Archive for July, 2008

Guest Post: Healthcare and India’s Low Income Market

Monday, July 14th, 2008

In the middle of June, Acumen investee LifeSpring opened its second low-cost maternity hospital in a peri-urban area near Hyderabad. They plan to have six hospitals opened by the end of 2008, and by the time this post goes live, they will have launched their third hospital in Nellore, a small town in southern Andhra Pradesh.

As LifeSpring and other Acumen Fund investees slowly and steadily gain scale, we have started asking broader questions about healthcare for the low-income market. Mainly, we want to understand the major gaps and bottlenecks to providing healthcare to the low-income market in India and how these issues can be overcome. The India office is presently working on a status report of the healthcare sector in which we are trying to understand the challenges of the industry for our target market. What follows is a brief summary of our understanding thus far. Your feedback through questions, comments, nudges, pointers and criticism are appreciated.

Simply put, healthcare for the poor seems to have three central challenges: affordability, availability and quality. Effective, viable solutions will need to address all three issues.

A scalable and sustainable micro health insurance model will probably rank as the highest value intervention to address the issue of affordability, especially in a country like India where, according to India’s National Health Accounts, an estimated 72 percent of healthcare expenditures are out-of-pocket. The idea of pooling risk to prevent unexpected health shocks from forcing a family further into poverty is intuitive and micro health insurance has been in India for some years now.

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A business plan to make pregnancy safer

Wednesday, July 9th, 2008

India successfully test launched a ballistic missile last week that could strike Beijing on a moment’s notice. Yet, 120,000 women here die annually giving birth.Lifespringmom

How does a country with the technology to produce nuclear weapons and launch ballistic missiles also have  the highest maternal mortality rate in the world? It’s 10 times higher than China’s.

LifeSpring Hospitals Ltd. aims to make a dent in India’s abysmal maternal and infant mortality rates by providing high quality care at affordable rates to lower middle-class women. The chain of maternity and children’s hospitals officially launched last year and has the ambitious goal of operating more than 30 hospitals in three years.

(I’m volunteering at LifeSpring’s corporate office in Hyderabad for two months before heading to grad school.)

LifeSpring charges about $40 for a normal delivery and a two-night stay in its general ward. A private room costs $120. LifeSpring promises its families, who earn about $2 to $4 a day, they won’t be inundated with unexpected costs. The prices are posted on the waiting room wall.

LifeSpring isn’t a charity. This is a for-profit business that believes making money is the only way to guarantee a sustainable future.

Anant Kumar, the company’s founding CEO, told me he wanted to run a company with a social mission, but didn’t want to be constrained by unreliable charitable donations or inflexible grant funding. Too many good projects start and then die, he said, when a grant isn’t renewed. Or directors become so focused on meeting grant conditions that they forget the project’s mission and needs of the population.

LifeSpring is an interesting company for many reasons, starting with its initial financing. Hindustan Latex, LLC, a government business that makes condoms, and Acumen Fund,a nonprofit venture philanthropy firm, provided start-up funding.

Like Google and Ebay, New York-based Acumen takes a different approach to philanthropy. The fund invests in for-profit social enterprises around the world.

 

From Acumen’s Web site: “We believe that pioneering entrepreneurs will ultimately find the solutions to poverty. The entrepreneurs Acumen Fund supports are focused on offering critical services – water, health, housing, and energy – at affordable prices to people earning less than four dollars a day. … The key is patient capital.”

Read more about Acumen here.

Increasing rates of childbirths in hospitals is a key strategy to lowering India’s maternal and infant mortality rates. India provides free health care at its government hospitals, but they are dreadfully overburdened, outdated and inconvenient for many people.

This is the niche LifeSpring aims to fill. The small hospitals are a hybrid between an outpatient clinic and small inpatient unit with 20 to 25 beds. To keep costs down, the hospitals outsource pharmacy and other services, refer out complicated cases, and offer few frills. But the hospitals are committed to meeting strict international quality guidelines.

The hospital’s quality policy states: “We at LifeSpring Hospitals: Realize that our customers have expectations from us; Believe in exceeding those expectations; and Doing it better every day.”

When I told Kumar about the 46 million Americans who lack health insurance and struggle to afford the rising costs of health care, he jokingly said he sensed market potential.

Maternity ward lesson

Wednesday, July 9th, 2008

LifeSpring

The staff and doctors at the LifeSpring hospital told me that they have to do exactly three things:
1. Realize that their customers* have expectations
2. Exceed those expectations
3. Do better at it every day

That’s as good a marketing plan as I’ve heard in a while.

(notice that they didn’t say ‘patients’)

By Seth Godin