Technology For Impact: Solving India's Last Mile Healthcare Challenge
Data doesn’t lie. It tells stories. The more diverse the data gets, the richer is the story – with multiple angles, and not-so-obvious connections. One such story is that of the India of 2017, told in three points using results of three data-intensive studies, conducted exclusive and independent of each other. It goes as follows.
• India is the country to watch for as one of the rapidly-rising innovation powerhouses in Asia. The 2017 Global Innovation Index study, an annual benchmarking exercise jointly conducted by WIPO, INSEAD and Cornell University, pegged India at the top of the table within the central and southern Asian region. On innovation quality, India stood at a solid 2nd amongst BRIC nations. Her world rank, however is 60th out of 130 countries.
• India could have been in the running to be a world leader in innovation but for its vulnerability to many diseases, snatching many of her people’s chance to contribute. The 2017 Healthcare Access and Quality Index study published by the journal, The Lancet placed India in the lowest rungs, at rank 154 out of 195 countries. India came out as one of the biggest underachievers in Asia in healthcare access. More than half of her adult population is under debt, and a third is pushed into extreme poverty due to catastrophic healthcare expenses – a rough measure of the quantum of India’s lost opportunity.
• Is India not fueling its innovation prowess to overthrow one of its biggest developmental roadblock – the health of her people? The answer is sadly in the affirmative. Sparingly and selectively, as evident from India’s start-up base in 2017 – a direct reflection on the direction the nation is taking. NASSCOM’s Start-up study for 2017 reported a paltry 6 per cent of those in health-tech against a whopping 55 per cent in travel-hospitality/food-tech sectors. Most health-tech start-ups directly target urban and semi-urban consumers, suitably informed and well-off to indulge in preventive healthcare via diagnostics and fitness-monitoring apps. These exactly cater to the ‘time and convenience’ need of this segment. The urban and rural poor along with middle-class households have remained largely untouched by the health-tech innovation wave. Their dual need is accessibility and affordability. This is India’s ‘Last Mile Challenge’ in healthcare. Topology along with lack of information and infrastructure are major impediments for timely delivery of health services to one and all. Innovation and technology targeted here would change India’s story, making a remarkable impact right at the grassroots, and in pulling up India’s latent potential.
The game changers–cum–change agents
This decade saw mobile apps and digital platforms that changed the game in their fields. A few recent ones have the potential to bring about a societal change in addition to being game changers.
eVIN is an excellent example in the latter category. It addresses the challenges in managing logistics and the cold-chain for distribution of vaccines. India has presented a stellar example to the world in her resolve, policy-making and implementation of vaccination drives to fight diseases. India is also the largest vaccine-manufacturer. Yet, she is home to one-third of the world’s unimmunized children. Much of this is to do with the tyranny of distance and terrain faced by health workers to procure and maintain stocks, to prevent shortages in remote and isolated areas within the country. More complexity is thrown in by the virtue of vaccines being biologicals. They have a short shelf-life. Through eVIN, the Government of India is working towards digitizing information on vaccine stocks across more than 27,000 cold chain points. Inventory can now be tracked in real-time via its smartphone app. SIM-enabled sensors allow temperature monitoring to ensure potency of vaccines during storage and transfer. eVIN’s full-blown execution will have a wide-scale impact – positively affecting lives of 30 million pregnant women and 27 million newborns annually.
Another example of an app aiming to increase access to cardiac care in rural India comes from the private sector. Uber Diagnostics is working together with NGOs to connect primary health care clinics in far-flung rural sites within India to cardiac specialists in big cities through their Cardiotrack platform. An ECG recorded through the portable Cardiotrack device saves considerable cost. More importantly, it enables timely detection and action for cardiac emergencies. Heart health is no longer an urban issue. The Indian Council of Medical Research recently reported an epidemiological transition in the health profile of India in the last two decades. More Indians now die of non-communicable diseases of the heart or brain than infections or nutritional deficiencies.
Several such tech-enabled health platforms are being developed and deployed around the world that Indian innovators and investors can derive inspiration from. For example, the Familia mobile app is being extensively used by health workers in Tanzania to reduce maternal mortality by increasing contraceptives prevalence.
Rapid advances in mobile and web-based technology, and data analytics, if used to support India’s health objectives will make her shine. The need of the hour now is for the government to roll-out policies that encourage investors to pursue innovation in health technology for a large-scale impact on the population. Will it? That's the million dollar question. (The author is thankful to Ms. Manishree Bhattacharya of NASSCOM for sharing useful data on India’s start-up ecosystem.)