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Assessment of
SughaVazhvu
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Who, What, How?
Problem
▪ Inaccessible primary healthcare
▪ 72% of the India’s total population is rural
▪ 1:30,000 Doctor-to-patient ratio
▪ 0.9% of GDP ~ $10/Indian Government expenditure
Solution
▪ Build Rural Network
▪ “Ayush” doctors
▪ Protocol based healthcare delivery
▪ Affordable and Accessible
Improve the well being of poor populations by focusing on designing, developing, and delivering innovative solutions in healthcare concerning rural communities in India.
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Background
▪ Directed by Dr. Nachiket Mor and Dr. Zeena Johar
▪ Support by the ICICI through ICTPH
▪ First RMHC opened in 2009
▪ Sughavazhvu Health Network Supply Chain and Expansion Plans in 2011
IKP
IKP Trust
ICTPH ICAAP IKPIMC SughaVazhvu
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Focus
▪ Thanjavur district, Tamil Nadu, India
▪ As of Feb 2012: 5 existing RMHCs 50,000 people
▪ Network of 10 RMHCs 100,000 people
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Strategy
▪ Systematic mobile household screening
▪ Rapid risk assessments
▪ Medical records
▪ Strict treatment protocols
▪ Supervision-training mentorship model
▪ Hub-and-spoke structure
MAP RISK
PROFILE MANAGE TRACK
▪ Track, quantify, treat, and prevent disease
▪ Data-driven diagnosis/monitoring
▪ Improved treatment efficacy and efficiency
▪ Efficient management of medical and personnel resources
▪ Improved medical outreach
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Business Model
Revenue
▪ Most funding by ICICI bank through ICTPH.
▪ Striving to rely more on patient-driven revenue
▪ Offers comprehensive healthcare at about 15 Rs per visit (~ $0.24)
Low-cost healthcare
Reinvest profits
+
IKP funding
Paying patients
- Patient-driven
profits
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Cost of Healthcare
EXPENDITURE Cost (Rs)
Primary Care – Direct 587 ~ $16
Primary Care – Indirect 208
Secondary & Tertiary Care 739 ~ $15
Estimated per capita expenditure 1,534
Estimated village-level expenditure (10,000
individuals)
15.3 million
Estimated village-level primary care expenditure 7.9 million
COMPREHENSIVE MANAGED CARE PLAN Cost (Rs)
Annual cost (without copays) 1020 ~ $20
Estimated village-level annual cost 10.2 million
Source: Mor, Nachiket and Karthik Tiruvarur, “Is Managed Care at all a Possibility in Developing Countries? – A perspective from Thanjavur”. The ICTPH Blog.
51%
49%
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Operations
Clinical and Outreach Supervisor
Biomedical Technology & IT
technicians
Physician – supervise ~ 12 RMHCs
Pharmacist
Lab Technician
Administrative Assistant
Led by nurse
Health worker
Source: Zertuche, Diego Rios. SughaVazhvu Health Network: Supply Chain and Expansion Plans. Cornell Institute for Public Affairs, 2011. 8
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Value Delivered
Monitors the health of the people in rural communities Affordable primary healthcare services to approx. 50,000
families
Capabilities
▪ Electronic medical records & bar-coded identity cards
▪ Standardized primary care with protocols that cover 70-80 basic diseases
▪ Streamlined supply chain using technology innovations to minimize costs
▪ In-house diagnostics
▪ Integrate primary care with secondary and tertiary care
Interventions
▪ Self help groups
▪ Women’s reproductive health
▪ Oral, dental, ophthalmic, cardiovascular diseases
▪ Community-based management of pneumonia
▪ Infant home fortification through Sprinkles
Quality
▪ Experiment and revise protocols
▪ Supervision-mentoring and continuous training
▪ Periodical internal and external evaluations
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Partnerships
Best practices
Secondary & Tertiary Care
Policy Recommendations
DHAN Foundation
Penn Nursing Science University of Pennsylvania School of Nursing
ARAVIND Eye Care System
SughaVazhvu Health Care Pvt. Ltd.
Tamil Nadu Police
Logos of SughaVazhvu partners are © of the organization. All rights reserved. This content is excludedfrom our Creative Commons license. For more information, see http://ocw.mit.edu/help/faq-fair-use/.
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Strength
• Low cost coverage
• Standardized protocols
• Empowering nurses
• Real-time connection between
doctors and nurses
• Information Technology & Quality
• ICTPH’s network & Low competition
Weakness
• Premature business model
• Scalability and adaptability
• Supply of skilled healthcare
professionals
• Funding Sustainability and Pricing
• Supply Chain
Opportunity
• Financial backbone - ICICI Bank
• Experienced CEO in creating
innovative business models in
micro-finance
Threat
• Future political interference
• Retention of trained personnel
• Competition from alternative
Healthcare Delivery Systems
• Reliance on access to IT – challenge
to scalability
SWOT Analysis
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Challenges
Immediate
▪ Develop sound business model
▪ Figuring out growth strategy
▪ Retaining/Attracting skillful talents
Future
▪ Political boundaries
▪ Regulation
▪ Sustainable Funding
▪ Economies of scale
FOCUS
▪ Funding sustainability
▪ Skilled force retention
▪ Adaptability & Scalability
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Recommendations
▪ Build partnerships
▪ Pricing model/market research to assess affordability in each region
▪ Exchange programs with prestigious hospitals, institutes, and companies
▪ Region-wide/Nation-wide campaign to promote its value proposition
▪ Focus on a specific intervention
▪ Leverage other players’ infrastructure with minimum investment
▪ Price discrimination to maximize profit
▪ Improve staff retention and attract talents
▪ Increasing awareness
▪ Replicate the success across interventions
▪ Achieving economies of scale
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MIT OpenCourseWarehttp://ocw.mit.edu
15.232 Business Model Innovation: Global Health in Frontier MarketsFall 2013
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