RHCF: Reaching

Primary Healthcare
to the base of the
Pyramid

Group 9
Siddharth Panpaliya-ABM18006
Hensi Sheth - ABM18017
Vidhi Agarwal- ABM18023
Aakarsh Gupta ABM18031  
Hemant Upadhyay -ABM18043
Prakash Jadhav ABM18047
Kuldeep Singh - PGP37216
1.1 Rural HealthCare Foundation- ABOUT RHCF

WHAT DOES IT DO?

RHCF is an NGO providing primary medical care to the downtrodden in rural India
through a model which is Reliable, Affordable, Accessible, Scalable and Sustainable. We
set up a chain of out-patient primary healthcare clinics in healthcare-deprived densely
populated regions of West Bengal. 

VISION MISSION
• To set up primary health care centers in the • To eradicate the lack of health care
remotest corners of India, replicating the facilities in rural India by creating a chain
current service delivery model. of primary health care units.
• The provision of a mobile hospital • To offer high-quality, affordable
equipped to provide basic medical services outpatient care in low-income, densely
at the doorstep of the poorest. populated regions, where health care
delivery by the state is sparse.
 RHCF: Evolution
1.2 journey

Early days Evolution Future

• RHCF owed its origin to Late • Started Mayapur clinic with a • RHCF is getting recognition
Shyam Sundar Nevatia’s general physician, a dentist, from across the globe.
philanthropic ambitions an optometrist, and UNICEF India are willing to
• Provided free medicines to homeopathy doctor work with them
Chaitanya Math in Mayapur • Gradually, opened 9 centers • Won Salaam Bengal award
• Later sons Arun and Anant • Entered into alliances with 2011,Indian volunteer award
took over  different organizations like and, 3rd ISB iDiya award
• Started with Rs. 5 for Rotary club, Smile Train • Aiming to open more centers
primary care and medicine Foundation, Medtronics etc. across West Bengal
• They Operated under their • Increased consultation fees to • Aiming to achieve
family trust  Rs. 40 for allopathic and Rs. 30 operational sustainability
for homeopathic doctor
Amazing Indians - Providing low cost healthcare in rural India

https://www.youtube.com/watch?v=EByN10ERgUM
 1.3 Business Model of RHCF- Modus Operandi

General Physician Dentist Optometrist Homeopathy Clinic Staff

Doctor
• A retired doctor • Highly • Highly qualified • Experienced
also serving as qualified BDS BOPTM • Highly qualified staff  in handling
center head • Paid Rs. 5 per • Paid Rs. 5 per BHMS patients
• Highly qualified extra patient extra patient as • Paid Rs. 5 per • Paid divided Rs.
MBBS  as bonus bonus extra patient as 3 per extra
• Paid Rs. 5 per • Threshold the • Threshold the bonus patient as bonus
extra patient as number of number of • Threshold the
bonus patients: 40 patients: 75 number of
• Threshold the patients: 30
number of
patients: 100
1.4 Business Model of RHCF- contd.
Patient given Token collected
number coded back at pharmacist Measurement of
ticket during medicine closing stock
collection

Corporate office Medicines

• Operations from home • Purchased 160 types of generic medicines per
• President: Anant, Responsible for month 
fundraising, volunteering and guidelines • Average cost of medicine per patient:
•  Arun responsible for operations, finance o Rs. 22 for allopathy treatment
and accounting o Rs. 6 for homeopathic treatment
• Falguni, Arun's wife responsible for • Buffer of 2 months of supply for each of the
packaging and distribution of medicines centers 
2.1 Rural People Challenges
Quality of Healthcare Services

Accessibility

Awareness

Affordability

Poor quality of healthcare in the public sector was cited by 57% of households  as the reason for
preferring private health care
 POLITICAL: Primary healthcare services delivered by government
P run hospitals are of poor standards. Total 15000 hospitals with
660000 doctors (80% of this in urban region) Doctor to people

2.2
ratio is 1:1700. 80% doctors work in private sector.

ECONOMIC: At US$ 65 billion, healthcare industry accounted for

E 4% of GDP. Public spending on healthcare is 20% of overall
expenditure.  
Macro SOCIAL: Rural people and especially from minority section are
Environment deprived from primary health care facilities. 15% of population,
S mostly urban, have private health insurance. Underprivileged
Analysis usually borrow from money lenders

TECHNOLOGICAL: Many technological advancements are

T
happening in healthcare industry. These big technological giants
are willing to collaborate with these public health centers. For
instance: Medtronics and RHCF collaboration. 

LEGAL: Government provides tax and other relaxation in terms

L of getting approvals for these public health centers
established with an aim of social entrepreneurship.
 3.1 4A analysis

Affordability • At a price of Rs. 40, the patient received doctor's consultation and medicine to be consumed in a week
• RHCF charged Rs. 400 for post operative care after eye surgery and Rs. 100 for eye glasses

• RHCF opened 9 centers across rural west Bengal impacting millions of lives 
Availability • In future, they planned to open enough centers in states of West Bengal to cater to more underprivileged
group

Acceptability • On an average 4000 patient visited RHCF centers every month with 6000 footfall in some centers
• Majority of the patients were from minority communities which depicts its social acceptance 

Awareness • In Mayapur, some miscreants spread rumors that RHCF was providing expired medicines. But, it did not
affect patient footfall which shows RHCF's better communication in spreading awareness
 3.2 Segmentation and Targeting
CUSTOMER PERSONA

DEMOGRAPHICS GEOGRAPHIC " I'll rather travel 20km and pay Rs. 40 For
effective treatment than avail free treatment at
• Age group- Middle to old PHC"
• Rural areas- West Bengal
age • Near Railways
• All genders • Not near urban civilization
• Low income- minority
communities

PSYCHOGRAPHIC BEHAVORIAL

• Seek quality treatment at • Users of primary health Meet Malti Devi, a native of Rural Bengal
subsidized price (Had care Age- 55
access to PHC, yet • Middle to high loyalty Low income group
Seeks quality primary healthcare- Physician,
preferred RHCF) (choosing RHCF over PHC)
Dentist, Optometrist or homeopathy doctor.
3.3 Positioning

Providing affordable primary healthcare to low-

income rural and underprivileged communities in
West Bengal.
3.4  RHCF: Unique Value Proposition

• Free medicine • In-house

for the 1st week doctors
• 80% savings available 6 days
for the poor a week from
patients 9am – 6pm

Affordable Flexible

Remedy Reliable
• More than 160 • Only certified
types of medicines doctors and
are stocked assistants are
• Free spectacles are hired who
distributed to prescribe reliable
patients generic
medicine
 3.5 SWOT ANALYSIS

• Diverse Product Portfolio of RHFC  • Low Return on Investment

• Managing Regulations and Business • Lack of critical talent
Environment
• Collaborations and partnerships • Model is not self sustainable
• Robust Domestic Market
• Inventory management
• Brand trust Strength Weakness

• Increase in Consumer • Political instability

Disposable Income Opportunities Threats • High dependence on Donations
• Opportunities in Adjacent
Markets
• Changing Technology Landscape
4.1Elements of the strategy of RHCF: STAGING
2007: Nevatias opened first Mayapur Health Centre for a fee of Rs.5 for primary care & medicines in West Bengal

2009: Rural Health Care Foundation was formed officially in West Bengal as a public trust

2009: Swarupnagar centre was opened later on in June 2009

2010: Namkhana was opened with Vikas Agarwal joining as a trustee with a donation

2011: Fourth centre at Sangrampur was opened followed by fifth at Mulkathi in October

2012: RHCG got enlisted with Give India Foundation for sustainable fund raising
4.2 Arena: RHCF targets economically underprivileged across the
state of West Bengal

RHCF primarily consults RHCF provides medical services RHCG has operations in 5 areas

Services rendered
Target Audience

Geography covered
economically underprivileged in the following areas: currently across the state of
section who cannot afford - Allopathic primary treatment West Bengal:
expensive primary healthcare. - Mayapur
- Homeopathy primary
Demographics segmentation: treatment - Swarupnagar
Income: Extremely low - Dental treatment - Namkhana
Age: 35-70 years - Optical treatment - Kusumgram
Geographic segmentation” - Russel street
No. of patients
Rural areas of West Bengal
Homeopathy 9%

Dental,
7%
General
59% Optical 25%
4.3 through successful Strategic Alliances and partnerships
Vehicle: RHCF chooses to grow organically from donations & also

RHCF continues to expand organically with the same service model when they find a donor contributing to the startup
costs.

Benefits, RHCF accrued from the strategy Smile train

fdn (cleft lip
therapy)

Increase in market share Rotary club

Medtronics
(cardiac
(cataract
issues
surgeries)
Economies of scale equipment)

Strategic
Provision of complementary services through Alliances
partnerships
Pratishruti GIF
Competitive edge in the market (wheelchair) fundraising

Anant Edu
Diversified business model ( new markets) initiative
(scholarships
)
4.4 medicines at a cheaper rate and incessant innovation in their practices
Economic logic: RHCF chooses to maintain its revenue by sourcing

RHCF focuses on Low-Cost Strategy for rendering services and continued fundraising to become more operationally
sustainable

• Instance: a)Patients will be given a waiver of Rs. 10 for every hour they wait
b)Incentive Based scheme for doctors
Innovation and c) Market development based on donors’ bearing startup cost
Collaboration d) Strategic collaboration with diff. org. for secondary healthcare

• Parameters: Number of centers operating, revenue across the centers

• Instance: a) Rs. 40 & Rs.30 charged for allopathy & Homeopathy respectively
b) Procuring “near-expiry” medicines at a cheaper rate
c) Economies of scale in ordering 160 types of generic medicines
Low-cost
• Parameters: Cipla’s product pricing as compared to its competitors under
primary healthcare
4.5 the necessary brand trust required for sustainable competitive advantage
Differentiator: RHCF’s accessibility and high responsiveness have driven

Human Capital Low cost quality medical care National Recognition & Brand
trust
- Best Recruitment Practices for diff - Quality service at as low as Rs.40
- Trusted brand among the patients
types of doctors. with one week free medication
- Conferred awards like Salaam Bengal
Instance: Elderly physicians are pref - High responsiveness among the staff
Award 2011, India Volunteer Award
- Improved employee engagement by - Free wheelchairs and education 2011, etc acknowledging its noble work
changes in incentives, control systems scholarships
- UNICEF expressing its interest in
- Motivated employees and staff - Fostering innovation and creativity working with RHCF brings in
enhancing the service quality. - Strengthened partnerships with NGOs international recognition
- Performance-linked bonuses and organizations to provide secondary - Hence, sustained fundraising through
provision healthcare various mediums is achieved effectively
- Daily monitoring of prescriptions - 
  
5.1 Comparative Analysis: RHCF Vs AECS
  
Comparative Analysis: RHCF Vs AECS -
5.2 contd.
6.1 Strategies that should be continued

Inventory management
• Low inventory resulting in low inventory holding cost
• Buying near expiry medicines at half the prices leading to saving 50% of cost (approx.)

Comparative purchase price of medicines (All price in Rs.)

Dosage Retail Jan Aushadhi Bulk Near expiry Discount

(mg) price price purchase purchase
price  price
Ciprofloxacin 500 97 21.5 13 6.5 50%
Diclofenac SR 100 51.91 3.35 2.1 1.05 50%
Cetrizine  10 37.5 2.75 0.8 0.4 50%
Paracetamol 500 13.56 2.45 2.1 1.0 52.4%
6.2 Strategies that should be continued

Social entrepreneurship

• In spite of all the challenges, RHCF has continued to follow their

mission of providing low cost health care to the rural people. It
should ensure that it doesn't deter from its mission. 

Focus on operational sustainability via collaborations

• RHCF collaborated with various organizations like Rotary club for cataract surgeries, Smile Train Foundation to
facilitate cleft lip and cleft plate therapy and, Medtronics for cardiac patients. 
6.3 Strategies that need amendments

Trial and error method of location selection

S. No Center Commenced Comments 50% centers were eventually

location operations on
closed/shifted because of lack of
1 Mayapur November 2007 Shifted twice patient turn out
2 Swarupnagar June 2009 Operational
3 Namkhana March 2010 Operational
4 Sangrampur January 2011 Closed
5 Mulkathi October 2011 Closed, shifted to Total set up cost: Rs. 6,00,000
Kusumgram
6 Malatipur August 2012 Closed
7 Kusumgram November 2012 Operational
8 Russel street October 2012 Operational Require better research before
establishing any other new center
 Well researched approach in finalising suitable
1 location for establishing new centres 

Future
recommendation
s 2 Focus on market development

3 Focus on achieving financial sustainability 

  Recommendation : Well researched approach in finalising
7.1 suitable location for establishing new centres 

Potential for
growth

Higher research and awareness on

Local these factors can lead to improving
political Competition 
factors strategy for location selection, thus
improving the overall sustainability

Collaboration with premier institutes

Long term
Culture & like IIMs, SPJIMR, FMS for
Religious
feasibility
committees incorporating social internships in
their programs and sought their
consulting in the required areas
Accessibility
 7.2 Recommendation: Focus on market development 

Where should they operate? (Ansoff Matrix)

• Important to fill up shortfall in operations

New Market

Market
Diversification
• Leverage the footfalls and goodwill of the alliance
Development
partners
• However, need to ensure non dilution of core
Market

mission
• A step forward to ensure financial sustainability
Market Product • Will help scale operations and subsidize fledging
Development centers
Existing

Penetration
Market

Existing service New service

Services
  Recommendation: Focus on achieving financial
7.3 sustainability 

 Optimizing  Maximizing
incentives to contribution  Diversification 
doctors margins
 Maintain proper
 Explore alliances &
 Conduct activity records of current
new markets to
based costing transactions
increase footfall
affecting margins

  Estimate the Evaluate the Collaborating with

margins and possibilities of UNICEF to seek
incentives trade off increasing sales or consulting and
to arrive at optimal reducing variable financial help from
incentives costs them

Based on our Breakeven Analysis, Russel Street and Kusumgram have to scale up in terms of number of patients with the
right awareness creation campaigns.
 7.3.1 Break-even Analysis
 
: To achieve the required financial sustainability

Use of Contribution
Service Revenue Cost Contribution patients /Patient
(Rs.) (Rs.) Margin (Rs.) (%) (Rs.)

Medicine 40 23 17 87 14.79 Cost/Center:

Eye Surgery 400 250 150 0.15 0.23 Initial set up cost =
Dental 40 20 20 0.5 0.1 Rs. 6,00,000/- (Exhibit 2)
Extraction Operating costs =
Blood sugar test 30 16 14 0.5 0.07 Rs.1,12,000 / month
(Exhibit 1)
Eye glasses 100 80 20 2.5 0.5
Dental Scaling 80 40 40 0.25 0.1
Allopathic 30 6 24 9 2.16 Break Even Volume (BEV)
medicine ≥ 1,12,000/17.99 =
Dental Filling 120 75 45 0.1 0.04 6225 tickets/month/center
Total 17.99
7.3.2  Financial Forecast: Focus on market development
Number Of Capital Operational Number of Patients
Centres Expenses Expenses Benefited Each Year

1ST year 2012 –

2013 Rs.18,00,000 Rs.40,32,000 3,20,000
3 new centres
Total: 8 centres

2nd year 2013 –

2014
3 new centres Rs.20,00,000 4,40,000
Total: 11 centres Rs.40,32,000

3rd year 2014 –

2015
3 new centres Rs.22,00,000 Rs.40,32,000 5,60,000
Total: 14 centres
 Employ social media websites for fundraising and
1 creating awareness among the youth to volunteer for
the cause.

Other Incorporating an OUTREACH PROGRAMME to focus on

Recommendation preventative care by conducting door-to-door tests and
s 2 screenings for early detection of eye disorders, NDCs,
malnutrition, etc among rural communities.

Employing newsletters, print media, Television, and

3 testimonials to achieve greater coverage & eventually
reach out to a larger audience in West Bengal.
Thank You