WISH

Context

India accounts for 20% of maternal deaths globally, with a Maternal Mortality Ratio of 113 per 100,000 live births*. The UN’s SDG target is to have fewer than 70 maternal deaths per 100,00 live births. 70% of these deaths are due to preventable and treatable causes, the consequence of a lack of access to affordable and quality public primary care. Primary health centers across the country are often located at a significant distance from the population. Due to prohibitive transport and medicine costs, patients avoid visiting a center unless gravely ill. Even when they do visit a center, key gaps in infrastructure, equipment, human resources, drugs and diagnostics mean patients often do not receive the care they need.

Furthermore, primary health centers provide a limited range of services, mainly targeted at maternal and childcare and communicable diseases, which is not aligned with India’s shifting disease patterns towards non-communicable diseases, currently the cause of 60% of deaths. In order to address these critical challenges in public health delivery, the National Government has mandated the upgrade of 153,000 health centers across the country. 

Solution

Founded in 2014 by successful technology entrepreneur Sunil Wadhwani, Wadhwani Institute for Sustainable Healthcare (WISH), registered as Lords Education and Health Society, is a non-profit organization that works to improve access to quality and affordable primary healthcare. The organization directly operates and manages health centers, where it tests its innovations. WISH collaborates with state governments through a range of process, device and technology innovations to increase quality of care, operational efficiency and cost effectiveness in the public primary care system for underserved communities in rural and urban India.

WISH currently works with government in two ways:

• Implementation: WISH directly operates and manages health centers in order to test its innovations. The organization:
  • Validates: WISH has launched a digital Health & Wellness Center with a range of process, device and technology solutions, which significantly improve quality of primary care. This model functions as a “demonstration site” to build evidence and know-how on high quality care.
  • Scales: WISH implements elements of its digital Health & Wellness Center prioritized for rollout within the state.
• Strategic Advisory: WISH signs an MoU with state governments to set up Technical Support Units (TSUs) to advise the governments based on its learnings from the implementation model.

Impact depth

WISH plans to increase access to affordable, quality primary healthcare from 23 million people in 2021 to 100 million people by 2027. Between its foundation in 2014 and 2021, WISH partnered with five state governments to improve primary care delivery and operated over 700 clinics and health centers. WISH also saw an increase in antenatal care, with a 12% increase in registration and 22% increase in early check-ups**.

WISH has contributed to the focus on maternal and child health, communicable diseases (HIV/AIDS, TB) and non-communicable diseases (SDG target 3.1, 3.2, 3.3 and 3.4) and has increased the recruitment, development, training and retention of the health workforce (SDG target 3.c).

*Statistics for 2018.

**End line results measured at the end of four years post takeover of primary care centers by WISH in Rajasthan in 2019.