for-poor/article2726917.ece

Out-of-pocket Insurance Government

Expenditure on healthcare

http://www.pwc.in/assets/pdfs/pharma/PwC-CII-pharma-Summit-Report-22Nov.pdf

http://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2012/08/30/000356161_20120830020253/Rendered/PDF/722380PUB0EPI008029020120Box367926B.pdf



http://www.thehindu.com/news/national/maharashtra-launches-health-scheme-for-poor/article2726917.ece



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Ideas in healthcare for CSR Narayana Health (NH) is an example of ‘affordable healthcare especially for tertiary levels’. Dr. Devi Shetty, the founder of NH, has been able to provide surgeries at lower costs because of what he identifies as ‘process innovation20’. Therefore, instead of investing entirely in new products/pills alone, he is an advocate of improving systemic processes. With the help of

Yeshasvini Micro Insurance, launched in partnership with the Karnataka State Government, surgeries are covered for all patients and family members of rural co-operative societies in Karnataka. Members are expected to make an annual contribution of INR 210/year21. Using innovative means of reducing cost of hospital services not only enables affordable healthcare but also ensures easy scaling up.

4.6. Awareness campaigns and community sensitization

While assimilation and dissemination of information is extremely pertinent to every healthcare issue, it is highly beneficial to the cause of reproductive and sexual health. Over the past many years, while maternal mortality has gone down, 150 women still die every day due to preventable pregnancy complications. Pregnant women, especially in rural and semi-urban areas fail to visit PHCs due to a number of problems, the major reason being lack of awareness. This leads to severe complications as they end up delivering at home with the help of mid-wives. Most of these problems can easily be mitigated through simple awareness campaigns and community sensitization as demonstrated by Dr. Duru Shah and Gynaecworld. Empowerment is 20Knowledge@Wharton (2010): Narayana Hrudayalaya: A Model for Accessible, Affordable Health Care? - https://knowledge.wharton.upenn.edu/article/narayana-hrudayalaya-a-model-for-accessible-affordable-health-care/ 21 Yeshasvini. (n.d.) About us - http://www.yeshasvini.kar.nic.in/about.htm

Ensuring affordable healthcare

• Narayana Health provides surgeries at low costs using ‘process innovation’

• With the help of Yeshasvini Micro Insurance surgeries are covered for members of rural co-operative societies in Karnataka

• Members are expected to make an annual contribution of INR 210/year

Spreading awareness

• Gynaecworld’s ‘Growing up’ program reached 50 lakh girls

• The ‘Kishori’ program educates Anganwadis about health problems prevalent among girl children. The Anganwadis in turn, spread awareness among other members of the community

https://knowledge.wharton.upenn.edu/article/narayana-hrudayalaya-a-model-for-accessible-affordable-health-care/

http://www.yeshasvini.kar.nic.in/about.htm



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Ideas in healthcare for CSR the keyword and one area of focus should be ensuring that women and adolescent girls are provided information to encourage independent decision making. Reproductive care of adolescent girls is also often ignored. Companies, especially from the FMCG and healthcare sectors, can play a direct role in boosting awareness. Gynaecworld’s ‘Growing up’ program focusing on adolescent girls in urban areas was conducted in partnership with Johnson & Johnson. This particular initiative reached 50 lakh girls and ‘educated children on reproductive and sexual health’.22 This type of program also fits in well with companies who have adopted schools or conduct after-school programs for students who have dropped out. An example of this is ‘Kishori’, a community-based program educating the Anganwadis who in turn went on to spread awareness among other members of the community on diseases that are particularly prevalent among the girl children such as anemia and malnutrition.

5. How do you decide your CSR strategy? Once companies are cognizant of the role played by their respective stakeholders, the existing situation in the communities in their areas of operation and have gained a rudimentary knowledge of CSR, they can start designing their CSR strategy. Samhita Social Ventures has created a robust CSR framework to design strategies with streamlined processes. This provides the companies with an end-to-end CSR strategy outline starting from defining the objectives for engaging with CSR, to the designing of programs and defining the intended impact. In order to ensure that the participants at the conference received a hands-on practical experience, a workshop was conducted in which each group was presented with a case study and the Samhita CSR framework. The members of the groups were then asked to apply this framework to articulate their CSR strategy and intervention. In order to understand this framework better and use it for your own CSR program, do get in touch with us at [email protected]

6. Conclusion

This paper has highlighted the drawbacks and limitations of the Indian healthcare system. However, as illustrated by many examples in this paper, there are ample low-cost easily-scalable solutions that have been proven to work and sustain.

22 Gynaecworld. (n.d). Dr. Duru Shah - Scientific Director of Gynaecworld Mumbai - http://www.gynaecworld.com/dr-duru-shah.php

mailto:[email protected]

http://www.gynaecworld.com/dr-duru-shah.php

http://www.gynaecworld.com/dr-duru-shah.php



15

Ideas in healthcare for CSR As one of the key players in the field of CSR, companies have a vital role to play in ensuring that there are better figures to be reported in the near future. A number of lives can be saved merely by improving affordability, accessibility and quality of healthcare. There are a plethora of programs, strategies, interventions and methods for CSR in healthcare and with the extensive bank of expertise, knowledge and funding, the corporate world can leverage this to realize a healthier India.

About Samhita Social Ventures

www.samhita.org

Address: B-305, Cello Triumph, I B Patel Road, Goregaon East, Mumbai 400 063

+91 22 2685 7800

[email protected] l [email protected] l [email protected]

Samhita Social Ventures bring together companies, donor organizations and high net-worth individuals to collaborate with NGOs and social enterprises. Our CSR consulting practice has worked with several leading companies to shape their CSR strategy, facilitate program implementation, run cause-related marketing campaigns and assess impact created.

Besides CSR, we also disseminate knowledge around CSR laws, theories, frameworks, best practices and impact assessment. Our conferences focus on effective CSR initiatives in sectors such as healthcare and education, thereby empowering companies to make informed decisions while allocating CSR budgets and designing programs.

Through CSR strategy and implementation, we have streamlined corporate funds to the tune of INR 24 crore for the sector. We have facilitated awards and grants of more than INR 38 crore. More than 3,000 NGOs and 150 social enterprises converge at our portal – Samhita.org. We have access to a network of 20,000 NGOs nationwide. This results in a deep understanding of and strong relationships with social organizations that lead to effectively managing implementation projects for our clients.

http://www.samhita.org/




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