Activity Description: With three quarters of its national population living in rural areas, access to primary healthcare is one of the most pressing issues facing India’s businesses and policymakers. Further complicating this picture is the fact that the government has so far had difficulty making a sufficient financial commitment to fund free, needs-based health services. Although currently on the rise, this spending only accounts for less than one percent of the gross domestic product. Private healthcare groups have also been unable to fill this gap in a country where nearly a third of the populaiton lives in poverty. The entrepreneurs behind Gram Mooligai found a unique opportunity within this seemingly insurmountable challenge to deliver much needed health services to India’s rural poor while tapping into new markets underserved by public and private actors alike.

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Aavishkaar (a Hindi word that means innovation) India Micro Venture Capital Fund (www.aavishkaar.org) came into existence to finance socially relevant, commercially viable and environmentally friendly enterprises that do not have access to project financing – loan or equity – from traditional financial institutions. Aavishkaar India fills an important niche as it is positioned between microfinance and traditional venture capital funds with its promise of equity support to small businesses. The projects that Aavishkaar support are in the range between Rs.500,000 (USD 10,000) and Rs.5,000,000 (USD 100,000).

Aavishkaar India Micro Venture Capital Fund (‘Aavishkaar’) concentrates on supporting micro enterprises based on grassroots innovations and seeks to:

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"Do it the right way (no short-cuts); Be innovative; Execute with discipline." - Vikram Akula, founder of SKS Microfinance

SKS Microfinance empowers the poor to become economically self-reliant by providing financial services in a sustainable manner. Vikram Akula, the 37-year-old founder of SKS Microfinance, who was featured in Time’s list of 100 ‘People Who Shape Our World’, believes corporatising the NGO sector is a must for meaningful poverty alleviation programmes. “A for-profit business model is the fastest way to put more money into more poor hands,” he says.

Launched in 1998, SKS Microfinance is one of the fastest growing microfinance organizations in the world, having provided over $ 92 million (Rs 425 crores) and has maintained loans outstanding of $38 million(170 crores) in loans to nearly 320,000 women clients in poor regions of India. Borrowers take loans for a range of income-generating activities, including livestock, agriculture, trade (such as vegetable vending), and production (from basket weaving to pottery). SKS also offers interest-free loans for emergencies as well as life insurance to borrowers. Its affiliate, SKS Education, provides education services to poor children, including running a government-funded school for girls who have dropped out of school.

SKS currently has 138 microfinance branches in the states of Andhra Pradesh, Karnataka, Maharashtra, Orissa and Madhya Pradesh, Bihar, UP, Rajasthan, West Bengal, Jharkhand, and Chhattisgarh. This year, SKS aims to reach 700,000 clients by March 2007. In the last year alone, SKS Microfinance has achieved nearly 161 % growth, with 98% on-time repayment rate.

For this American-educated Fulbright scholar, a for-profit business model is not about maximising profits. It’s about maximising resources. “It allows you to tap private funds, unlike NGOs, where you survive on grants. You are accountable to your shareholders and, thus, cannot develop bad habits. You become more client responsive and allow them to guide your business,” says Akula, echoing the thoughts expressed by Infosys CEO Nandan Nilekani, the only other Indian on the Time’s powerlist.

Set up in 1998 with a sum of Rs 20 lakh that Akula managed to raise from 360 individual donors, most of them friends and family in the US where he was brought up, today SKS has a capital base of Rs 13.9 crore.

It has private equity participation from Silicon Valley entrepreneurs like Vinod Khosla, Ravi Reddy and Sandeep Tungare. Sidbi, a public financial institution, holds 7% for a crore invested. However, its client community remains its largest shareholders.

Apart from having a fully-automated, proprietory management information system (MIS), it has pioneered the use of smart-card technology at the village-level. The MFI is currently working with VISA International on a pilot project to develop and deploy wireless POS devices that would automate field operations and reduce transaction costs.

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Medicine Shoppe India, the second largest pharmacy chain in India, is establishing health centers in rural India aimed at providing high quality yet affordable health services for poor and marginalized rural consumers.

Medicine Shoppe India has considerable success serving India’s urban populations – with a strong emphasis on safety and quality – and with the help of Acumen Fund’s expertise will be able to expand into rural market.

In addition, Medicine Shoppe India has innovated a new store format where health services would be offered at no cost, but medicine or other pharmacy products would be sold at affordable prices. To build awareness of their products and services at the village level, Medicine Shoppe India hopes to partner with one or more rural ICT network orchestrators.

The Challenge
In India, close to 12% of rural income is spent on healthcare and 66% still do not have access to critical medicine.Hospitalized Indians spend on average 58% of their total annual expenditures on healthcare, with over 40% borrowing heavily to cover expenses and over 25% falling below the poverty line because of hospital expenses. Almost 7 out of 10 medicines sold in rural India are either substandard or counterfeit.

The Impact
The company currently operates 103 stores across six states, mainly in urban areas as of May 2006. Over the course of the next five years, Medicine Shoppe will establish 130 health centers in rural areas.

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Activity Description: Rahimafrooz Batteries Limited is a subsidiary of Rahimafrooz Energy Services, a private energy company operating in Bangladesh. In an attempt to tap Bangledesh's underserved and rural markets, Rahimafrooz Energy Services created Rahimafrooz Batteries Limited, which sells and installs a wide variety of solar powered devices, including solar powered water heaters and solar emergency lanterns.

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Based in Madras, India, the Foundation of Occupational Development, or FOOD, is a non-profit organization that works to implement sustainable development projects that often involve ITC.

In a recent project, FOOD provided cellular technology and marketing information so that urban women could receive higher payments for their domestically produced goods. FOOD in partnership with infoDev established a closed group communication network for community based women organizations to promote inter-city direct sales of products made by artisans and skilled workers. This is accomplished by providing the community based organizations (CBOs) with communications links by way of cellular phones to enable them to network for marketing their products. Existing CBOs are organized in such a way that products made by CBOs in one city will be sent to a CBO in another city for marketing in their area.

Activity Description: Run by students of the University of Dhaka and based in Mirpur, Dhaka, and Bangladesh, Xayan-IT is an ICT-driven social venture which provides youth with theoretical and practical ICT education. The objective of Xayan-IT is to harness the skills and talents of young people to help them create sustainable and challenging employment for themselves.

Activity Description: Since 1999, Kothmale Community Radio (KCR) has been serving as an interface between the rural communities in the central hill region of Sri Lanka and new communication technologies through its Community Multimedia Centre (CMC).

The eTUKTUK is a community building initiative that aims to converge the technological benefits of digital communications and new media with community radio. The eTUKTUK is a self-contained mobile telecentre and radio broadcasting unit housed within a three wheeled motorcycle.

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MIGHTYLIGHT is a simple-to-use, long-life, environmental friendly, pollution free, multi-purpose light using not only solar power but also most innovatively using a high technology, extremely energy efficient LED as its light source. This LED consumes only 1 Watt power and is rated to last 100,000 hours i.e. more than 30 years at the rate of 8 hour consumption per day (instead of conventional bulbs that consume much more power and fuse often).

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Of the half a million or so villages in India, about 310,000 villages have been declared to be electrified and 80,000 more villages remain completely un-electrified.

Decentralised Energy Systems India (DESI) runs a "Village EmPower Partnership project" to help provide energy and jobs in rural villages of India in an environmentally sustainable way. Each small biomass
power plant (100kw) built by DESI is owned by a village cooperative and creates at least 50 direct and indirect jobs per village. The increased income particularly helps improve the health and overall quality of life for women, while also increasing farm output and incomes.

Activity Description: Villagers in India lack access to affordable healthcare. As a result, life expectancy in villages is 8 years less than for city dwellers, the prevalence of disease is high, and diseases of poverty such as malaria and tuberculosis often go untreated.

Jiva’s "TeleDoc" is a low-cost eHealth program which provides effective Ayurvedic healthcare, and brings high-quality medical attention directly to rural India. In the ‘Women's Healthcare’ component, TeleDoc will provide training, software, and village-appropriate information resources addressing women's reproductive health—including pre-natal and post-natal care.

Activity Description: Dimagi offers customized, low-cost services in health informatics and software development through its team of specialists in medicine, public health and engineering, to bridge the gap between clinical needs and engineering constraints.

Dimagi's systems are built upon power efficient and practical, robust hardware platforms that range from mobile phones to mini-PCs. The engineering team has experience developing and deploying systems for rural India, South Africa and Zambia.