Indian Hybrid Organization Fighting against Unequal Access to Primary Healthcare

Photograph: DFID
Photograph: DFID

Doctor shortage, poor infrastructure, long wait times (especially for women), high diagnostic costs and extensive travel for treatment… all of these results in avoidable deaths and high mortality rate in rural India. According to the Lancet (2015), more than 2,000 primary health centers in India were operated without a doctor and more than 5,000 have no pharmacist.

Addressing these issues, Rural Health Care Foundation (RHCF), co-founded in 2007 by a compassionate social entrepreneur Arun and Anant Navatia, runs 12 self-sustaining primary healthcare centers in West Bengal. Despite the fact that RHCF charges only 90 cents for consultation and medicines for seven days, 75% of its total expenditure is generated through fees charged. In addition, patient charge could be reduced by 10 cents for every hour of waiting so that poor patients are more likely to afford its service. RHCF’s scaling strategy focuses on providing primary healthcare. It prioritizes geographical coverage, supported by strategic partnerships with other mission-driven organizations. While RHCF treats 25 thousand patients per month, its partners performed over 9,000 eye surgeries and provided more than 32 thousand spectacles to the poor. In order to reduce its cost, RHCF purchases not only generic medicines at bulk but also near-expiry medicines.

Although RHCF has been faced with various challenges, non-monetary rewards attract doctors and young professionals as its volunteers. The co-founder, Arun Navatia said, “social entrepreneurship is like an addiction. Once you get hooked on to it, it is difficult to come out. An old lady who was a beggar by profession for cured in our center in Mayapur. She gave us a donation of 10 rupee so that we could buy sweets. The gratitude that one sees in their eyes is our reward – thats what keeps us going (Indian Institute of Management Bangalore, 2013).” Overcoming difficulties, RHCF has been in consultative status with the UN Economic and Social Council (ECOSOC) since 2013.

Today, medical tourism is an emerging industry in India on the one hand. Its sector is estimated to be worth US$3 billion and projected to grow to &7-8 billion in five years (Economic Times). For example, the luxury Japanese-style general hospital in Bangalore was jointly ventured in 2014 by Secom medical System Co. Ltd and Toyota Tsusho Corporation. Yet, on the other hand, 400 million people still have no access to essential health service and 6% of people in low to middle income countries are tipped into or pushed further into extreme poverty because of health spending, according to (WHO/ World Bank Group Report, June 2015).

As RHCF’s scaling-up strategy, it sets a goal to establish additional primary health care centers in the remotest corners of India. RHCF highly appreciates donations to reach out the last-mile vulnerable populations. Followed by RHCF, Aravind Eye Care System and Vaatsalya Hospitals, more hybrid organizations pursuing dual objectives are expected to fight against inequality that threatens our social and political stability.


This article is based on Shreyas Navatia’s presentation at Yale School of Management in April 8, 2016. His permission is obtained to publish this article.


Indian Institute of Management Bangalore (2013) RHCF: Reaching Primary Healthcare to the Base of the Pyramid.

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