For everyday well-being to be tangible, especially for the vulnerable, we know that many parts of the system need to change. Our work in primary healthcare draws from close to 2 decades of extensive work in partnership with some of the most marginalised communities in the world - tribal and indigenous communities, those who are gender non-binary, and those living in poverty in rural and urbancommunities.
We understand through extensive ethnography and public health practice, that unless we address how the health system is experienced, a life of well-being may remain a distant dream for the marginalised. This is the foundational understanding behind our flagship program, Invest4Wellness (i4We), as well as, our incubation of the CPHC Alliance.
Let's talk about i4We
i4We is a system innovation in primary healthcare. It combines health and wealth interventions, and focuses on well-being for the poor and marginalised communities. It is intentionally designed to be affordable, quality-assured, and scalable.
The ethos behind i4We is to make well-being tangible for the poor and marginalised, and take healthcare to unreached populations.
The thinking around i4We began with a central question - How do you co-create a life of everyday well-being for marginalised communities , often living in squalid conditions, with little to no wherewithal, prey to a gamut of diseases and disorders, and struggling to survive? Several components were co-designed with the community, which marry core evidence with action research, lived experiences, and implementation science.
i4We is currently delivered in four settings: urban, rural, factories, and sex workers’ collectives, and is adapted to each of these contexts.
The success of i4We lies in it being a self-sustaining program owned and run by community institutions. While designing i4We, it was incredibly important to put in place five revenue streams: 1). Interest spread on inter-lending among members, 2). Sale of health products, 3). Fees for facilitating schemes and insurance, 4). Direct sponsorship of marginalised families’ health, and, 5). Start-up Grant Capital for 5 to 7 years. These revenue streams enable the model to break even, and be self-sufficient.
A Social Return on Investment (SROI) exercise run on i4We, in its early days, reflected an increase in the communities’ health outcomes, economic benefits, social cohesion and social capital, increased confidence and self-reliance. An SROI of 2.32 was demonstrated after 1 year of implementation - i.e. 1 INR invested, delivered 2.32 INR in the hands of people.
Started in 2017, the model is operational in nine locations across India, covering 56,165+ people, and growing rapidly. The model was co-created with a range of partners including Vrutti (a livelihood resource centre) and Catalyst Management Services (CMS), and is supported by various partners in different locations, including companies like - Marks & Spencer, Migros, Levi Strauss & Co., Social Venture Partners, Morgan Stanley, Ashraya Hastha Trust, PCMH Restore-Health, PCI 360 etc.
The health outcomes driven by i4We are the result of a combination of factors - determined investors, a committed implementation team that marries skills with lived experiences, and a community that has been a part of the model from the very inception.
A glimpse into the CPHC Alliance
When we focus on health and well-being around the needs and preferences of individuals, families, and the community they live in, we arrive at the Comprehensive Primary Health Care (CPHC) approach. To make this transformative agenda a reality in India, Swasti supported the commencement of the CPHC Alliance, launched on the eve of World Health Day, 2021.
Several organisations signed a Statement of Intent to form the CPHC Alliance in India. Founding members include United States Agency for International Development (USAID), Asian Development Bank (ADB), the Bill and Melinda Gates Foundation, LGT Venture Philanthropy, and Swasti.
The CPHC Alliance brings the public and private sector, civil society, donors, philanthropic organisations, and individuals together, to help propel the agenda of strengthening primary health care.
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