Krishnamurthy (Gopi) Gopalakrishnan

Organization: 
World Health Partners
Year founded: 
2008
Country: 
India

The WHP model builds on the existing and often unregulated private health delivery networks by bringing order and high quality of service to informal health markets.

Focus: Health
Geographic Area of Impact: India
Model: Leveraged Not-for-Profit
Number of Direct Beneficiaries: 550,000 (2012)
Annual Budget: US$ 5.6 million (2012)
Percent Earned Revenue: 5%
Recognition: Social Entrepreneur of the Year 2013

Background
In much of the developing world, over 70% of the health facilities are often in the urban areas, while over 75% of the population resides in rural areas. The challenge is getting public health programs to deliver services close to the patients amidst a variety of systemic, resource, and infrastructure challenges. This is particularly true for preventive services like family planning and antenatal care. Governments have attempted to address the challenge of health care delivery by dispatching a cadre of formally trained professionals to rural areas, but this is costly and has often backfired as these “outsiders” lack deep communities ties and must work for years to build trust. Additionally, urban professionals are often not willing to live and practice in remote and challenging locations. Village-based informal sector providers, on the other hand, are integral and respected members of their communities, even though they often have minimal or no formal training in medicine. Hence, they present a unique opportunity to leverage the existing labor supply that will, by its nature and attributes, remain in place to serve their respective communities.

Innovation and Activities
The WHP model uses technology and franchising to increase the quality and coverage of essential health services to rural areas, including the poorest states in India – Bihar and Uttar Pradesh. Here, the model leverages the informal health system by franchising rural providers and integrating them into the nation’s formal health care delivery system. WHP franchisees use “Sky” brands: “SkyHealth” centers are internet-enabled, and can connect patients with city doctors through audio-visual devices that also transmit patients’ vital diagnostics. “SkyCare” providers connect their patients with doctors on their mobile phones. In addition, WHP has certified pharmacies and diagnostic labs in their ecosystem of health services.

The franchise system allows WHP to leverage local community relationships, provide a way for rural providers to refer acute patient cases to trained medical professionals, and administer an oversight mechanism that ensures quality of care delivered by rural providers. The system offers significant benefits for rural providers as well. As part of the WHP network, health providers, whose primary interest is curative care, get a major financial opportunity to facilitate city-based doctors’ care in villages via telemedicine, in addition to door step delivery of high quality generic medicines and family planning products, as well as collection of samples for diagnostic investigations. These value-additions dramatically increase the quality, breadth, and desirability of their services. In return, they need to fulfill WHP’s mandated objective to deliver less profitable preventive services, such as antenatal care and family planning. Rural patients benefit from affordable and preventative care and unprecedented access to qualified doctors. Sky providers earn for every telemedicine consultation conducted (25%-40% of the consultation fee goes to WHP). Cost per consultation to the client ranges from US$ 0.10 for a simple phone consultation to US$ 4 for consultation with a specialist. To ensure that Sky providers do not discriminate based on ability to pay, WHP subsidizes consultation fees for those presenting a government issued below poverty line (BPL) or insurance (RSBY) card. Through WHP services, patients on average save US$ 6 per episode of illness, factoring in a day of lost wages and travel costs to health access points. To date, WHP supports 4,727 SkyCare rural providers and 529 SkyHealth clinics in the states of Bihar and Uttar Pradesh in India.

The Entrepreneur
Gopi Gopalakrishnan founded the first large scale rural social franchising program, Janani, in the state of Bihar in 1995, devoted to providing reproductive health services. Gopi has been a member of India’s Population Commission, advising the Ministry of Health and Family Welfare, and the National Rural Health Mission. In 2007, Gopi received a prestigious civilian honor from the Government of Vietnam for his contributions while serving as Country Director of DKT International in Hanoi. Gopi was educated at the Birla Institute of Technology and Science in Rajasthan.