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Entrepreneurship       Unleashed

Janani is a non-profit Indian Society that implements a large service delivery programme in three of the poorest states of India. The programme is modeled on the premise that the only option available to supplement the public sector in scale and impact of service delivery is the private sector. The NGO sector accounts for barely 0.7% health care in India and by itself is not a viable option.

There are vast sections of the population in India, mostly poor and rural, who do not have access to good quality health and reproductive health products and services. About 16% of couples in reproductive union—25 million in total—want to either space or limit children but do not use a modern method of contraception, mainly due to lack of access. In poor states like Bihar, the unmet need is about 40%. Not addressing this need is a violation of some fundamental reproductive rights. Unwanted children also exact a huge price on the economy and the nation’s wellbeing.

India has a vast public sector but during the five decades since the country’s independence from colonial rule, the public sector has not been able to address the needs of the poor fully. There are an estimated 450,000 private doctors, 1.25 rural providers and 12 million shops in India—leveraging such resources provides a huge opportunity to supplement the public sector in scale and urgency. Janani’s programme does just that.

	Janani is an affiliate of DKT-International, the Washington-headquartered charitable organization and the most cost efficient social marketing organization in the world. Janani’s programme currently covers Bihar, Jharkhand and Madhya Pradesh, home to about 203 million people. Using the private sector to serve the needs of the poor comes with an inherent contradiction: the private
sector is primarily involved in an economic activity in which maximization of profits is the overall objective. Reorienting this sector to address the needs of the poorer income groups is not easy.

Reconciling the ability of the poorer clients to pay for services with the need for creating worthwhile profits for the providers is the challenge that Janani faces. The programme design does this either by subsidizing products or generating large caseloads so prices can be lowered. Often, it is a combination of both.

Janani defines its role as an intermediary which redirects the energy of the private sector towards the poorer sections. This it does by developing the right framework, by creating a conducive environment, and by ensuring that its programming does not violate the basic tenet of the private sector—earning profits. Janani also uses technology—internally defined as processes by which the organization transforms labour, capital, materials and information into products and services of higher value—to create viability in its operations.

Using a money element strongly factored into the design, however, makes an effective management system possible. It gives reliable short-term indicators so necessary for efficiently running such large-scale service delivery programmes. Lack of such indicators, either validated by money or by other devices, is the major drawback of the public sector management model.

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Last updated on March 2008