NB Health Care
Corporations are the Missing Link: Private sector is uniquely positioned to improve newborn survival in India
Every year in India, 760,000 babies do not make it past the first month. The country accounts for 27 percent of global newborn deaths, the highest in the world. While we’ve made progress globally in reducing mortality for children under age five ? a Millennium Development Goal – we have a long way to go in saving our newborn babies. What’s especially tragic is that we don’t need expensive or specialized health care services to improve newborn survival in India. In fact, we already have the knowledge and tools to prevent more than 75 percent of newborn deaths, through the use of simple, cost-effective measures.
The global development community – international agencies, nonprofits, foundations and governments – recognizes the urgency for a call to action on newborn survival. It has set collective targets and worked hard to mobilize different stakeholders around this issue. In India, however, because we are the highest contributor to global newborn deaths, we need more than government resources and nonprofits addressing this challenge. The research we have been doing at Dasra, the Mumbai-based strategic philanthropy foundation where we work, has highlighted a critical “missing link” that can help India address newborn survival at scale: corporates (or corporations).
The private sector has the expertise, the power to innovate and the ability to build sustainable models at scale. Dasra has seen that while each stakeholder plays a critical role in this fight, the corporate sector in particular is uniquely positioned to build momentum and have meaningful impact.
The recent impetus behind saving newborns has generated a consensus around what needs to get done. For example, The Lancet – one of the world’s most highly respected medical journals – released The Newborn Series, a set of papers that presents the clearest picture so far of the gradual progress on newborn survival. Taking into account The Lancet’s findings and several multi-stakeholder consultations, UNICEF and the World Health Organization convened a group of partners to develop the Every Newborn Action Plan (ENAP). This document highlights the latest evidence on effective interventions and delivery mechanisms, including identifying the roles of all actors in ending preventable newborn deaths.
Following ENAP, the Indian government released the India Newborn Action Plan, which details the government’s strategy for reducing India’s newborn mortality rate from 29 per 1,000 live births to a single digit by 2030, five years ahead of ENAP. Achieving this ambitious target undoubtedly needs unprecedented scale and innovation in the country.
Enter corporate India, the one stakeholder that is in a position to fill this gap.
There are, broadly, two ways in which corporates can get involved in the fight for newborn survival. The first is through commitments that qualify under Corporate Social Responsibility (CSR). The recently passed Companies Act 2013 requires Indian firms of a certain size to contribute 2 percent of their average net profits from the previous three financial years toward CSR. This will be the first year of its implementation and estimates suggest that it may generate $1 billion to $1.5 billion in CSR spending. This has the potential to transform health outcomes for Indian babies. Even more exciting is the fact that CSR results not only in the transfer of funds to the social sector but also expertise.
Some CSR programs have seen success through providing funds, operational support and/or business knowledge to nonprofits. Others have supported global alliances. An example of the latter is Johnson & Johnson, which supports the Mobile Alliance for Maternal Action (MAMA), a partnership between USAID, Johnson & Johnson, BabyCenter and the UN Foundation. MAMA’s model capitalizes on the widespread mobile phone coverage in India by sending voice-based messaging in local languages to educate pregnant women and new mothers about proper care. This is done through a partnership with a local nonprofit, ARMMAN. BabyCenter lends its expertise in baby care to make the messages user-centric. And having tested this model in South Africa and Bangladesh has enabled MAMA to bring some of the lessons and best practices to the India program.
TATA Steel has adopted a slightly different approach. Recognizing its long-standing and close ties to the local community as well as its ability to manage large programs on the ground, the company has chosen to wholly own and operate its CSR program in Jharkhand – the Maternal and Newborn Survival Initiative (MANSI) program. MANSI is a multi-stakeholder partnership with TATA Steel receiving technical assistance from the nonprofit SEARCH in implementing “home-based neonatal care.” Under this model, local women and government health workers are trained in basic antenatal and newborn care. MANSI has reached 167 villages and 83,000 people and is exploring scaling the program with the government of Jharkhand.
While CSR initiatives addressing newborn survival have made considerable progress, creating shared value – a relatively new approach – has also been gaining popularity in the private sector. Creating shared value “involves creating economic value in a way that also creates value for society by addressing its needs and challenges.” For example, Novartis, a global pharmaceutical company, runs Arogya Parivar, a social business that recruits and trains local villagers to become “health educators.” These educators build local demand for Novartis’ products, which are then sold at village health camps.
LifeSpring Hospitals, like Novartis, also pursues business and social objectives in parallel. The hospital is a 50:50 equity partnership between HLL Lifecare Ltd and Acumen Fund, an impact investing fund. It subsidizes the cost of health care for poor women by using a tiered cost structure so that midwives can provide maternal care and doctors can oversee a larger number of patients.
This is the most optimistic time for saving newborns; we know more than ever before about addressing this issue and about the roles that different stakeholders can play. There is global support around improving newborn mortality rates. The Indian government, too, has declared it a development priority. We now have proven models for public-private partnerships that have the potential to scale. Corporates can use this momentum to accelerate the nation’s progress on newborn survival. The future children of India need and deserve this.