The cost of health care in Pakistan drives 7 million people into poverty each year according to a 2010 World Bank report. Public health expenditure represents less than 1% of GDP and consumers pay out-of-pocket for 97% of private sector services. Naya Jeevan, Urdu for “new life”, is a non-for-profit social enterprise dedicated to providing affordable health care to low-income families in Pakistan. Founder and CEO, Asher Hasan, stopped by the R4D headquarters to update the CHMI team on the organization’s groundbreaking work.
Beyond what Naya Jeevan does, is the story of why they do it. During his visit to R4D, on the heels of his participation in the annual forum of the International Partnership for Innovative Healthcare Delivery (IPIHD), Asher Hasan shared the story of six children that inspired his life’s work. Their mother was a domestic worker employed by Hasan’s family, and their father worked as an auto mechanic. Determined to break the cycle of poverty, their six children were enrolled in school and had bright futures. However, a catastrophic stroke left their father paralyzed and the children were pulled out of school, diminishing hopes for a life without poverty.
These bright futures could have been persevered, and the cycle of poverty may have been broken if access to health care was accessible and affordable to Pakistan’s myriad of informal, low-wage workers.
Naya Jeevan’s insurance model works with corporate employers to target the large non-corporate informal workers that operate within their networks. For instance, at Unilever (Naya Jeevan’s first partner) one corporate employee utilized an average of 4.5 domestic workers, who each had an average of 6.2 dependents. In this context, one employee indirectly supports between 20 - 25 individuals from Pakistan’s poorest populations.
This insightful PBS video story features Unilever and other companies that have adopted the Naya Jeevan model. Both employers and beneficiaries are pleased with the outcomes.
Watch Combating Poverty in Pakistan by Offering Health Insurance on PBS. See more from PBS NewsHour.
Naya Jeevan targets this supply chain with a socially responsible insurance model that uses corporate employer subsidized health insurance to provide services to:
- low income corporate employees and their families;
- domestic staff (maids, cooks, drivers of the corporate officers/managers);
- low income vendors, distributors, suppliers, and customers on a loyalty plan.
With passion and conviction, Asher has grown Naya Jeevan from an unfunded landscape analysis with a group of Berkley graduate students to a sustainable, scalable, and replicable health innovation. Naya Jeevan’s self-defined “ecosystem of empowerment” health model is a multifaceted package of health services far beyond basic health insurance.
At the core of this model is a cashless health/life and disability insurance program that equates to roughly $2/month. This is packaged with a range of programs including:
- A 24-hour Tele-Health Line staffed by Naya Jeevan physicians who are delegated a roster of patients. This maintains continuous care and patients build a trusting relationship with their care provider. These doctors also serve as advocates for these lower income patients when they enter private hospitals for emergency care by liaising with the ER staff, ensuring discrimination does not interfere with quality care.
- Medical screenings and health risk assessments are provided at the start of membership for all patients.
- A philanthropic rescue fund is set up to cover care that may not be included in the insurance scheme.
- Preventative health workshops that educate consumers and build a basic level of health promotion among users
In 2010, Naya Jeevan received an innovation grant from ILO’s micro insurance facility to help further scale their project. The learning agenda for the grant included analyzing the value of multinational corporations, academic institutions, SMEs and NGOs as efficient distribution channels for the Naya Jeevan health plan. Emerging lessons from this report can be found here.
Asher also shed some light on upcoming initiatives that sound very exciting:
Access to safe transport for women is a huge unmet need in Pakistan and Naya Jeevan has proposed the “Busanti” Public Health Bus as a potential solution. Hindi for "spring", Busanti aims to provide public transportation coupled with access to an affordable health plan. The bus will also employ public health nurses that provide women’s health information to passengers during travel. Check out their video submission to Grand Challenges Canada :
Pharmacy Benefit Management and mobile banking proposals are also underway at Neya Jeevan. These initiatives aim to streamline the consumer process by collaborating with Pakistan’s major banks to create ATM cards that can serve as cashless platforms for filling digital prescriptions, receiving discounts on pharmaceuticals, and other health services.
Neya Jeevan is also in the process of creating an outreach program for diasporas in North America who wish to provide access to health services for relative still in Pakistan. This program, dubbed Rejuvenate, is predicted to cost $30/person/month and can provide a means for North America’s Pakistani community to provide health services to family back home.
During his time at R4D, Asher also spoke to the many lessons Naya Jeevan learned since they launched in 2008, including:
- “Doing your homework” is crucial: Naya Jeevan interviewed over 250 corporate, academic and public sector stakeholders during their primary market evaluation.
- “Diversifying your suppliers” puts you in control of your product: Naya Jeevan negotiated contracts with three insurance providers and a network of over 170 medical centers.
- “Offer tangible services with intangible insurance”: Naya Jeevan expanded their core to include preventative health services in 2009.
- “Have a contingency plan”: Hasan spoke at length about the 2010 floods in Pakistan that displaced 20 million people. During this time, the focus was on rural rescue and relief and not the urban populations Naya Jeevan targeted. The program shifted gears and went into rural populations that were within an hour to urban centers and enrolled 5000 rural members.
Over the past 3 years Naya Jeevan has collaborated with over 100 organizations to expand their model and serve 23,000 active members enrolled into the health plan.
As they continue to grow CHMI is excited to hear more about their efforts to provide affordable and accessible care to those at the base of the pyramid in Pakistan.