Why is India’s Healthcare system in the ICU?


Health in India is in the Intensive Care Unit. Not because of the quality of care or qualification of professionals but ecosystem factors which keep the system ill.


Corruption in healthcare in India is rampant, both in the public and private sector. Needless procurement, unnecessary tests, over prescription of medicines, blatant favours to vendors, cash for service, kick-backs to other doctors,
recruitment scandals, each one small or big is keeping the system on the ventilator. If there is one thing which should be fixed first, it is making corruption disappear in health. Greater transparency will direct the investments already in place in the right direction and bring the right service to the right patient.


Overinvestment in new infrastructure, underinvested in service delivery monitoring and accountability

Billions of dollars are wasted every year by the government into building new hospitals, facilities, ordering equipment and other capital expenditure. We need to first make sure what we invested in, is really working before investing again. I have written about this earlier here.


Lack of Nurse Practitioners who can provide primary and preventive care

India will never have enough doctors to meet the international guidelines. On the other hand, most primary care doesn’t need specialized medical degrees, particularly for NCDs. Our lack of Nurse practitioners who can practice and prescribe for most common illnesses is really unfortunate. We are using high cost resources like doctors to provide basic services and underutilizing a large army of trained nursing personnel

Ignoring nutrition at our own peril

We have focused all our efforts in the past on medical care and ignored food and nutrition. Particularly micronutrients in the food. Most of us are deficient in minerals and vitamins, because of our dietary habits and the type of staples, vegetables and fruits we have access too. A concerted effort to focus on locally grown, nutrient rich foods, particularly in the school age population is the single biggest investment we can make for the future. Read more about Ashoka’s efforts on Nourishing Schoolshere.

Overmedication, Overspecialisation and Overreliance on diagnostics

A longer term solution to get out of the ICU and keep out of it is to focus on primary care. But we are focused on going the other way – over specialisation. Instead of clinical tools, we have become over dependent on diagnostic tools, which is also linked to the corruption issue above. And most disturbingly, the rampant use of antibiotics and other medications without considering side effects and long term impact. Clearly, our priorities are misdirected, as primary care doesnt provide enough incentives for doctors and hospitals. However, unless we build our capacity in primary care, the system will continue to be in the ICU.

So if we are serious about taking healthcare out of the ICU, we have to create the environment of transparency by cutting out corruption, build immunity by focus on nutrition, keep people from getting back into ICU by focusing on primary care and leverage our monies better by focusing on service delivery rather than infrastructure. And get Nurse Practitioners to the forefront, if we want to do all of this on a war footing.

Early to rise…


Story on coaching in Hindu Business Line

It is here that coaching gains importance. Dr Ashwin Naik, who co-founded affordable healthcare services chain Vaatsalya in 2004, says it is challenging to juggle multiple roles during the early stages of the entrepreneurial journey, particularly for first-timers.

“As they say, it is lonely at the top. A coach can bring in fresh perspective, which could open up a new set of opportunities,” he adds.

Dr Naik agrees that coaching is not for everyone. “First, there needs to be self-awareness and a desire to change… the coach is there to facilitate the journey, but the hard work has to be done by the entrepreneur,” he adds.

Read more at Hindu Business Line

Not without my coach


From Mint – July 13 2015

In April, Ashwin Naik, co-founder and director of Bengaluru-based Vaatsalya Healthcare, moved away from his executive role as the company’s CEO. He had co-founded Vaatsalya, an award-winning chain of affordable hospitals in under-served tier-2 and tier-3 towns, 10 years ago with fellow doctor V. Hiremath.
Naik, 42, has now become a full-time resident fellow at Ashoka, which describes itself as one of the world’s largest network of social entrepreneurs, as well as an angel investor in DisruptHealth, a preventive health start-up in Bengaluru. Giving up managerial control of a venture he had built from scratch is the entrepreneurial version of a Rubicon crossing; he needed help to think it through and act on it.
In the middle of 2013, he reached out to Renee Freedman of SupporTED, a group that provides pro-bono coaching to TED (a gathering of equals discussing ideas worth spreading) fellows such as he. “I wrote to her saying I was at a stage when I wanted to explore something new, and I needed to work on both building my leadership capabilities as well as building a team at Vaatsalya that could lead the company. I thought a coach would really help me.”

Read more at Mint Site

Vaatsalya’s Ashwin Naik: Co-founder of India’s largest hospital chain in towns – timesofindia-economictimes


Inspirations: The team members of Vaatsalya. When I interact with the nurses and staff at the hospital, I am hugely inspired by their desire to do their best for the patients.

Life@50: As Chairman of the National Association of Social Entreprises, I have met many great social entrepreneurs who are changing India. I hope to play a small role in facilitating the growth of social enterprises

via Vaatsalya’s Ashwin Naik: Co-founder of India’s largest hospital chain in towns – timesofindia-economictimes.

Is the honeymoon over in the social enterprise sector?


When shoeshine boys start giving stock tips, then you know something is wrong, goes an old Wall Street dictum.

When this aphorism begins to resonate in the field of impact investing and social enterprises endeavouring to address some of the most intractable societal challenges of today, then it is indeed worrying. Last month, at the annual industry conclave of hedge funds in the US, Reuters reported that there was much talk about impact investing and philanthropy. This, coming from a $2.4 trillion industry category that epitomises greed and profiteering—even if it claims ‘excesses of the past is past’— is a dire indicator of the frightening hype that pervades the space that social entrepreneurs now operate in.

It has ramifications for India as the country is still recovering from the microfinance bubble that burst, debilitating an entire industry that worked for the poor. India is believed to be a crucible for innovative social entrepreneurship and any sway of interlopers can be disastrous.

“The hype around impact investing far outweighs reality,” warns Vineet Rai, founder and chairman of Intellecap, with over a decade’s experience in funding and handholding social entrepreneurs through the Aavishkaar funds. “The expectations being raised are just beyond the capability of the system to deliver.” Ashwin Naik of Vaatsalya, a network of low-cost hospitals in tier-II and tier-III towns, agrees. An onrush of investor interest, of all hues and motivation, is fuelling the sector and, at the same time, expectations of social entrepreneurs are reaching sky high. “We are expected to sort out deeprooted societal problems overnight,” he laments, and also apportions some blame on social entrepreneurs who, for various reasons, throw up impact targets and numbers of beneficiaries, whether in education, healthcare or water and sanitation, that are highly unrealistic.

The fact is ushering change and outcomes at a systemic level in these difficult arenas would require years or decades of work. Short-termism is incongruent to this sector. “It is about time we set our own expectations right,” says Naik, who however is not as alarmed as Rai. The latter insists that many social entrepreneurs don’t want to be described as ‘social’ anymore, given the scary hype and circumstances.

More at Economic Times