Wharton Around the Globe: Improving Access to Primary Care in Mumbai, India

Contributor: Viba Saligrama, WG’17
To learn more about Vibaclick here.

 

This past spring break, three members of the Wharton Global Health Volunteers (WGHV) traveled to Mumbai, India to work with Swasth Foundation (Swasth). In India, “Health Shocks” drive 60 million Indians below the poverty line each year. Primary care can reduce the “Health Shocks” by 2 - 2.5 times, but inadequate public infrastructure leaves the urban poor without enough access.  Swasth is working to address this issue with a mission to create Health for All. They have built 18 low-cost, scalable, and patient-centric clinics providing one-stop access to high-quality, affordable services at less than half the market rates. Swasth plans to scale and build 50+ clinics in the coming years.

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The Swasth clinic directly sources drugs, has an in-house pathology lab, and low overhead model that allows them to provide drugs at 50% off the suggested retail price and services at very low cost. However, many in these urban communities are unaware of the great advantages of visiting a Swasth clinic. To increase membership, the Wharton team worked on developing and marketing a discount pass program. The team analyzed clinic data to understand the frequency and demographics of current Swasth patients, constructed patient surveys to test attributes that patients would value most in the discount program, and developed an implementation plan for launching the new program. Some of the attributes to be tested included greater discount on drugs and labs, unlimited primary care visits, and pass fees. The team thought of potential partnerships with the dabbawallas and domestic maids to promote the program.  The model is similar to direct primary care in the USA. 

The team also researched opportunities for Swasth to provide broader insurance coverage for hospitalizations, as this seemed to be a large concern for many in the urban working class communities.  Organizations like LIC, Apollo Health, and Star Health provided preliminary premium quotes and Swasth will continue to refine these proposals in the hopes of eventually providing broader insurance coverage or cash payouts in the event of hospitalization.

The Wharton team had the opportunity to visit Swasth clinics and were very impressed by their use of space and technology. In each clinic, there is a small patient waiting area, dental area, primary care area, lab sample collection, and drug dispensing. Each patient is uniquely identified with a patient ID, and all medical information is tracked in a custom-built electronic health record. Patients are also provided with paper copies of their medical history in a Swasth folder. The clinics effectively used limited space to be  truly patient-centric. The team also shadowed a community outreach worker to better understand the needs of patients and importance of the clinics.

Everyone at Swasth was truly passionate about improving healthcare, and it was energizing and rewarding for the Wharton team to learn from them about low-cost innovation and support this cause. The Swasth team also enjoyed working with the Wharton team and hopes to stay in touch and work with other Wharton students in the future as they continue to scale.  All members of the WGHV who were selected to participate this past spring would like to thank our alumni for assisting in making this trip possible.  

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Hardik Mehta (Swasth), Viba Saligrama (WG 17), Yang Hu (WG 17), Ravi Mulani (WG 18), Sundeep Kapila (Swasth Founder)

 

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Ravi Mulani (WG18) and Yang Hu (WG 17) working in the Swasth office.

 

 

Contact Viba at:
vsali@wharton.upenn.edu