Strategy Management Case-1
Piramal e-Swasthya: Attempting Big
Changes for Small Places – in India and
Beyond
Anand Piramal and his team sought to "democratize healthcare" in India through the
development of a new service delivery model. If Henry Ford could build and deliver cars
to everyone in the United States, Piramal thought, then why can't India deliver
healthcare to the 70% of its citizens who lack access to it? They began pilots in 2008 but
soon ran into unexpected difficulties. After a second round of pilots in early 2010, they
had to decide whether to proceed and if so how.
Presented by: Group 8
Alok Kumar -MP18002
Anurupa Samaiyar-MP18007
Manish Singh -MP18020
Md Azim Ashraf -MP18023
Sanjeet Kumar -MP18036
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Strategy Management Case-1
1. PROBLEM ANALYSIS
1. A: Problem Definition: The Piramal e-Swasthya revenue has gone down as they are not
getting enough patients per village to make the service Sustainable, Profitable and Scalable.
1. B: Diagnosis:
The current model employs educated females known as Piramal Swasthya Sahayikas (PSS) to carry out
the daily operations and also to attract the local customer (patients) in their village. Earlier the model
was predicted sustainable if each PSS could serve seven patients per day. But as the demand decreased
it was then reduced to 3 patients per day. But even this target was not achieved as each PSS on an
average received less than one patient per day. By 2010 they had lost 26 villages out of original 40
villages and were able to add only 60 more villages. Although the initial survey done by Anand Piramal
and his team suggested that good number people/villages showed openness to service (receive care over
the phone) the model was not generating enough revenue at a cost of $500,000 per year.
There were many reasons for the above-mentioned outcomes.
I. The patients were referred to other hospitals like public health care and private
clinic in case of illness was more serious. Piramal e-Swasthya would refer one tenth
of the patients to other providers which annoyed some of the patients. The negative
word of mouth publicity by patients and government providers stopped others from
visiting Piramal. And the public health practitioners would delay the service and
make them wait longer if they were referred to by the Piramal e-Swasthya.
II. The satisfaction level among the customers was decreasing as the patients were not
getting immediate results as compared to the service of quacks who offered steroids
which provided immediate results, though compromising on long term. The quacks
were opinion leaders and had political influence. The patients were happy to see
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Strategy Management Case-1
immediate benefits. The quacks also threatened the villagers to not visit the Piramal
e-Swasthya. Besides this, the quacks also offered flexibility in payments. Patients
could pay later and even barter for the service.
III. The PSS were young women with low status and were part of a conservative
society and many limitations were imposed on them. Hence, they proved inefficient
as they interacted only with small community and demand for the PES services
decreased. The PSS were lacking in the right motivation for this job because many
of them became PSS just to increase their social status.
Solutions
Better communication
Partnership with public health doctors-Educate Quacks about harmfulness effects
of steroids
Choose the sahayika from the family of the sarpanch, which will be more influential
Improved incentive structure-Make Pes ambassadors, earn discount on referrals or
commission per patients
Tie up with anganwadi’s
Spread success stories among the people
Education about steroids and long run consequences of its uses which cure the
symptoms and not the root cause
The business model was not economically sustainable
Spread awareness that PES is not meant to be a one-stop solution for all types of
illnesses and it is beneficial to have PES in the villages
Positioning – that it is not a one-stop solution – POP -
Home Visits and Health Camps will increase awareness among villagers.
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Strategy Management Case-1
SMS program for dosage and reminders and monthly disease themes (HV and HC)
Enlarge the stakeholders and Educate market (Training village leaders)
Enlarge the scope and add services like water purification tablets.
Alter the model from village to village to meet the ground reality
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