This piece was published on the World Health Partners blog.
Recently, Ashoka India selected WHP’s Founder and President, Gopi Gopalakrishnan to be one of its new class of twelve 2015 fellows. The fellowship is aimed at fostering the work of leading social entrepreneurs who present innovative solutions to social problems in India.
Ashoka is the largest network of social entrepreneurs worldwide, with nearly 3,000 Ashoka Fellows in 70 countries. Founded by Bill Drayton in 1980, Ashoka launched the field of social entrepreneurship and has activated multi-sector partners across the world, which looks to entrepreneurial talent and new ideas to solve social problems. The fellows are the core of the Ashoka community and offer valuable insights on how the world is moving and what is needed next.
“I am so thrilled and humbled to have been selected as one of Ashoka India’s 2015 fellows,” said Gopalakrishnan. “It is truly an honor to join this prestigious community of creative and dedicated social entrepreneurs. I think this will be a wonderful collaboration and a way of forwarding WHP’s work to bring healthcare networks and services to underserved communities.”
Gopalakrishnan is being recognized for his work pioneering new approaches to realizing the potential of existing, information healthcare providers in India. WHP is helping to fill service delivery gaps and meet health needs in underserved, rural communities of Uttar Pradesh and Bihar in India as well as in Kenya with plans to expand.
In rural India, where the ratio of qualified doctors to patients is 1:25,000, as many as 40 percent of the government primary health center do not have doctors or diagnostic facilities. Doctors, in both the public and private sectors, often choose not to work in remote, rural communities because the pay is low and it can be isolating.
In the absence of qualified doctors in these communities, informal healthcare providers may assume the role of caring for the sick. Some of these providers have been trained as optometrists or pharmacists or have had experience working as an assistant to a doctor. Other providers may open clinics in rural villages and prescribe medicines without any formal qualification or training. Although in some areas, these so-called “quacks” need to be shut down for providing sub-par care, many of the informal healthcare providers do offer effective healthcare to the extent their training allows.
Part of Gopalakrishnan’s approach and vision for WHP has been to build an innovative social franchising and social marketing model that links informal providers with more highly trained healthcare professionals within a network linked by telemedicine connections. The network is operated with basic SIM cards in areas where Internet connectivity is low as well as another system that allows for video conferencing in areas with better connectivity.
Participation in this network allows for ready referral and consultation systems, imposes quality of care standards, and offers additional training and support for rural providers. The network allows informal practitioners in rural communities to easily talk to doctors in cities. With this kind of support, the informal providers can better diagnose and treat patients, ultimately providing a higher standard of care.
This approach has produced impressive results. There are more than 11,000 rural centers in India run by entrepreneurs work in collaboration with personnel from the public sector under an official arrangement with the government. This combination of medical skills of the public sector combined with the entrepreneurial and people skills of the private sector has led to a 50% drop in diarrhea and pneumonia—two major killers of children—in three years; intra-uterine device insertions went up over 30 times; and tuberculosis detection and treatment went up nine times within one year.
Network participation also mandates that providers offer the less lucrative, but essential, preventive care services such as immunizations and family planning, but allows them to bundle these services with curative services that are often better compensated. This approach helps to ensure communities can get access to comprehensive preventive care.
Gopalakrishnan’s work at WHP has also prompted the creation of local, healthcare commerce eco-systems, including supply chains for generic drugs and diagnostic services offered by local entrepreneurs. These ecosystems offers additional employment opportunities in resource-poor communities as well as much needed healthcare services. So far, Gopalakrishnan’s vision has brought together a network of over 12,500 cost-effective providers across India and Kenya, which have provided healthcare services to millions of rural patients, 51% of whom are in the two lowest economic quintiles.