60 million Indians go from above poverty line to below poverty line due to ‘health shocks’ in the family since between 65-80% of health expenditure in India is out of pocket.
High quality primary and preventive health services can reduce the incidence of ‘health shocks’ by half.
Urban poor in India experience higher health inequity and disease burden in comparison to rural India.
“Health shocks” are the single biggest cause of impoverishment in India. Every year, ~60 million Indians go from above poverty to below poverty line due to a health event in the family. Forgoing income, covering costs with savings, borrowing, using loans or mortgages, and selling assets and livestock to pay for healthcare costs are some of the key reasons.
Based on research, between 65-80% of health expenditure in India is out of pocket, while the average is 15% in developed nations, 35-40% in middle income countries (China, Mexico).
Based on a pilot that we ran with the International Labour Organization in rural Maharashtra, we observed that high quality primary care can reduce the incidence of health shocks by half.
Our focus on the urban poor is due to 4 key factors:
Urban slums are characterized by overcrowding, poor hygiene & sanitation and the absence of civic services. As per UN-HABITAT, slum population in India is expected to double to 200 million by 2026.
The urban poor in India currently have 3 alternatives for primary-preventive healthcare services. However, none meet their specific needs of affordable, convenient and quality care:
Public/ Govt Sponsored | Charitable Clinics | Private Clinics | Swasth’s Aim | |
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Quality | ![]() |
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Convenience | ![]() |
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India’s slum population to double to 200 milion by 2020
Average incidence in urban is 3.1% vs 2.3% in rural
Anemia incidence among urban poor women is 59% vs 48% in the non-poor
Dependence on high-cost exploitative private providers