IRD-CHMI Hub Meeting Part 1: A Focus on Sustainable Business Plans

In the first of a two part series, we overview the sustainability plans of the IRD-CHMI Hub’s member organizations.

Public health organizations are increasingly developing  operations that focus on sustainability. However, integrating a successful business model is often a daunting challenge.

Interactive Research and Development, CHMI’s Regional Innovation Broker in Pakistan developed the Health Market Innovations Hub to bring together public health groups in the country to find innovative solutions to healthcare delivery. The second meeting of IRD-CHMI Hub was held on May 3rd and 4th in Karachi, Pakistan. Whilst the Hub has previously covered a variety of themes, the second meeting focused on the challenges of sustainability and business plans for public health programs in Pakistan.

A new group of participants in the hub broadened the scope of the discussions, and each program shared their innovative business models. The programs that attended the meeting were Naya Jeevan, SINA Health, Innovations for Poverty Alleviation Lab, Interactive Health Solutions, Education & Welfare Trust, Indus Blood Center, Community Health Solutions and Pakistan Innovation Fund.

Naya Jeevan

“It’s all a numbers game”

Naya Jeevan is a not-for-profit social enterprise that provides low-income families with affordable access to quality healthcare. Naya Jeevan offers its insurance program in Pakistan at subsidized rates under a novel national group health insurance model.

Naya Jeevan’s model leverages corporate value chains to provide affordable healthcare insurance to the poor and uninsured in Pakistan. The organization approaches major corporations, usually multi-nationals, and finds people working as suppliers for the company who are not covered by the company’s basic insurance plan. It offers these people bulk health insurance at subsidized rates after individual negotiations from various health insurance providers. The large number of people recruited for the plan helps lower the per person cost of covering each individual. Using this model, Naya Jeevan has identified a large percentage of Pakistanis who work for or with a corporation and can thus access this type of health insurance plan.

Naya Jeevan has discovered that certain health insurance plans are not feasible for the lower socioeconomic demographics of the country. Citing an example of a restaurant chain, Naya Jeevan discussed how the restaurant owners were wary of renewing the health insurance of their employees as most of them had not needed the free hospital stay coverage included in the plan. As a result, the company discovered that what the demographic really found costly were the regular clinic visits and outpatient treatment options for more common health issues such as the flu or the common cold. Thus, Naya Jeevan now offers a customizable plan to its corporate clients allowing them to choose which part of the healthcare will be most needed by their employees.

What makes Naya Jeevan distinctive from traditional health insurance companies in Pakistan is its readiness to absorb risks by insuring the poor, and to focus on delivering healthcare rather than maximizing profits. It has built a health model where it plans to incorporate benefits such as ambulance services, adding pharmacies into their plan and providing a 24 hour helpline to low-income clients. In this way, it plans to create a hub to organize healthcare delivery in Pakistan so a Naya Jeevan user can use a single card to access hospital visits, outpatient care, and medication from the pharmacy as well as other services.

SINA Health, Education and Welfare Trust

“The same people who were threatening to kill us a couple of years ago were now having a cup of tea with us.”

 SINA Health, Education & Welfare Trust is a professionally managed, not-for-profit trust founded in 2007 that provides quality primary healthcare to less privileged communities. To date, SINA has established seven quality primary healthcare clinics in urban slums of Karachi. The organization provides high quality care through its centers by establishing Standard Operating Procedures for each patient interaction.

Since its establishment, SINA has overcome a range of challenges ranging from staff recruitment to security. It has now found an innovative approach to finance its operations by using Zakat, a mandatory charity for all adult Muslims above a certain income level. In Pakistan individuals are required to give an annual 2.5% of their savings to charity to be redistributed to the neediest people in the country. SINA targets areas where more than 70% of the local residents are eligible for Zakat. They then negotiate with the government and wealthy individuals to acquire a substantial amount of the Zakat allocated to the area. This money contributes to around 75% of their funding to support development of new clinics, renovations and staff salaries. The remaining costs are recovered through charging small user fees. Operational costs for the programs are now exceeding a million US dollars per year.

SINA’s partner organization ChildLife has also sought to improve quality of care at public sector paediatric and neonatal emergency care facilities. Before the program, the survival rate for a patient entering an emergency room was 15%. Medicines were not readily available, nursing staff was not well-trained and the doctors were overworked. SINA first took charge of the pharmacy and established a supply-chain that improved the survival rate to 22%. Subsequently nursing staff were trained in best clinical practices, increasing survival rates to 44-45%. Finally, SINA added new doctors to the clinics, recruiting young residents who were looking for quality training and experience. This allowed the survival rate to increase to almost 70%. The program now seeks government and philanthropic support to expand into other healthcare facilities.

Innovations for Poverty Alleviation Lab:

“Don’t reinvent the wheel. Invent something new”

Innovations for Poverty Alleviation Lab works to bridge the gap between technological innovations and social development. IPAL aims to develop a platform for social impact where different methodologies are infused together to create an environment conducive for innovations for sustainable and affordable technology.

IPAL is linked to Information Technology University in Lahore. They recruit the best and brightest of Pakistan’s young technological minds and equip them to start social enterprises based on technological innovations developed in their coursework at the Lab. While more of an educational hub than a social business, IPAL’s contribted a fresh perspective on the use of technology in public health and successfully commercializing innovative designs.  The lab has worked towards developing low-cost glucometers, water purification devices as well as RFID enabled cards for measuring filtered water dispensation. IPAL also suggested providing their students to the present organizations as summer interns to help develop innovative, low cost health solutions.

The second part of this blog series will discuss other program participants as well as the Disruption Theory as it applies to the healthcare delivery in Pakistan.