Improving Global Health by Leveraging Corporate Value Chains.

Author(s) Asher Hasan1
Affiliation(s) 1Executive, NAYA JEEVAN, Karachi, Pakistan.
Country - ies of focus Global
Relevant to the conference tracks Advocacy and Communication
Summary NAYA JEEVAN collaborates with MNCs such as UNILEVER to cascade its "global health plan for the marginalized" up and down their Corporate Value Chain (CVCs), enrolling low-income stakeholders (suppliers, distributors, micro-retailers, informal domestic workers such as maids, drivers, etc) in a market-based retail incentive/loyalty program that can potentially serve the needs of 660 million lives globally.
What challenges does your project address and why is it of importance? In Pakistan and India, at least 800 million earn less than $3 a day. Like other developing nations, South Asian governments spend just 1.7%-3% of GDP on an under-resourced and overwhelmed public health sector. Consequently, 97% of all health care expenditures occur out-of-pocket and ‘catastrophic’ medical expenses (e.g. for heart attacks, pregnancy complications, etc) are a major precipitant of generational poverty. The three priority issues that low-income, marginalized populations have to contend with are: (i) Access, (ii) Affordability and (iii) Quality.
How have you addressed these challenges? Do you see a solution? NAYA JEEVAN’s accessible, affordable, quality healthcare plan for underserved communities has been cascaded by UNILEVER to over 2500 sales distributors nationwide and 400 microretailers (ice-cream wallahs) who lie at the end of UNILEVER's supply chain. UNILEVER has financed the annual health insurance program costs ($30/life/year) of these microretailers and their dependents in a tiered loyalty/incentive program in which the corporation pays a contribution for health insurance that is prorated to the performance of the retailer. This model can be replicated globally with a varying degree of Corporate co-financing/subsidy which is contingent on: (i) the strategic value of these supply chain partnerships (ii) the cost of the health plan in that specific market and (iii) the impact on their bottom line – i.e increased revenue/sales per dollar invested in this loyalty program. NAYA JEEVAN’s accessible, affordable, quality healthcare plan for underserved communities has been cascaded by Kansai Paints (a Japanese industrial/residential paint company) to over 200 small business painters who lie at the end of Kansai’s supply chain. Kansai has financed the annual health insurance program costs ($30/life/year) of these painters and their dependents in a tiered loyalty/incentive program in which the corporation has fully subsidized the health insurance plan of their loyal customers. This model can be replicated globally with a varying degree of Corporate co-financing/subsidy which is contingent on: (i) the strategic value of these supply chain partnerships (ii) the cost of the health plan in that specific market and (iii) the impact on their bottom line – i.e increased revenue/sales per dollar invested in this loyalty programNAYA JEEVAN’s health insurance plan includes:• Annual medical check-up, which promote the early detection of disease
• A 24-hour telemedicine helpline managed by doctors and available to all beneficiaries to handle any concerns or emergencies that may arise.
• A Health Rescue Fund, which assists beneficiaries for uninsurable conditions or when their hospital management/health care exceeds the maximum annual insurance coverage.
• Preventive Health workshops that detail the causes, symptoms, treatments and prevention against most common maladies to allow individuals to be better able to protect themselves and their families. Our workshops include: Healthy Heart – Keep your Heart Happy & Nutrition – How to Eat Right.
How do you know whether you have made a difference? NAYA JEEVAN has successfully enrolled over 23,000 low-income workers across more than 20 corporations into this incentive program. We have already enabled over 200 critical, life-saving interventions and over 5000 urgent medical consultations by mobile phone that would ordinarily have led to hospitalisation (the aversion of hospitalization has a major impact on worker productivity and health system costs that are saved.In addition to the above, we have conducted a baseline health risk assessment and are monitoring our members for the following outcomes:• Poverty alleviation – by reducing the financial impact of catastrophic medical expenses
• Reduction in Maternal/Child Mortality - through timely intervention and 24/7 access to ambulances, medical doctors, ERs, trauma centers, etc.
• Improvement in Primary Health Outcomes - through preventive health education and behavioral change workshops

• Mitigation of Child Labor/Sexual/Physical Abuse

Have you or the project mobilized others and if so, who, why and how? NAYA JEEVAN has engaged more than 5000 volunteers and stakeholders across the Corporate sector to sponsor the healthcare of children from NGO schools. Over 250,000 residents in an urban slum (Sultanabad, Karachi) have been mobilized to take preventive health measures (nutrition, child immunization, antenatal care) by visiting our Community Health Center.Over 200 secondary/tertiary care centers have been integrated into our nationwide provider network on a cashless basis.
When your donor funding runs out how will your idea continue to live? Naya Jeevan negotiates a basic inpatient (hospitalization) group health insurance plan from various underwriters (for example Allianz-EFU, Pak-Qatar Takaful, IGI Insurance, Saudi-Pak Insurance etc.) at below-market, discounted rates of about USD $16/person/year. By expanding access to a previously untapped low income working population, Naya Jeevan is creating significant value for insurance underwriters who are able to save substantial resources in associated sales/marketing/business development expenses while leveraging Naya Jeevan’s service delivery platform to provide value-added services (VAS) uniquely tailored towards this customer segment. Consequently, insurance underwriters are able to offer Naya Jeevan the health insurance plan at highly discounted group health plan rates of USD $16/person/year.2. Naya Jeevan forms partnerships with various clients including both international and local corporations and businesses such as: Unilever, Espresso, Cafe Flo, Sanofi, Philips, Haque Academy Group, Deutsche Bank, Haji Group, PICT, etc. The supply chains of these clients include a large number of low-income employees from the service industry and informal sector who do not have access to health insurance at all. As discussed, the ‘missing middle’ population forms the target market for Naya Jeevan and clients like local companies/MNCs in Pakistan form the most efficient distribution channel to tap into these masses. Naya Jeevan sells the health insurance plans to clients at ~ US$30/person/year, representing 1.28 – 4.26% of the employee’s monthly payroll (of USD $50-150 per month).Naya Jeevan currently has 70+ clients through which health insurance is being distributed to its low-income members.

3. As part of their respective corporate and business programs, clients finance on average $24 (80%) of the annual $30 health plan cost, with the remaining $6 (20%) paid by the low-income workers directly through payroll.

The clients see this program as a channel to encourage worker productivity/loyalty among their employees and as part of their corporate social responsibility.

Naya Jeevan has witnessed steady growth in its business model, validating proof-of-concept of its sustainability.

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