Authors: Devendra Tayade and D.V.R. Seshadri

Synopsis :

Published on Harvard Business School Publishing (HBSP) site on March 08, 2021

Summarised by Minal Agarwal, Manager ISB-CBM

Basic Healthcare Services (BHS) is a primary healthcare organisation based in Udaipur, Rajasthan. Dr. Pavitra Mohan and his wife, Dr. Sanjana Mohan, started BHS with other dedicated public health and development professionals as a not-for-profit organisation in 2012. The vision behind setting up BHS was to provide access to reasonable quality, ultra low-cost healthcare to poor people in rural Southern Rajasthan. The case sheds light on primary healthcare in rural India and various challenges in setting up a private-initiative-driven healthcare system for the poor. This is important given that the public healthcare system for the poor has failed in most parts of the country.

BHS worked on an innovative model, which was less dependent on the doctors. It collaborated with community health volunteers who were trained regularly by a team of doctors at BHS. Each primary center followed a standard operating procedure that helped the volunteers handle 90% of the patient independently. At each BHS clinic, patient details were entered into a simple online system. The data could be accessed by any authorized personnel.

Dr. Mohan and his team would regularly meet with the villagers and educate them about different diseases and possible treatments. These communications helped them in fosterning trust. Patients were also ready to pay a nominal fee (in the range of Rs. 50) for their treatment, since they were assured of quality healthcare. Repeat visits were included in the same fee that the patient paid.

BHS had done very well in bringing the organization to its current stage. Its work had helped alleviate the suffering of tens of thousands of people in the area where they chose to operate. However, Mohan’s dream was to reach out to the last mile of patients across the country. To achieve this dream, Mohan had to address two big challenges: Financial viability and organizational growth.

  • BHS had a limited scope of increasing its revenue through patient fees. Can Mohan motivate other like-minded doctors to build similar ecosystems in their respective proximate geographies of operation? If so, how was he going to do this?
  • BHS had worked on the public-private partnership by collaborating with the local government at several government-run primary healthcare centers (PHCs). Several of these that were hitherto defunct, were running well after BHS took over the operational responsibility of these centres. Could BHS replicate the same model for other areas?
  • Some healthcare organisations had dedicated teams for mobilizing grants and donations. Will that require new competencies for successfully leveraging? How as Mohan going to develop those competencies, especially in a resource-starved environment in which BHS operated.
  • How was Mohan going to get the committed manpower needed to scale up the footprint of the organization?

There were many options for growth that Mohan could pursue. However, one wrong step could result in his already financially fragile organization, to come to a screeching halt.

Learnings from the Case:

  • Understand the strategy and business model of an idealistic, private initiative to deliver value to those at the bottom of the pyramid organization who are in need of life-saving services.
  • Evaluate the role of collaboration and stakeholder engagement for the success of an organisation that operates in a resource-constrained environment.

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