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>View discussions about this entry Country: India
Organization: Narayana Hrudayalaya Institute of Medical Sciences
Focus of activity - Other
Year the initiative began (yyyy) - 2003
Positioning in the Mosaic of solutions
Define the innovation - What is the main focus (product, services, etc) of your innovation? Who are the primary beneficiaries? How does it make health and/or health care more affordable, accessible, and simpler to achieve/use? How does it differ from what currently exists in the market? The cost associated with ill-health- including medical bills and indirect costs such as lost income- can be catastrophic for the poor. Recent studies reveal that rural households spent nearly 10 to 26 per cent of their total household income on healthcare. Out-of-pocket payments are estimated to finance about 60 per cent of health expenditure, which is an important barrier to access services for the poor
Contributing Rs 120/- per person annually to the Yeshasvini Scheme, the farmer in Karnataka provides a secure healthcare cover for himself. The scheme provides him free medical consultation any number of times, Investigations at discounted rates, and free surgical treatment at network hospitals. Context for Disruption: - Describe how your innovation is transforming traditional health or related systems in the short and long term. In India, estimates suggest that 90% of India’s families earn their livelihood from the unorganized sector, contributing 40% of the nation’s GDP. However they do not have any form of insurance or security (maternity benefits, retirement, health insurance). The poor are particularly vulnerable to the lack of health security. The burden of treatment is devastating for major health issues. In fact healthcare costs are one of the primary reasons for rural indebtedness and poverty, with morbidity cutting into their budgets in two different ways, i.e. they need to spend large amounts of money for treatment and are unable to earn while under treatment. Yeshavini Scheme was our solution to making healthcare affordable.
The scheme was launched for the farmers of Karnataka who are members of agricultural cooperative societies. In the event of a sudden health problem, even the farmer who has some land and cattle finds himself at the mercy of the local moneylender who charges exorbitant rates of interest when he needs to deposit money for treatment. The scheme has proved to be a boon to the rural community who spirals into depths of debt and suicide, due to the illness, crop failure, famine and drought. The Scheme now gives him the right to walk into a private hospital, avail of the best treatment without having to spend anything. Delivery Model - How does your innovation reach its target populations? What mechanism(s) (e.g., communications, distribution channels, etc.) do you have in place? What is your current market penetration? How do you measure this? The scheme is also one of the best examples of efficient public-private partnership in health between a state government, rural cooperatives, public and private healthcare providers. The scheme was initiated by Dr Devi Shetty, Chairman, Narayana Hrudayalaya Institute of Medical Science, in association with the Department of Cooperation, Governement of Karnataka.
A Trust, which has representation from the doctor community, as well as the Government runs the scheme. The Government machinery already in place is used to reach the target population. The rural agricultural cooperative societies are governed by the Department of Cooperation and its organization. Using the existing channel of communication has brought down the administrative costs to the minimum. This also ensures the communication reaches each farming society even in the most remote part of the state. Key Operational Partnerships - What key partnerships have you established to make your disruptive innovation model possible? Who are your partners (business, social, government, other) and what are their roles? How central are these partnerships for your initiative. The cornerstone of the Scheme is its partnerships. The Government provides support in terms of infrastructure for the scheme, the network of hospitals provide treatment for fee as well as complementary free consultation and discounts. The Hospitals also support the scheme by accepting a much-discounted rate for the services rendered.
Access to quality private Hospitals makes the Scheme attractive to the members, while access to such a large target population would not have been possible but through the Government machinery Financial Model - Describe the financial model for your innovation. What percentage, if any, of the total operating costs does earned income (from products, services, or other fees) represent? The Yeshasvini Scheme collects Rs 120 annually from its members, which builds up the core fund. The Government compensates any shortfall in the finances. A Third Party Administrator has been employed by the Trust to administer the Scheme for a fee. In the year 2006-07, 1% of the premium collected was paid to the TPA as fees.
Effectiveness - What has been the measurable impact of your project to date? How many people have benefited from your program in total? What policies, communities, or institutions have been influenced to make fundamental changes because of your work? The success of the Scheme can be measured in terms of the number of people who have utilized the scheme. Over a period of 4 years over 80000 surgeries were conducted.
The utilization for surgery ranges from .55% in the first year to 1.97% in the year 2006-7. This is apart from the members using the OPD consultation facility offered by the hospitals for free. Occupancy of Hospital beds in Karnataka state was as low as 30 % couple of years ago. Many small hospitals were on the verge of closure because of the low occupancy. With large number of the society now capable of paying for the services, the hospitals also shown considerable growth. Upgradation of facilities is also being done since there is an assured clientele.
Scaling up Strategy - What is your priority for the next 3 years and please describe why. Schemes like Yeshasvini works on large membership base. Efforts are on to make the Scheme most member friendly and also include services beneficial to the patient. For eg, recently accident and emergencies have been included under the scheme. Expensive Cancer treatment is also being considered.
Origin of the Initiative - Tell the personal story that will help people connect to your work. How did the initiative start? Was there a particular individual or event driving the idea? Tell the reader the story behind the innovation. Years as a practicing doctor, made Dr Devi Prasad Shetty come face to face with the reality of Indian healthcare. He understood that at least in the more developed southern states, illhealth was not because of the lack of health infrastructure, but because people couldnt afford it.
He made it his mission to make Health accessible to the poor. The scheme was a result. Contact Information:
Priti Jacob
CEO, Micro Health Programme Narayana Hrudayalaya Institute of Medical Sciences (Business ) pritijcb@yahoo.com 258/A, Bommasandra Industrial Area, Anekal, Bangalore 99 India Tel: 080-27835208 Fax: 080-27835208 Website: www.yeshasvini.org Discussions about this entry |
Affordable Health for all
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