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UnHerd with Bindu Ananth: Bridging gaps in affordable healthcare access

Posted on November 28, 2024November 29, 2024 by Purvi

Hosted by ACT, UnHerd brings you the unheard stories of individuals who are challenging conventional principles to disrupt the social impact landscape. From social entrepreneurs to venture philanthropists, dive into real-world conversations on what they’ve experienced and learned about changing the status quo.

Our ninth episode of UnHerd features Bindu Ananth (Founder of Dvara Health Finance), in conversation with Anam Sherwani (Manager, ACT For Health). Bindu shares her journey of building NEEM, a subscription-based platform connecting rural patients to trained health workers for doorstep care and medicine delivery.

Tune in on Spotify or watch the episode on YouTube to learn how Dvara Health Finance is using tech-enabled innovation to transform access to affordable healthcare for Bharat.

Anam:

Hello folks and welcome to the penultimate episode of UnHerd, a podcast hosted by ACT that delves into the extraordinary stories of individuals who are challenging conventional principles to disrupt India’s social impact landscape. Today, we’re diving into an issue that impacts millions of families across India – the rising cost of accessing quality (health) care. Every year, about 10% of Indians are pushed into poverty due to hospitalisation costs, and countless others skip essential healthcare altogether because they simply can’t afford it.

Our guest for the day is Bindu Ananth, a social entrepreneur committed to enhancing the access to affordable quality care for patients in rural and underserved areas. As the founder of Dvara Health Finance, Bindu has developed the NEEM program, a tech-first subscription-based platform solution that provides patients access to a network of trained local health workers who deliver quality care and aid medicine delivery at their doorstep.

Bindu, welcome to UnHerd! Thrilled to have you with us!

Bindu:

Thank you Anam, pleasure to be here.

Anam:

Bindu diving right into it, you come from a finance background. You’ve worked with companies like ICICI, chaired Northern Arc Capital, and have been a member of three RBI committees. How did you land up on public healthcare as a problem statement? Why did you decide to solve for it?

The spark that lit the fire: Identifying gaps in access to healthcare financing

Bindu:

So most of my career has been focused on financial services for the poor. And I have done this within different institutions – first in ICICI Bank, where I was part of the wholesale banking team. I think ICICI was a real pioneer in some of this work – this was about 20 years ago – and then I had the opportunity to set up, along with my co-founders, an organisation called Dvara.

And there again, continuing with the same theme of what will it take for India to make its financial markets deeper, make formal access available to every last village in the country, what are the new innovations that are needed? And it was also an exciting time because at the same time that we were doing Dvara, you had all of these wonderful, bold experiments happening in the background of Aadhaar. And so, I think it was just a wonderful confluence of many entrepreneurs doing interesting work in this space, but also terrific policy work, terrific regulatory work by the RBI. But the common theme in all of this is thinking about, what are low-income households (facing) in India? What gaps are they facing? What are the shocks that finance is helping them deal with?

If finance works well, it should absorb a lot of the uncertainty, the anxiety in people’s lives and that state is what one might think of as being financially included rather than having access to product A, B, and C.

And so, if you think about finance more broadly, we’ve done very well, I would say, in the last 20 odd years in terms of just physical access. But if you think, if you dig deeper and you think about, “How is people’s financial well-being? What are people doing with the money that they have access to?” I personally started to see many more gaps in that picture. For example, the fact that a lot of borrowing that our clients do essentially finds its way back to healthcare and hospitalisation, either for themselves or for a loved one. And that’s at least a good 25-30% of what probably constitutes all of lending to the poor. Now, it’s not necessarily a bad thing. I think if you have a loved one in hospital, really any source of money that helps get them the best treatment is fantastic. But if you think about what happens afterwards – hopefully the relative does well, comes back home. But there is a period of recovery both for the person who was hospitalised as well as the caregiver. And it won’t be an instant going back to things as they were. And now the additional point is that you have this sword hanging over your head, of this loan that has to be paid back pretty soon, starting next month onwards. That creates a very different sort of pressure. We find that borrowing for healthcare typically triggers a set of reactions that creates a lot more financial stress. And then to repay that loan, people potentially have to borrow from elsewhere or they have to sell assets. So all of this is somewhat of a negative spiral.

And so for me, the motivation was really that, well, a lot of the foundations of financial inclusion etc. seem to have been done well. Let’s think about what are some of the unsolved problems. And for me, certainly, this struck a deep chord to say that, can we think about better ways for people to pay for healthcare such that it does not end up creating this much financial stress? Surely there must be better ways to do this than the emergency sort of borrowing. What might that look like? How can we structure it? How can we deliver it at scale and offer it as a meaningful alternative to the microfinance type model that happens today? So that was, and I would say really for me, an important sort of starting point.

Anam:

As an organisation and as a founder, you’re really building a tech-first healthcare solution. There’s a massive behaviour change that you have to address, right? Underserved communities do have a preference for in-person consultations with doctors and they do believe in restorative rather than preventative healthcare. When one thinks of subscription-based models for these households, the CAC (Customer Acquisition Cost) is very high, and the ARPU (Average Revenue Per User) is not as high, initially at least. So what were some of the (early) failures for Dvara, and what were the learnings that followed which allowed you to build better as an organisation for these households for this specific customer segment?

Bindu:

Let me just start with the fact that, yes, each low-income household or each informal sector household perhaps individually represents a fairly modest spending power or purchasing power. But if there’s one thing that financial inclusion, some of the other successful models in social enterprises, have taught us, it’s that the real power is in aggregation. So, if you put together the total spends of these households, it’s really in that sense a volume game. You cannot make this work by working with a modest number of households. It’s really about small amounts multiplied into millions and hundreds of millions. That’s what creates the magic. For our work right now at Dvara Health Finance, we are fairly focused on, I would say, the missing middle in the context of, let’s say, health insurance, which is to say people who are not working in organisations like Infosys or Wipro or ICICI Bank and hence covered by corporate insurance covers etc. Neither are they employed in the government, whether it’s railways or State Bank of India, and therefore covered by government funded insurance schemes. Neither are they poor enough to be eligible for social insurance programs like Ayushman Bharat. Because often some of this is confusing because you have so many different pieces of the puzzle. There’s really this large missing middle, you know, 200, 300 million people, who are not poor, who have enough cash flow, so to speak.

Let’s just put a face to this person. Think about this as somebody who in town of Satara is running a shop, is running a stall near the temple, is somebody who’s on his feet for 12 – 14 hours of the day. The number one issue that this individual running the shop is facing is that he’s time poor, which is to say that if he’s not at the shop, he has to put the shutter down. It’s literally a one-person enterprise. Now if you tell this person, “Listen, travel 4-5 kms away, there is a friendly neighbourhood clinic, go wait for an hour and the doctor will see you,” you’ve lost the person’s attention. So I think the thing to appreciate is that there is a very large segment that values convenience enormously, because time is money for them, as much as it is for a person running a much larger business. And therefore services that are conveniently delivered, ideally at the doorstep or at the shop front. This is the core insight that microfinance tapped, because there was always this puzzle to say here are banks willing to provide loans at 8%-10%. How come customers are borrowing money from microfinance lenders at 24%. That just seems irrational. But I think the missing piece was the one that was available at my doorstep, whereas in the other I had to travel, I had to wait. And these are real costs. So that’s the opportunity that we are going after.

But if you think about the total spending that this group does on healthcare out of pocket, it’s a pretty large number. So in India, the overall out of pocket expenditure is roughly in the region of three lakh crores or three trillion rupees. That’s a pretty big chunk and a lot of that comes from this segment that doesn’t have insurance.

But I would argue that the bigger problem is what are they spending that three lakh crores on? 80% of that is curative in nature. And within that, specifically spends at hospitals, typically specialty type centres. Very little of it is primary preventive. And even within that 80% of curative, there’s a lot of unnecessary diagnostics, expensive medication that I didn’t need. I had a headache. I went to a nearby doctor and the doctor just immediately sent me to get an MRI done, so there is a lot of wastage. Clearly, there’s a large number of people who today are paying out of pocket. However, that is not yielding any meaningful results for them in terms of good health outcomes. What if we really focus sharply on that market and deliver a consistent, reliable, convenient service. Our experience on the ground is certainly very, very encouraging in terms of adoption. I think a lot of the things to figure out is about how do I deliver it consistently and at scale. Those are the real challenges.

Traversing tough roads: Pivoting from a financial service to a health product

Bindu:

I will say that one of the things that we did early on which did not work and probably because of my own background is that we approached it too much as a financial services problem. The first version of our offering was actually something called a health savings account in which we said, “Let’s just help people instead of borrowing at 30% rates of interest for health. Why don’t we help people save for emergencies?” And savings represents a kind of lower cost for the household. And so we built a lot and we created a fintech type proposition, all of it of course aimed at health. And that simply did not work out at all because in some sense, it did not resonate with the customer.

Health as an issue was well understood but savings specifically for health that just did not, I think, feel right to the customer. So we, in some sense, completely pulled back from it. And instead of a health savings account, effectively we then launched a health subscription product. And the big difference between the two is that the first one feels like a financial product. The second one feels like a healthcare product, in which I’m subscribing to NEEM, what do I get in return? I get actual access to a healthcare team. I get a health worker who comes to my home, takes my vitals, monitors me, delivers me affordable medicines, all of that, which feels a lot more tangible. And of course, in the process of accessing the subscription from us, the household did save quite a bit. Because, for example, we provide generic medicines for chronic diseases, which are a good 50%-60% cheaper than what they would buy from the local chemist. So the intent in both cases was the same, to bring down the monthly expenditure on healthcare for the household. But the first version of it was the financial offering. And this is given that my experience and my lens tends to be financial.

Whereas the improvement on that spoke to the customer a lot more because it felt real, felt tangible and felt like it had a services component, not just a financial component. So that pivot was critical for us.

Anam:

How did you build out the user-centricity within NEEM as a program?

Bindu:

We have to be deeply focused on the customer and as we already talked about, even rural India for that matter is many many segments all bunched up. So it’s always helpful to have a clear sense, like in any company that you would do, to say exactly who are you building for, what problem are you solving. But going with the hypothesis and keep iterating to say, okay, maybe this segment is already well served by government schemes and it would be hard for them to get a good value perception of what NEEM is. So for example, we’ve crystallised many things such as the fact that our typical customer underneath would be somebody with a monthly household income between let’s say Rs. 18,000 to Rs. 40,000. But the question is, is NEEM the right solution for them? If you bring in a fairly low-income person into a subscription program, then the month on month payment is soon going to become a challenge because of income uncertainty.

Start with some clarity, refine it as we go along and then start to crystallise many of these things for the team at the frontline. Because I think one mistake that many of us founders tend to make is the assumption that we operate sometimes at 30,000 feet and it’s all clear in our head, of course. But if your execution is happening, let’s say, through a frontline sales team or a frontline service team, who’s local, you owe it to them to provide them clarity in terms of this is a criteria for people who you want to bring into this service or this offering. These are the five benefits that we will provide. These things we do not provide because there’s also a fair bit of confusion in terms of what does the government do versus what do you do, what do private hospitals do. So I would say that’s really important and as much as possible, we’ve tried to write these down and document it so that people when they go out have a sense of exactly what to do. I think that’s really important for scalability.

If you listen carefully to your teams, make sure that your teams are listening carefully to customers, then that whole feedback loop starts to build, which is fundamental for any organisation, particularly anybody in the social impact space.

Anam:

That’s super interesting, Bindu.From a founder’s perspective, what really keeps on driving your conviction?

Bindu:

Yeah, I think 2-3 things. My team and my conviction in subscription is coming from, I would say, almost a conceptual angle to say that, can we take the one-off, Rs. 1,00,000 payment to the hospital, which is what we think of as a problem, and instead of that, break it into small chunks of 100 rupees, 200 rupees paid for every month so that we don’t end up with that Rs. 1,00,000 situation. So our approach to this is very much rooted in the customer and what will make sure we produce good outcomes there. But that’s my point of view. Now the whole challenge in all of this is to say what does the customer think about all of this? And particularly in healthcare, it’s very well known behaviour that people would much rather pay for things that are curative when it comes to that, rather than demand for primary care services.

I think by going on the field, talking to customers, listening deeply to customers, you figure out what is the right balance to strike. So the focus area for NEEM, for instance, given this constraint is to say, it’s going to be really challenging for me to work with a person who feels completely well, whose vitals are normal and then say, okay, pay me something every month to make sure you remain in the pink of health and so that you don‘t get hospitalised. But the customer’s point is, “Who’s thinking about hospitalisation anyway? I’m not going to get hospitalised because I’m in the pink of health.” So that would have been a very hard challenge. And we realised that quickly.

Bindu:

And we said, okay, maybe the real opportunity here is to focus on people who are newly diagnosed, let’s say, with blood pressure, newly diagnosed with diabetes, a stage one or stage two. And now it’s not about preventing diabetes from occurring. The conversation really becomes about, if you don’t do anything about your health, you could end up with a significant event like hospitalisation etc. Work with us so that we can keep you managed at your home and so, maybe closer to thinking about it as what one might think of as secondary prevention rather than primary prevention. And again, that’s where I think all the detail comes in because healthcare is such a vast space.

Somebody could be working on smoking cessation. Somebody could be working on health or weight loss. All of those are valid. You have to figure out where the circles intersect in terms of where you can make an impact, where it’s meaningful, and what is the customer willing to pay for.

So back to your question Anam, around what makes subscription tick. I think one is making sure that your offering speaks to a real felt problem of the customer, not something that I think is good for the customer to do, but the customer has to feel it. One of the things we did, for example, again, based on feedback is that we were initially doing only diabetes and CVD, cardiovascular diseases. A lot of patients told us, “Listen, one of the things that I’m spending a lot of money on is pain – lower back pain, neck pain.” And remember, we talked about our typical customer being somebody who’s on his feet for 12 hours a day or a woman who’s working on the farm for long stretches of time. So just the physical wear and tear. They said, “If this is about us, then why not include that in your offering rather than talk about things like diabetes, which frankly, I don’t right now care a lot about.” And you know, health workers brought that message back to us and we’ve now integrated chronic pain into a subscription because it felt widespread enough of an issue. So one, think, get the kind of core segment value proposition right to the specifics of what is included in your subscription has to be the right mix of things that affect the customer here and now, versus things that are more sort of medium term impact because the longer the time frame, the less salient it feels today for me, right?

And then finally, the number one most important thing Anam, is the front line. I think one of the most differentiating aspects of NEEM is the fact that it’s delivered by a local trained health worker, the name is Sakhi. She is somebody who is the face of the program. This is not, at least for this market, a pure tele-medicine type approach or an app based approach. We are convinced it’s not the solution at all for all the reasons that we talked about. There needs to be a strong, obviously, technology backbone, but it has to be what one calls an assisted model.

So the health worker is really driving a lot of that action. She’s driving a lot of the adherence because, in chronic diseases, there is no magic. I mean, what has to be done is very clear. The medicines have all been around for many, many years. But the key question is, can you persuade your patient to stay on medication for extended periods of time, even if she feels better? That’s where a lot of the programs go off the rails and that’s where the health worker engagement is so critical and at least in our case that those set of reasons seem to be contributing to pretty good retention rates on the subscription.

First principle lens: Raising the bar on what trained healthcare professionals can do

Anam:

That is very fascinating, Bindu. How did you approach integrating this component of a NEEM Sakhi into your tech based model?

Bindu:

Before I started Dvara Health Finance, right before that, I worked with this wonderful company called Niramai (another ACT For Health portfolio startup), which has a unique technology for breast cancer detection using AI and thermal imaging. Working in that setup, one of the things that surprised me early on is that we do these Niramai screenings for a whole bunch of women. And at that point, it was not a diagnostic technology, it was a screening technology. So, for every 100 people that we screened, perhaps for 6 or 7, we’d say, “Listen, it seems that there is some suspicious activity, a suspicious looking lump. Please get it confirmed using an ultrasound was the typical recommendation.” And that would be signed off by a doctor. To my utter surprise and shock, almost nobody would go on to do that confirmatory ultrasound.

So they do the screening, they take the trouble to come do the screening with us, take that fairly troubling report to say there’s some suspicious activity and then disappear. And during my early days in Niramai, I would tell Geeta (Founder, Niramai) to say, “I am going to chase these women down.” I said, okay, maybe it’s just that travel is a problem, planning is a problem. So we’d get appointments for them to do their ultrasounds. And I personally said to a few women to say, “I’ll come with you. Let’s go do this ultrasound. Can I pick you up from the passport office?” “Yes, yes, madam. I’ll be there at 10 a.m.” And they would simply not show up. So it was a surprise for me. But if you talk to people who are veterans in healthcare, in cancer care etc., loss to follow up is a very widespread phenomenon, which is just people who don’t pursue the next logical step of whether it’s diagnosis or treatment. And all of these things remind you that, gosh, how in this context then are you going to go in with a pure tech solution? Because you need to have a muscle around persuasion, kind of getting the job done, right?

Your first instinct is to say that in all healthcare, the human should be a doctor so that you have the least issues with respect to expertise, compliance of law etc. But again, the penny drops that listen, if you want to serve the vast parts of our country, not just tier one, tier two, tier three locations, there are simply not enough doctors who can provide that sort of coverage. And there are, again, many people before us who figured that out. When we scanned the space, we saw fantastic examples of health worker-led models. What we did notice was that there was a distinct difference in the level of ambition that Indian programs had for their health workers relative to some of the global exemplars. If you look at the Indian health worker experience, it’s fairly low skill, low trained, often unpaid volunteers.

I think what helped us is that we went in with a little bit of that clean sheet of paper and said, we are going to push this as hard as we can within what laws permit us to do so I think we approached that health worker role with fresh eyes. We did not think that this was some low-level unpaid work, we immediately said this is full-time work. This is not an individual who’s a volunteer. I also walked away from this notion that the health worker should be some sort of entrepreneur, generating sales to pay for her salary to say, why would we do that? The service is conceptualised by us. She’s the one delivering the service. If we are confident that what we have designed is good for the customer, it will be adopted by the customer. We should not let the health worker take that revenue risk. So we pay the health workers like it’s a full-time job, because it is. And then this revenue risk is taken by us. That freed up the health worker.

And we found them not surprisingly, immensely trainable, very hungry to pick up new skills. Manisha Adkari, one of our best health workers – she comes from a small village in Mhasward in Satara. She used to work at a wonderful local bank called Mandishi Mahila Bank, who was one of our early partners. She used to be one of their savings agents. And remember I told you our initial sort of product was a health savings account. So the initial cadre were people who were encouraging people to save, leaders of self-help groups. Again, no clinical background at all. But what does it mean that they really knew how to do well? It was to connect with people. It was to sort of understand what their anxieties are vis-a-vis themselves, their kids.

What are your fears with respect to this medicine, why you’re not taking it regularly, what’s going on?

So we are not going to spend any time training Manisha Adkari on, “These are the body systems. This is the left ventricle. This is the right ventricle.” If you think about clinical education, there’s a good reason why doctors take at least 10 years to get to a minimum level of training. But that’s not what we’re trying to do here. We are trying to get this health worker well-versed in using, for example, an electronic health record system. She has to be well-versed in taking accurate blood pressure measurements. Tomorrow, we’d like her to be well-versed in taking a blood draw and preparing a sample. So these are very different skills. You’re not creating a mini doctor or a low-skilled person, you’re really creating a new set of skills. So I think the fact that we were able to approach it without any of that legacy around how health workers usually behave helped us a lot.

Anam:

I want to shift the gears a little bit here and really understand what your journey has been like as a founder in the social impact space. Because you’ve been at it for a while and (having spent time with) a lot of time with social entrepreneurs and founders in this space, it becomes more about how they’re always looking for a silver lining that keeps them going without really having a (silver) bullet in the hand. What has that journey been like especially given the multiple pivots, the new learnings and deeper insights that you’ve uncovered? What has really kept you going at it?

Future Forward: Staying aligned with your mission and with happenings on ground

Bindu:

I think most people in this space are here because of a deep sense of mission. And I think that’s a given. Otherwise, you would not be here trying to do these things. And if you’re one of the people lucky enough to assemble a team around you, that shares that mission. I mean, I think to me, that’s really critical. And that keeps you going. It can be a co-founder but it can also be, I think the rest of your early team. And that’s something that I’ve been incredibly lucky to have.

It’s the health workers, it’s the sales team, it’s the program management team. And one of the things we consciously do is to make sure that you’re very tightly connected to that team.

So I would say, you know, always surround yourselves with people who give you that energy. And that’s the fuel that we need because none of these problems, if they were all easy they would all be done by now. So we do need to build that mental energy for the marathon. Ultimately, in some sense, how do I, how do the teams have a sense of progress? Typically, it’s customer volumes, transaction volumes, etc. but I think for enterprises like us, it’s good early on to start to measure outcomes much more directly. So one of the things that I’m very grateful for is that our medical advisory board pushed us on is to say that, “I want to see you publish almost in real time your data in terms of what’s the change in status on blood pressure, what’s the change in status on diabetes, what’s the change in status on chronic pain.”

Make the data very visible, right from the CEO down to the health worker, to our partners, so that there’s a sense of this is what drives us. So we recently celebrated the fact that at the end of September, we had achieved 70% control among all our hypertensive patients, which means that when they came into the NEEM program, they were hypertensive. Anything over 140 by 90 at the time of entering the program. And in the most recent home visit that the health worker did, 70% of people were below 140 by 90, which is what represents control in the context of diabetes. So, 7 out of 10 people and the balance 30% may not have achieved control, but are starting to show significant improvement. And I think aligning everybody to that kind of north star, that in my experience also provides just more enduring motivation of the type that’s very different than a quick win. You do need some of those.

Anam:

Thank you for sharing that Bindu and honestly couldn’t agree more on that one. How do you see the financial inclusion space within the public health care system evolve? What do you feel is something that needs to evolve for meaningful impact to get created at scale for India?

Bindu:

I would think about it as how do we deliver financial protection to all Indians, which is to say, you often hear this in our circles, that most Indians are one hospital visit away from poverty, right?

That’s really what I think we need to change. How is that going to happen? It’s going to happen when more and more people have that safety net of saying, if something happens to me, I don’t have to draw on my own personal resources to pay for that event. It may or may not be insurance, but some pooling that’s happening so that it’s not literally just me left to my own devices to pay for that one lakh rupee hospital bill, right? And like I said, it’s not just a problem of poor people in India. We saw during COVID how vulnerable we are even in terms of the upper middle class, how one would think of it. If the hospital bill jumps from one lakh to three lakhs, you’re another 20% of the population that will go into poverty. So that’s the overall kind of problem statement in terms of how we solve that at scale. I think certainly organisations like Dvara but many more people are working at the primary care level.

Bindu:

We need, I think, hundreds of organisations relative to what we have now working on primary care. And using interesting payment models – we are big on subscription, but there surely are other models out there. But the whole point is to say, don’t wait for the patient to walk in and pay every time they see you.

The problem with fee for service is that you will come only when you fall sick. We want to figure out payment models where the patient is incentivized to come to you with everything. I have a cold, my kid has diarrhoea. The more you come to us, the happier we are, right? It needs to be that sort of approach at the primary care level.

So that I think that has to evolve a little bit. There is a fantastic role for technology to play there to say, how can that layer of primary care organisations now start to do a lot more? I certainly see in the not too distant future, our health workers being able to do a fair bit of cancer screening using mobile ECGs etc. So a lot more information action can happen at the primary care level. That starts to become substantive.

I think a significant piece of digital public goods infrastructure that needs to get created is between players like us and where the hospitals and the insurers currently sit. Today, the links between these two simply don’t exist. We are doing our own thing. They are doing their own thing. Is there a way to build the connectivity between these two layers such that only

people who pass through a primary care organisation, they get referred to a specific hospital, let’s say for surgery. So that it starts to rationalize some of these flows a little bit more, rather than people directly ending up at the hospital for something that could have been resolved at the primary care layer. So I think about this more broadly Anam, you need to build a little bit more middleware that helps connectivity between primary care and secondary tertiary care. And the middleware is typically around protocols for payments, protocols for referral, insurance, sort of participation, claim settlement. I think the path to scale is in leveraging the work of primary care organisations, but making sure that the handshake to the rest of the system is also getting built out properly.

Anam:

With your journey in perspective, what would be your advice that other founders can also keep in mind as they try to build for this problem?

Bindu:

Rural healthcare is a tough nut. There is no willingness to pay. CAC is too high. I personally think that you got to go deeper and solve for this at a segment level. And hey, this is India, right? Any micro segment you take is a hundred thousand plus people. So we should not be afraid of going deep.

And the second piece of it is what are you bringing to this whole problem statement? And in my case, I’m acutely aware that I am not a health expert.

You can think about my lack of health background as a disadvantage. I think of it as an advantage because I’m able to look at it with a different pair of eyes. Having said that, you do need genuine expertise, if you are offering a healthcare program. So build a personal advisory board that will give you that guidance, be willing to give you tough, harsh feedback early on. Because you may not always get that from investors. So I think building that group around you is always helpful.

And then I think the third thing Anam, that you had asked me earlier on, is around keeping the veil of motivation always running deep. Which is getting in knowing that there is not going to be a quick win, right? So build stamina to stay in it for a while and pivot as needed, driven by customer feedback. But you know that the payoff when it happens is going to be huge because that’s the nature of the problem. I do think thinking of it as a marathon rather than a quick sprint is really important.

Anam:

This, Bindu, has been an incredibly inspiring conversation. Thank you so much for joining us today!

Bindu:

Thank you so much, Anam.

Anam:

This brings us to the end of our episode of UnHerd, a podcast presented by Team ACT. If you enjoyed this episode, subscribe to our Spotify and YouTube channels, where we’ll bring you more unheard stories of people who are passionate about creating impact at scale in different ways. People who truly stand apart from the herd. Follow us, like, subscribe and share.

Women in startups: Transforming the leadership landscape

Posted on November 27, 2024 by Purvi

Launched by ACT For Women in 2023, the Women in India’s Startup Ecosystem Report (WISER) found that women made up 35 percent of the startup workforce in 2022 (the corresponding figure for the corporate sector was 19 percent) and indicated that, with timely and targeted action, that number can rise to 50 percent by 2030. However, it also highlighted the need for deepened focus as 10 years into their careers, 8 out of 10 men in startups occupy Director-level positions or higher, compared to only 5 in 10 women.

At ACT, we believe strongly that the problem is not women but the systems around them and so, to build on this actionable insight, we partnered with Harappa education (now acquired by UpGrad) through a strategic grant to pilot a transformative Women’s Leadership Program designed to bolster the representation of women leaders within Indian startups. The pilot cohort of 28 high-potential women managers from varied backgrounds were given the opportunity to hone critical skills such as personal branding, professional networking, and negotiation in male-dominated settings over a 12 week period. The program included 6 self-paced virtual courses, 2 strength assessments, 3 live masterclasses, fireside chats and an in-person city meet. For instance, the “Networking: The Skill That Never Stops Giving” course taught participants the nuances of creating meaningful professional relationships, while the “Get Out of Your Own Way” session addressed internal interferences like imposter syndrome. The cohort also benefited from Thrive Drills, which reinforced these concepts in practical scenarios. The program also went well beyond the learner and engaged a sponsor from the startup on a parallel journey of learning gender-agnostic decision making, inclusive leadership techniques and more.

The results have been promising. A significant majority of participants reported increased confidence in building their professional networks, crafting personal brands, and supporting other women in their fields. Many experienced positive shifts in self-awareness, with 73% showing improvements in networking and 59% becoming more adept at handling challenging conversations. Feedback from participants highlighted the program’s impact, with several noting newfound confidence, enhanced communication skills, and a commitment to support other women.

As ACT For Women continues its mission to foster a diverse and inclusive startup ecosystem, the Women’s Leadership Program stands as a powerful model for nurturing future women leaders in India holistically without solely putting the onus on women themselves.

Khushi Baby joins the ACT For Health portfolio

Posted on November 20, 2024November 22, 2024 by Purvi

Across India, over 1.3 million community health workers —including ASHAs (Accredited Social Health Activists) and ANMs (Auxiliary Nurse Midwives)—work tirelessly to bring healthcare to the nation’s hardest-to-reach communities. These health workers are often the first and only link to healthcare for populations in rural areas, urban slums, migratory groups, and families with low health literacy. Yet, despite their invaluable role, community health workers face immense challenges due to inefficient, paper-based reporting systems and fragmented digital health tools. These issues contribute to data inconsistencies, misaligned health targets, and delayed remuneration leaving community health workers overburdened and spending over 25 million hours each month on redundant data entry. Without real-time, high-quality data, public health officials are limited in their ability to drive targeted actions and data-driven decision-making.

Khushi Baby is a non-profit organisation dedicated to improving primary healthcare through digital tools by empowering health workers, partners, and governments to build integrated health systems and enable data-driven decision-making. With its Comprehensive Integrated Health Platform (CHIP), Khushi Baby has created a single, unified interface to streamline data collection, remuneration, and real-time tracking across primary healthcare programs. This allows community health workers to focus on what truly matters—caring for their communities—while providing public health officials with hyperlocal insights to make informed, data-driven decisions.

Founded in 2014 by Ruchit Nagar and Mohammed Shahnawaz, Khushi Baby has grown from a maternal and child health solution to a health system solution using a tech-first approach. This is evident through Khushi Baby’s CHIP model.. Initially launched in Rajasthan, the platform has onboarded 75,000 community health workers and integrated 12 vertical health programs, reaching over 46 million people across 40,000 villages. By digitizing health records, Khushi Baby enables seamless data sharing, facilitates early interventions in high-risk pregnancies, improves vaccination rates, and supports community health workers in reducing malnutrition as the technical nodal partner to the Ministries of Health.

ACT For Health is now supporting Khushi Baby to scale this proven model to the state of Karnataka, building a new and improved version of CHIP as an open-source Digital Public Good (DPG) and laying the groundwork for similar efforts in Maharashtra. “ CHIP 2.0” is projected to reach a total of 100 million citizens at the last mile and empower a total of 150,000 ASHA workers at a cost per beneficiary of 2.62 INR. This open-source approach not only provides a pathway for Karnataka but also paves the way for other states to adopt and tailor similar digital health solutions.

At ACT For Health, we are excited to support Khushi Baby’s mission to empower health workers and enhance primary healthcare delivery for India’s most underserved communities through a tech-enabled approach!

ACT For Environment welcomes Alt Carbon to its Portfolio

Posted on November 20, 2024 by Purvi

The Carbon Dioxide Removal (CDR) sector, though still in its early stages globally, is emerging as a key driver for achieving net-zero emissions. While traditional emission reduction strategies could reduce emissions by 11%, prioritising CDR offers a potential 38% reduction annually. As an area with exponential growth potential, the CDR market is primarily fueled by voluntary carbon credits, which are expected to expand 20-fold to reach $1 trillion by 2037. And within this VCM market, removal credits—particularly engineered solutions like Enhanced Rock Weathering (ERW)—are gaining traction. ERW stands out for its capacity to store carbon for over a thousand years, ensuring high levels of permanence and offering robust verification protocols.

Positioned as India’s frontrunner in ERW, Alt Carbon is leveraging this technique to capture CO2 by applying finely crushed basalt, rich in essential minerals like magnesium and calcium, to agricultural lands. This process binds atmospheric CO2 with soil minerals, transforming it into stable carbonates that sequester carbon in the ocean for thousands of years. Beyond its carbon capture benefits, ERW also raises soil pH, a vital improvement for the highly acidic soils of tea estates in India’s North-East, where declining productivity has long challenged farmers.

Founders Shrey and Sparsh Agarwal, fourth-generation tea estate owners with deep ties in the tea community, have secured access to 2,000 hectares for expansion, with partnerships covering an additional 8,000 hectares and potential access to 40,000 hectares across Darjeeling, Assam, Tripura, and Uttarakhand. With rigorous measurement, reporting, and verification (MRV) protocols established in partnership with IISc, the company is close to obtaining certification for its removal credits. With a solid foundation and early results, Alt Carbon has attracted $7 million in forward purchase orders, including $500,000 in pre-purchase from Frontier, and is well-positioned for further growth.

To drive scalability, the company is now establishing the Darjeeling Climate Action Lab (D-CAL), an in-house MRV facility that will allow it to process over 600,000 samples annually, enabling credit commitments to Frontier and NextGen starting in 2025. This internal facility is also projected to bring credit costs down to $100, improving the economic viability of carbon removal. For the broader ERW ecosystem, D-CAL offers a cost-efficient MRV service to help other ERW players achieve market viability.

Backed by a dedicated team of 35, including geochemists and business development experts, Alt Carbon is on a promising trajectory with clear targets: removing 0.23 million tons of CO2 by 2027 and scaling up to 1 billion tons by 2040. At ACT For Environment, we’re excited to support Alt Carbon’s journey as they set new standards in scalable, scientifically rigorous carbon removal, advancing India’s progress toward net-zero emissions!

ACT For Health doubles down on AdagioVR

Posted on November 20, 2024 by Purvi

India’s mental health crisis is a silent epidemic that affects over 197 million people, with 70-90% of mental illnesses remaining untreated. Factors such as lack of awareness, deep-rooted stigma and a significant resource gap – with <1 psychiatrists, psychologists, and social workers per 100,000 people – contribute to the growing severity.

To address these challenges ACT partnered with AdagioVR in 2023 – an early-stage start-up making Eye Movement Desensitization and Reprocessing (EMDR) therapy available to the vulnerable communities through virtual reality. The therapy program entails working with the user to identify core target issues and delivering personalised VR sessions with facilitator support. With ACT’s support AdagioVR launched their first pilot in India, delivering EMDR therapy to 150 members of the transgender community in partnership with MITR Trust. The pilot helped validate the effectiveness of AdagioVR’s solutions with:

A 93% reduction in depression/ stress levels and 90% reduction in trauma impact

Unlocking a partnership with the Directorate General of Health Services (DGHS) for an ICMR-funded clinical study in leading hospitals in Delhi
Onboarding various NGOs and Corporates as clients in B2B segment

Given such strong outcomes and traction, ACT For Health is excited to double down on AdagioVR with a follow-on grant to help them establish a product market fit for the Bharat audience through product testing on a diverse user cohort of 3-5K, and to enable them to experiment with pricing models to identify a revenue generation model viable for grassroots and government, while building a strong team.

We look forward to partnering with AdagioVR in making quality and affordable mental healthcare accessible to Bharat!

Medoplus joins the ACT For Health portfolio

Posted on November 20, 2024November 22, 2024 by Purvi

Of India’s population, 68% – or 900 million people – live in rural communities. Yet 80% of healthcare infrastructure and manpower is located in urban areas, with residents there living five years longer, on average, than their rural counterparts.

A typical household in Bharat spends a large portion of its income on healthcare expenses that skyrocket during a health crisis, with less than 1% of the rural population covered by insurance. This financial strain, combined with the loss of income associated with travelling to urban areas for treatment, causes many patients to delay seeking medical care. These delays contribute to worsened health outcomes and ultimately higher treatment costs. Additionally, purely digital solutions have shown limited potential to address these problems as a significant portion of the rural population struggles with levels of digital literacy and maintains a strong preference for physical interaction.

Medoplus, a healthcare startup founded in 2020 by Dr. Prakash Bakshi, Neeraj Chandra, and Shekhar Yerramilli, is committed to addressing these primary healthcare challenges in rural India sustainably, leveraging the founding team’s collective experience of over 50 years in executing large-scale initiatives and a deep understanding of rural communities. Over the last 4 years, MedoPlus has operated an online platform that connects rural patients with qualified healthcare providers – including doctors, labs, and hospitals – from primary to tertiary care. Platform users can map symptoms to the appropriate healthcare professional, search for nearby providers, book virtual or in-person appointments and tests, pay digitally at discounted rates, and securely store their medical records.

Given the low levels of digital literacy in rural India, Medoplus operates through a network of local health agents who assist patients in navigating the platform and the healthcare system. Through this model, Medoplus has unlocked quality and affordable primary care for 275,000 patients in Uttar Pradesh, resulting in a savings of 600,000 hours in waiting time and INR 3 crore in direct healthcare costs for these patients. Medoplus has observed a clear preference among patients for in-person consultations, with many opting to delay their healthcare visits by several days, even when teleconsultation options were available. In response to this trend, Medoplus is excited to launch a cluster-based e-clinic model designed to better meet these preferences, while ensuring access to high-quality and affordable primary healthcare in a sustainable manner.

With ACT’s support, over the next 14 months, Medoplus will test this cluster-based e-clinic model that harnesses technology and a community-driven service model. These eclinics, staffed by a rotating team of five specialists, will facilitate doctor consultations, medicine purchases and pathology testing closer to home for over 100,000 patients in Uttar Pradesh’ Barabanki district. The patients will also benefit from a network of community health workers, supporting their health journeys at these clinics and across the secondary and tertiary levels of care via the Medoplus app.

At ACT For Health, we look forward to catalysing impactful healthcare solutions by funding Medoplus’s initiatives towards improving access to quality and affordable primary care for patients in rural India, while setting the foundation for a scalable and sustainable model!

UnHerd with Mohit Bhatnagar: Catalysing change through capital, connections and collectives

Posted on September 24, 2024September 24, 2024 by Purvi

Our seventh episode welcomes Mohit Bhatnagar (MD, Peak XV and Board Member, ACT) who, in conversation with Aakanksha Gulati (CEO, ACT), shares his learnings on what it takes to catalyse social change through collective action and his insights on the importance of founders building for Bharat.

Listen to this episode on our Spotify channel or watch the conversation on YouTube.

Aakanksha: Hello folks and welcome to the seventh episode of UnHerd, a podcast hosted by ACT that delves into the extraordinary stories of individuals who are challenging conventional principles to disrupt India’s social impact landscape.

Our guest today is a pioneer in the Indian venture capital space. He’s a Managing Director at PeakXV, formerly known as Sequoia Capital India and Southeast Asia – one of the largest venture capital firms globally.

Mohit has helped catalyse some incredible founders and has led investments in companies that you might have heard of – like Zomato, Freshworks, OYO, Meesho, and Cars24 amongst many others. He started out as an engineer at Ericsson, soon after which he co-founded a mobile startup called Brightpod. He then returned to India from the U.S. to join Bharti Airtel in 2002, helping scale it to the first 100 million users.

Armed with sharp insight on how the internet and technology could disrupt India in the coming decades, and with a deep desire to be part of India’s growing entrepreneurial energy, Mohit transitioned into the venture capital space where he’s played a significant role in leading India’s journey towards becoming a global startup hub. How I know Mohit, however, is as a philanthropist with a big and bold vision – a vision somewhat different from what we’ve seen in the philanthropic space in India over the last many decades and we’d love to deep dive into that more today.

Welcome to UnHerd, Mohit!

Mohit: Thanks, Aakanksha! You’ve done me proud with that introduction.

Aakanksha: I think that was just a short version of everything you’ve done over the years! But getting right to it, Mohit, I’ve heard you describe yourself as an accidental VC, but as someone who’s looking from the outside, even when I connect the dots backwards – to me, your professional journey makes a lot of sense. A young engineer and failed startup founder with immense learning. Then a professional who led an internet mobile juggernaut’s growth in its early years. So it’s no surprise that you were able to channel all that knowledge into leading India’s tech startup boom from the forefront. But connect the dots for us a bit on your philanthropic journey. How did your interest in social impact come about? Were the seeds planted in your early years or was this a gradual evolution?

The Spark That Lit The Fire: Catalysing a bias for ACTion, the startup way

Mohit: So Aakanksha, I became a VC all the way back in 2006 and one of my early investments was in Ujjivan Microfinance, and it allowed me to see how you could create a very successful commercial public small bank while also alleviating poverty. I saw the double bottom line impact that, in this case, venture capital could provide – where you were basically not just creating a very well run, profitable enterprise, but you also did good for the communities that nurtured that company. I saw that same trend play out when Zomato gave birth to Feeding India and to Robin Hood Army, where it was all about creating a business around food, but it also meant you could actually feed the hungry and the not-so-privileged. At Freshworks, creating programs that allowed Computer Engineering and Science to be offered to folks who did not have access to it, to helping women come back to work after a break. So I just found all these different entrepreneurs who were building very exciting businesses, but while they were doing that, they had somehow found this ability to actually nurture and give back to the community; to the communities that were sort of giving birth to them.

Mohit: I think it is firmly established for me that founders are very unique human beings. They have this uncanny ability to go long, to be relentless in their pursuit of trying to achieve something that creates a large company, but also solves a really hard-to-solve problem. And so, if they can build these massively successful companies, they can definitely also lay the foundations for a better world. And I think that’s where it all began to come together.

Aakanksha: Let’s get a little bit more personal, Mohit, because I think as you started noticing this in your professional journey, I know you also started dabbling as a donor, you were starting to sit on some not-for-profit boards. And in particular, I know there’s a plan that was made on the back of a napkin with Ashish Dhawan. So share a bit more about that? How did all of this culminate into you saying, hey, actually, I’m someone who also wants to become a philanthropist?

Mohit: Given that I was convinced that founders can create massive change, I started writing grant checks in an individual capacity to some small businesses. I remember this one particular founder who came to me looking for a consulting gig. He had unfortunately gone blind during the course of a very successful career. And I told him, instead of giving you a consulting gig which will get over in six months, why don’t you actually create a company that can actually help blind people navigate their mobile phones more efficiently because you seem to be doing it quite well. You just arrived for this meeting with an Uber!

And so, Pramit created this software application called Louie that actually helps blind folks voice navigate multiple mobile phone screens. And I was going about this journey enjoying these kinds of creations, till I realised that they all suffer from the same common set of problems. They need their next round of capital, they need to hire world-class talent, especially on the engineering side, to build really world-class products. They need networks that can actually help them scale and get promoted across various state governments or various private enterprises. And it was with that thought that I sat down with Ashish (Dhawan) because he had obviously lived a private equity journey and had now started Ashoka and was giving back at scale.

And I think that’s the napkin you’re referring to, where we actually used the placemat at Amour Cafe at Malcha Marg to actually draw out a little bit of a picture that shows how we can have these different verticals around Health, Education and Environment where we can create a platform that allows them (founders) to get easier access to funding, easier access to people and easier access to government, when it makes sense. And I think that was the birth of the idea, at least in my head.

Aakanksha: So it seems like all of this was brewing, it was culminating into something that was drawn, and then COVID happened. And I think that’s when we saw a lot of this coming together in a big way Mohit, because ACT raised almost 600 crores during that time and deployed it to create great impact. I have always felt that it really brought your philanthropic aspirations and mission and vision to life in a big way. So share a little bit from that time? What did you learn about philanthropy, about impact in ACT’s first avatar, and maybe also, what did you learn about yourself?

Mohit: Yeah, it was a crazy time. I think COVID was the closest I’ve seen to war. As things were just failing all around us, each one of us looked inward, made sure our families were safe, made sure our firms, our companies, and our employees were safe. But it was at such a scale that I think it shook us all from inside. I remember a bunch of us investors and founders – Abhiraj (Bhal) from Urban Company, Mekin (Maheshwari), Prashanth (Prakash) and Shekhar (Kirani) from Accel, GV (Ravishankar) from Sequoia. We all got together and we were like, we’ve got to do something here. And I think what resulted was a very special period where literally on a daily basis, we were spending close to 10 to 12 hours reviewing ideas that could actually put a dent into this massive challenge that India was facing.

To pick one, I remember oxygen being by far the single biggest challenge – as to how we basically get all forms of oxygen into India and Indian hospitals quickly. And we had a group that was basically overnight learning all about PSAs or these oxygen plants. We put 106 of these machines, using startup ecosystem infrastructure. And we got them put into the smallest hospitals in the widest, most far-out states of India. We had to lift close to 30,000 plus oxygen concentrators from places like China and others. And we used the logistics infrastructure of the startup world, think Delhivery, think Flipkart, and imported these machines and then were able to distribute them. We used the balance sheets temporarily of many of our startup ecosystem players like Zomato and others to actually help place the orders for many of these oxygen tanks. So my single biggest learning was how everybody came together.

Mohit: But the reason it was working was just shared trust in the collective – that we were trying to do this in a much more purposeful way for the country. So the single biggest learning is doing this in a collective way is way better than trying to do this individually.

Aakanksha: I remember I was watching it from the outside during that time. And I remember the word that kept coming in my mind was…it just felt magical. And you use the word ‘collective’, and I know many people since have spoken about how ACT was one of those really great examples of collective philanthropy and collective action. And I think for me, a few things that really stood out during that time was one, there was no full-time team. At the peak, there were 400 or 500 volunteers, and yet work streams were forming, great outcomes were being delivered, people were really creating their own seat at the table, building conviction about what was the need of the hour – they had a high bias for action, were using data and experts, and leveraging the ecosystem across the private, social and public sectors to really bring it all to life. But transitioning from that, what would be interesting is to share about how that evolved into ACT in its current avatar and how we describe ACT today is that we call ourselves a tech first venture philanthropy platform for social change in India. But embedded in that are at least three ideas, if not more. The first, around tech first solutions for social change. The second is around venture-like grant making. And the third, which you’ve spoken a little bit about already is this platform approach. So share a little bit about how that kind of evolution happened? What were the underlying insights and what really gave you hope that this would really be the next chapter that would be worthwhile?

Mohit: Like I said, COVID was a little bit of a wartime scenario. And when we all reflected as it was coming to an end, I think we all realised that we had all gained more than we had given. It was very fulfilling for a lot of us involved that we were able to think beyond our own personal needs and come together to do something a little larger and more purposeful. And so, there was this strong thought that we have to sort of keep the platform going because we don’t know when the next crisis is going to come, and we certainly feel like we can create impact, so this is something worth doing.

There were two big challenges. First is, everyone made time for fighting COVID and then everybody went back to their day jobs. And so from 350 volunteers who were fighting COVID along with us on the ACT platform, we had to now quickly transform to a full-time team. And I think that’s one of the biggest wins that we’ve done collectively here with your help and your leadership, is to actually build a solid, high-quality team.

The second thing I realised is health consumed us all during COVID, but a lot of folks in the startup ecosystem cared about other causes. Things like education, environment, equal rights for women were equally important causes for many folks in our ecosystem. And since this had to be a collective and a platform, it was important that it stood for the three or four largest purposes that folks cared about. So we broadened it from just Health to include Education, Environment, and Women as three new verticals. Each one of them having their own dedicated teams, each one of them having their own IC where ideas are brought up to the IC and grants are given.

[It is] super important that we include people who know the most about the problem before we try and attempt to solve it with the tech-first approach. So If you look at our three ICs, we have an Education IC, an Environment IC, and a Health IC. On the ACT For Health IC, we have people like Nachiket (Mor), who actually spent decades thinking about how public health can be envisioned for India. People like Dr. Ajay (Nair) from Swasth, Sandeep (Singhal), who’s a venture capitalist. Similarly in ACT For Environment, we’ve got GV (Ravishankar) and Prashanth (Prakash), who try and filter through ideas to see where most change can happen. On ACT For Education, we work together with Ashish Dhawan, who has spent time at Central Square Foundation, creating a beautiful institution there. Mekin (Maheshwari), who’s ex Flipkart, but now spends all his time helping education through government initiatives. I think bringing in these cross-functional experts is one way that this platform comes alive for me.

The second thing is solving common sets of challenges. It’s easy to say we should be tech-first. It’s really hard for us to expect our grantees to hire and access world-class tech talent. So if you see that as a common need, you can create a platform like Tech Advisors, where we go out to the startup ecosystem and say, we don’t need your money, we just need your time. If you’re a programmer and care about social causes, can you spend some time with our startups and actually help them create the right technology architectures? For example, how needle moving would it be for a grantee at ACT to get a 12 week access to a UI/ UX expert from Urban Company or an ex Google Engineer that actually spends a 12 weeks sprint with them and gets that thinking and process correct.

And when you’re starting something as wide as gender parity, you need to come from a place of actually seeing what the current data is. And we can talk about this till we go blue in the face, but I love the team’s approach of saying, let’s make gender parity first come alive in our own startup ecosystem. And to that extent the WISER report – that has 200 startups participating and has McKinsey putting together the structure and then working with people like Udaiti to put together an annual research – is highly thoughtful and insightful around the current state of affairs.

I think at this point now we have close to 40 grants given across these different verticals post-COVID. And close to 15-20% of them have got follow-on funding, which by the way, just to digress, is exactly the venture model.

The venture capital model is that of the power law. Out of all the investments we make, close to 10% or 15 % of investments are the ones that really drive the mega returns of the fund. And I think that’s the new thinking that I hope ACT can bring to the world of venture philanthropy. I think what we want to try and catalyse here is moonshot ideas to solve really hard-to-solve problems that haven’t got solved. And it’s completely okay for 15% or 20% of the ideas that we give initial grants to be the ones that scale. Because these are hard problems and not every idea that we apply to it will work. And so this ability to think that risk is good, not everything has to work and it’s okay to fail so that you can come back stronger on your second idea and we collectively learn is the venture philanthropy model that I think we really want to try and underscore.

Traversing Tough Roads: Balancing risk and impact

Aakanksha: I want to double click on one thing you said Mohit, because this used to come up a lot in our early days, less so now. But you know, a lot of people would ask us that this is philanthropic capital. And some of the solutions are not going to make it, which has happened by the way. There are some incredible solutions that we backed, who unfortunately were not able to figure out a sustainable business model that worked for the Bharat audience, which we are very, very centred on. And so, that’s one of the things that comes up – how do you make peace with the fact that this is supposed to be money for impact, but you’re saying that we need to have a risk appetite. Would love to hear your take on that.

Mohit: Look, at the end of it, you’re solving for impact. Everything else is mere conversation to get that impact. I don’t think we benefit the world or India by becoming the 101st foundation that does it the same way. What we’re attempting to do is an experiment called venture philanthropy with this new approach of risk taking and moon shots. It may or may not work in itself, but we are willing to give it a go. And I think the answer is, as long as we hold the bar high on impact. So for example, let’s take a company like Rocket Learning that we’ve partnered with. When we first started with them, close to a third of their annual budget came from ACT. But today, less than 10% of their annual budget comes from ACT. So it’s an example of how we can catalyse others to start giving and participating in growing some of these social unicorns.

Rocket Learning has over 3 Mn learners across 10 states of India. They have finished an RCT with J-PAL that suggests quite carefully that anyone who goes through a Rocket Learning course is better prepared to succeed in school. Parents are changing behaviours to actually spending more time with their children to make them successful in school. I think it really doesn’t matter whether there are two other Rocket Learnings that did not work in order for Rocket Learning to work. It’s more important that the 3 Mn learners and that Rocket Learning scales to 30 Mn.

Aakanksha: Very, very well put. So building on the Rocket point Mohit, what do you feel actually has been the most exciting part of the last three years given our current model of venture philanthropy? It has been a short span of time obviously, and like you keep reminding all of us, this is not a time to declare victory at all, far from it. But share a bit on what’s been exciting and fueling that energy for you?

First Principle Lens: Developing successful models of change for Bharat

Mohit: Yeah, I think it’s important to remember that nothing’s really done yet. It’s 1% done, if that, and we’ve got miles to go. I would say there are three things that are beginning to give me at least confidence that we’re on the right track. The first one is it’s hard to be a founder in the social impact sector. It’s super hard. It’s a frustratingly long time to be able to see the impact that you’re trying to see. It’s super hard to access capital for you to actually attract the best talent and then go long. It’s super hard to work with many other constituents and partners who actually ask more questions and ask for precise answers way before you’ve actually discovered what the answers can be.

I think that, when we create a Rocket Learning, where someone like Azeez (Gupta) who graduated from Harvard and had so many other options in life that he could spend his career on, decides to become a social entrepreneur. Someone like ACT, along with the ecosystem, supports him. He then becomes a role model. He, Utsav (Kheria), the entire team, then become role models for the next set of founders who have a choice to either go into the for-profit commercial world or actually go in the social impact world. So I think we’ve helped create a few role models. I look at Karya, look at Rocket Learning, I look at many of our other founders. They’re beginning to demonstrate some of the characteristics and skills that inspire the next gen.

I think the second thing we’ve done is, outside the individual company, we’re beginning to establish a few new business models. For example, Karya uses this concept of, we’ll pay you well for the work you do. They actually use rural Indian women to help perfect the models, the AI models being created by the Valley companies. And you can ask anybody to upskill. Sometimes the benefit of upskilling and paying for that upskilling is not so obvious to the person, but not only are these women now earning, they’re actually gaining their confidence and now they’re going to be upskilling themselves because they want better lives for themselves and their families. So I think these are new business models that we will try and put into place, which again should help provide new frameworks for the next gen.

And finally, capital is scarce in social impact, and I think when we provide this initial seed capital from ACT, it allows business models to get created. It allows companies to move the ball forward. Cloud Physician is one of these companies that ACT had partnered with during COVID time, when it was so hard to go face-to-face for medical reasons. Cloud Physician’s remote management of ICUs was a critical reason that ACT gave them a grant. Well, that business model has scaled and today is very relevant because now Cloud Physician now services over 200 hospitals across India in a for-profit manner and they have attracted venture capital funding for their next round. So giving rise to new business models that then catalyse further rounds of funding would be the third thing. So role models, new business models, and catalytic funding would be the three things I think that make me feel we’re on the right track.

Aakanksha: Love it. And so the flip side of that coin, what do you feel have been the biggest challenges or, even in the coming time, roadblocks that we might face? And I’ll share some candidly, which again, we do grapple with. I think the first big one is just this – the hope but also the peril of really betting on tech first solutions, right? I continue to believe that given the scale of our country and if we really want to see some big change in our lifetime, I feel technology is key and that both digital tech and deep tech are going to be critical enablers. Having said that, they do come with their own challenges, again, because of the (Bharat) audience that we’re working with. There are behavioural roadblocks, access roadblocks, affordability roadblocks that come in the way. So that’s one big one.

Another one that we also hear about a lot is it is going to be hard for one solution to really be able to attack all of what is Bharat, right? It is just a very, very diverse population that varies across cultural context, language, again, economic layers and so much more. What do you see as the biggest challenges that ACT needs to be prepared for in the coming time and in being able to really double down on this tech-first venture philanthropy model?

Future Forward: The path ahead for social entrepreneurship

Mohit: I hope to see more founders and more capital. These two things would be the challenges that I would focus on. I feel with things like ACT and other foundations out there, we just don’t see India’s best talent stepping in to solve some of these hard problems. And I wish I could wave a magic wand to tell people that this is a more purposeful, better mission to follow in life. And if you can give your best years to solving hard problems in education and environment and healthcare, I think we’d all just be way better off. So attracting India’s best talent to these problems is probably statement number one. To that extent, I want us at ACT to try new experiments around incubation, where we actually pick some of these hard problems. So that would be one problem area.

Second is, I hope eventually, if you go out and you become a $10 billion company, I would want you to give 1% and create a foundation of your company. If we can create a $100 million foundation across 10 companies, that’s a billion dollars of foundation (capital) that can emerge from the startup ecosystem.

Mohit: It’s not just the quantum of money, but those same founders will have a massive vision and ability to actually execute against that vision to use that money in a very catalytic way. So I want to attract more capital that comes not from things like CSR, which is a little bit of a tick box for many, but literally put a percent of your very valuable company into giving back to the communities that have actually nurtured you to be so successful. Capital and people.

Aakanksha: Thank you for surfacing both of those. I want to go back to founders because actually that’s been a theme, I think, in everything you’ve shared today – how your journey in the space began, what’s going to be really valuable in the coming decade as you just articulated. And so one thing again I’ve heard a lot of VCs talk about is – here are the traits of a successful founder, founders who are going to go on to build great companies, maximise shareholder value – these are their recognizable traits. Over the last four or five years, what do you feel are the traits of a successful social entrepreneur? What are the qualities you feel they exhibit, the skills they need to bring to the table to ultimately create what you said, the double bottom line?

Mohit: I think one common trait, whether you’re getting invested in by PeakXV or you’re getting a grant from ACT. Founders need to show up every day. And they need to do that for over a decade. If you really, really apply yourself to a problem for that long, you will find a way. You will crack it. And so this trait of going long, not taking short-term decisions, but knowing that you’ll be doing this and working on this problem 10 years later, just is a very different kind of human being who doesn’t flit or get distracted every time there’s a challenge that comes up. I think the one thing that’s different that I’ve noticed in our social impact entrepreneurs is you don’t need to be so sharp elbowed. For you to win, nobody has to lose. There’s the ability to be a whole lot more collaborative knowing that you have like-minded folks who are trying to solve the same problems and the ability for you to share. For example, India is such a great example of creating Digital Public Goods. I would want ACT to give a lot of grants to a startup who then creates digital public goods that are easily given and transferable for no cost to other startups so that they can keep building on top of that. So I think this collaborative nature is a core part of our entrepreneurial ecosystem.

Aakanksha: Couldn’t agree more. Mohit, you’ve seen a huge transformation in India, would say, maybe 2010 to 2020 with the startup economy and again, India becoming this hub of the largest number of unicorns only behind, I think, U.S. and China. What is your hope for India at large for the coming decade? Especially when it comes to the kind of social change or social movements you want to see in the country, what comes to mind?

Mohit: I think one of the biggest issues going on in the world right now is that the rich are getting richer. Globally, we’re seeing issues around immigration into rich countries and the set of social challenges it’s creating. I think given the size of India, it is hard to move the country as one together. There will be these pockets of acceleration across different parts of our population.

Unless we are able to constantly think of things like the digital divide, constantly think of how digital payments can allow for a more inclusive future, I think we risk seeing some of the frustration and then some of the negative elements of that. And so the dream I have at least is while we continue to measure our success in GDP and growth and so on and so forth, is this ability to measure our success in how many people are able to get a solid education up to 10th grade. How many people have access to basic and better than basic healthcare. The environment, I would say, continues to be a lower priority in India than it needs to be. It gets a lot of lip service, but we are getting more and more accustomed to living in dirty and polluted cities, that’s got to change. So I think India of the future is one where the quality of life, I would say the disparity is not as much.

Mohit: I think it’s super important at this stage to create very successful role models that others can follow. India had its first set of IITs and they’ve become globally so successful and sought after. Ashish is trying that with Ashoka and you know, Ashoka’s success in itself will not change India, but Ashoka’s inspiration to so many other institutions getting created will transform education. So I feel like that’s the role we play at ACT. Our job is to create social unicorns, if you will, that really deliver an impact in education, in the environment, in health, in gender equality. And if we’re able to do that, not only will we see that one success in that one or two companies, but we should hopefully create a little bit of a snowball effect.

Aakanksha: Superb. And I’d love to end with a call to action, Mohit. If you had to make a clarion call for the young people in India; folks who are in a position to lend their voice, to lend their time, to lend their money, what would be a big bold call to action that you would make?

Mohit: Look, honestly, this is not a ‘nice to have’. This is not a clarion call; I would say it’s each of our responsibilities to get involved and make yourself accountable to yourself that you need to not just pontificate and talk about these issues, but get involved to solve them. If you think the ACT way is a way to solve it, get involved with us, with your time, your money, or your voice. If you feel there’s a different way to do it, that’s fine too. But get involved. Don’t be a bystander passively to the set of challenges that India faces.

Aakanksha: Love it. Thank you so much, Mohit.

Mohit: Thank you Aakanksha, thanks for everything you and the team do.

Aakanksha Gulati: This brings us to the end of our seventh episode of UnHerd, a podcast presented by team ACT. If you enjoyed this episode, subscribe to our Spotify and YouTube channels, where we’ll bring you more Unheard stories of people who are passionate about creating impact at scale in differential ways. People who truly stand apart from the herd. Follow us, like, subscribe and share!

UnHerd with Tarun Saini: Building ed-tech for Bharat

Posted on August 29, 2024November 17, 2024 by Purvi

Our sixth episode welcomes Tarun Saini (Founder, Vidyakul) who, in conversation with Sunaina Mathur (Manager, ACT For Education), shares his experience of building an ed-tech solution for Bharat and talks about the importance of knowing one’s user.

Listen to this episode on our Spotify or watch the conversation on YouTube.

Sunaina: Hi everyone and a very warm welcome to the sixth episode of UnHerd – a podcast hosted by ACT that delves into the extraordinary stories of individuals who are challenging conventions to disrupt India’s social impact ecosystem.

As you all know, India gained tremendous momentum in online learning during the pandemic and today, is said to be the second largest e-learning market in the world. While we have over 250M children in India’s schooling ecosystem, 80% of these children actually attend state boards. Hailing from underserved communities, these people often do not find high quality, contextualised ed-tech solutions that can help them in their learning journey.

This is exactly the problem that our guest founder will be talking about. Tarun, from Vidyakul, is on a mission to ensure that ed-tech levels the playing field for Bharat’s children. Having grown up in a small village near Ambala himself, he has witnessed firsthand the constraints of a rural Indian classroom and set out to create an affordable solution that caters to state board students exclusively. An affordable app-based freemium solution that hosts educational content for Hindi-medium, English-medium, and vernacular languages, Vidyakul is helping over 2.5M students across Bihar, UP and Gujarat find success in their board exams to unlock brighter futures.

Welcome to UnHerd Tarun, great to have you with us today!

Tarun: Same here, Sunaina, and thank you so much for giving me this opportunity.

The spark that lit the fire: Early experiences that fuelled the mission

Sunaina: You started your life in a small village near Ambala. You grew up, finished your higher education in Australia and spent almost six years working in Australia, which for a lot of people is the ideal life trajectory. But you decided to make that shift back to India. Could you share a bit about that journey?

Tarun: You mentioned it was an ideal life, but it’s not an ideal life honestly. The struggle is 10 times more than it is here.

As you mentioned, my childhood was in Ambala. I’m from a small village, which is so small that you could see it in two minutes if you wanted to. Everyone knows each other and that is the beauty of the village. I completed my schooling in a Hindi medium school. Our village had one teacher who taught us everything – physics, chemistry, math – all the subjects.

I had often seen that parents or families believe that they can financially afford to either spend money on their boys or on their girls. If they had enough money, then it was a very different situation, but if they didn’t have basic financial stability, then most families would spend more money on the boys.

But when I landed in Australia, I saw the atmosphere was very different. The value of women’s education is very different. And after years, when my sister got married and came to Australia, I saw how she built her life. She did her M.Com from a private university and in Australia, she became a chartered accountant and began running the firm. So, with that, we both became ideals for our village. Whenever our friends and family saw us, they saw how our financial situation had changed.

Our experience made us realise how important education is. One is academic, the second is financial literacy and spending time away from one’s village and home. That was a big learning experience. When I used to travel to India from Australia, where the education system was robust, I saw that our villages hadn’t seen much of a change. So I thought, why not do something to empower the background we came from.

I had built a house in Australia, I had my PR. But I thought, let’s just go back and see how we can start up. I still remember, I made that decision within 7 days. I went to my sister and told her, I’m going by an Air India flight tomorrow. This is the key to my house and car. I may come back, I may not. She said okay. You go ahead. That’s how the journey started.

First principles lens: Building user centricity from the bottom up

Sunaina: There were a couple of interesting things you said, Tarun. First, the fact that girls don’t get equal opportunities and as you grew older, you understood that maybe some things could be done differently. And we’ll come to that a little later in the conversation.

The second very interesting thing you mentioned, was the network effect you saw in the village because you and your sister set an example which inspired the rest. Can you talk a bit about that network effect in the village? What made you want to build for Bharat?

Tarun: I think the most important thing is that I come from that same market. Every entrepreneur should be familiar with the market they’re building for. Understand how the consumers live, what they buy, what they use. Each of us three founders at Vidyakul come from the same background. So, that was an advantage.

As for why Bharat? Apart from a deep rooted connection, it’s fun to do something for where you’re from. And I believe very strongly that every family’s situation can change in the Bharat segment, and it can happen through education. Education is the only weapon for them to come out from these situations.

Sunaina: That’s very beautifully put, Tarun. But this audience is very price sensitive, acquisition costs are very high. How do you connect with your audience? What’s the secret behind Vidyakul’s user stickiness?

Tarun: We earlier spoke about the community effect, I will give you a very small example. In a village, if even one farmer uses a fertiliser or a new seed variant that improves the crop and yield, the entire village will shift to using that seed and fertiliser. This is because the village is a very small community where everyone talks to one another. For example, when I went to school, the entire village knew which tuition I went for, which books I carried, and if I looked even a bit healthier, people would ask my parents, “What is he eating?”

So the community factor in a village is very very strong. I would say that if you give one person your product to use, and that person understands your value and outcome, then by the next year the entire village will be using your product.

So when building for Bharat, you really need to understand the district, taluka, and village to map it. It’s a very deep market and that’s why I said, those from Bharat know how to innovate for it. (But yes,) it’s a very price sensitive market. Students compare your price with the value they gain out of the product, and education is very high-stakes.

Education is more of a service market I would say – it’s value driven and so the outcome is at stake. So, you need to be very careful with the quality. We measure impact by assessing a student’s performance before and after Vidyakul. For example, a child who used to get 50% in his exams, who then started getting 70-80% and has consistently improved. We have mapped this very deeply for every child who comes to Vidyakul.

So it took a year and we saw the network effect take place in one village. We visited that village and highlighted the student’s example. That she – let’s say she’s Ram’s daughter who studied at Vidyakul – has topped the district. If you publish that (information) in that particular district and village, where everyone knows everyone, it becomes impactful. And the quality that you deliver should be consistent.

Sunaina: I want to dig deeper into gender. You spoke about your own home and the problem of inequity is so pervasive in even urban India, and it’s quite ingrained in rural India as well. So how do you navigate this at Vidyakul?

Tarun: 100%. I think this is the day to day task for us to educate the families.

Education is a movement and we’re just at its starting point. Awareness is the most important thing. Parents need to know how much value education will create for their children.

If we speak of women’s education, in tier 3 and tier 4 towns, mothers are very aware, because their mindset is very clear. Whatever they went through, they don’t want their daughters to go through. They are very clear that their children are destined for more than just household chores.

So when you target boys, you usually run campaigns for the dad. But when you run a campaign for girls, the mother should be there. Because the emotions are much stronger. If she fights for her daughter’s education, the husband will listen.

Traversing tough roads: Building with patience and deliberation

Sunaina: Thank you so much for sharing that Tarun but it wasn’t an easy journey. It was an uphill battle, especially considering the time that ed-tech has been having. And you’ve still been at it and you’ve been able to build a sustainable business out of it with a very price sensitive audience. If you can share a bit about the challenges that you faced during this journey, and how you navigated them?

Tarun: Everyone has the impression that as soon as Covid came, the ed-tech landscape began to boom. But honestly, that was the first stage of ed-tech in Bharat. Those in metro cities were already aware of ed-tech–how to use it, and they had the money. But when it comes to Bharat, they knew nothing about ed-tech when Covid hit. There was some distant awareness through platforms like YouTube and Whatsapp, but that’s when the ed-tech market in Bharat actually began forming.

While in metro cities the usage of ed-tech is falling, but in Bharat, it’s just starting to rise. And we are very proud to say that within the last 3 years, we have built a very strong fundamental business, where we’ve gone from 1000 paying users to lakhs.

I think the biggest challenge was being patient. As a founder, you want everything to happen within a month. Second is building the team. I think for us the biggest advantage was that we came from a similar background, but finding the right mindset is a very unique task because you can get good people who actually build for the metros and they understand their market. But people who are building for Bharat are in very limited companies and you have to go in the districts or states to find the right people to build with.

Third, when we started, we mostly got influenced by other ed-tech apps. And this is the first stage with founders. They take an app, say it’s very good and think it’ll be successful if they change it in certain ways. But it doesn’t work like that. One day we said, we are going to build for our own market. We’ll build a product based on our own understanding. And right now, we are at a stage where our product is very unique, and is so deeply embedded in Bharat, that we know if there are issues in particular districts with a particular subject, their homepage will actually reflect those issues. That’s how deeply we’ve understood our end users.

So I would say, don’t get too excited in the early stage. Don’t copy anyone. And we made that particular mistake initially, so we learnt to stick with our audience and build for them.

Future forward: Advice for entrepreneurs building for Bharat

Sunaina: Two things that you said that I do want to highlight. One big thing is building bottom up. Not just the product and the feedback, but even the team. Because ultimately, for every insight, you won’t be able to go on ground. And that’s where your team’s insights become valuable. That is why, even though the Vidyakul team has 100 plus people, the Bharat centricity is still there.

And the second thing you said, that ed-tech in Bharat is still nascent. During Covid it was in its awareness phase and only now is it reaching widespread acceptance. If you were to articulate specific advice for people who are starting out in ed-tech and tell them about the Bharat opportunity, what would you like to tell them?

Tarun: It’s important to build knowledge and perspective of Bharat. Most people building from ed-tech have themselves been through CBSE and good schools, and are therefore solving challenges they faced themselves. But CBSE is a very small part of the entire education system. UP alone is much bigger than the CBSE. CBSE has 21-25 lakh students in 10th grade and UP’s Hindi medium board has 32 lakh students yearly, so it’s much bigger. So those who don’t come from that segment will have challenges in building that mindset.

I truly believe that the day we see more founders from Bharat, they will automatically start building for Bharat. That I am 100% sure. Because they have lived that pain, they are able to relate to it.

Sunaina: Building for Bharat from Bharat. That’s beautiful. Tarun, so we are coming towards the end of the conversation, but a reflective question is, is there something you would change about Vidyakul’s journey? If you were starting Vidyakul today, what would you do differently?

Tarun: The failures we have seen in the past 3-5 years have taught us to build sustainably. So I have no regrets. But for those who are solving for Bharat, I’d encourage them to find entrepreneurs building for similar segments. This will help you fast-track the process.

And if I were to go back, I would stick with a very small segment. When we started, we were excited to do everything. But if I were to start again, I will pick one district and I’ll go very deep into that particular district first for PMF and once I have a profit and then I build for Bihar or any other state. So I think those two would be my top lessons.

Sunaina:

Thank you so much, Tarun, for taking the time today!

This brings us to the end of our sixth episode of UnHerd – a podcast presented by team ACT. If you enjoyed this episode, subscribe to our Spotify and YouTube channels where we’ll bring you more unheard stories of people who are passionate about creating impact at scale in different ways. People who truly stand apart from the herd.

ACT For Health welcomes Forus to its portfolio

Posted on August 8, 2024November 17, 2024 by Purvi

India faces a significant challenge with visual impairment, accounting for one-fifth of the global disease burden. Recent surveys suggest that nearly 62 million Indians encounter visual impairment, with conditions like diabetic retinopathy and age-related macular degeneration increasing in prevalence due to the ageing population as well as the high occurrence of NCDs like diabetes and hypertension that cause ophthalmological complications. At the same time, uncorrected refractive error significantly burdens public health, as approximately 60% of visually impaired individuals require corrective measures. These errors can diminish productivity and hamper learning, particularly in school children. Furthermore, they may pose safety risks to the public when professionals such as drivers suffer from these conditions.

While technological innovations in ophthalmic screening have been around for decades, most of the routine screening devices are expensive, bulky, and not suitable for resource-limited settings. For example, a table top fundus camera used routinely in ophthalmic clinics can range from Rs. 15 to 20 lakhs. This has made widespread screening difficult outside of well-equipped urban centres, leaving many without access to essential eye care services.

There is an urgent need to develop and deploy innovations that are not only affordable but also portable and digitally enabled for tele-medicine applications, which could operate under resource constrained settings. Forus Health, a holistic digital ophthalmology platform that unifies devices, specialists, and AI to deliver comprehensive eye screening services globally, is addressing this gap in a big way – their proprietary hand-held autorefractors and non-mydriatic fundus cameras are designed to screen for refractive errors and retinopathy respectively in resource constrained settings without the need to dilate pupils.They have undergone rigorous clinical and field testing in multiple reputed institutions and have been certified by CE and USFDA.

Our grant support to Forus, in collaboration with the Karnataka Department of Health and C-Camp, has enabled the deployment of Forus’ fundus cameras (3nethra series camera) at Primary Health Centers (PHCs) and Community Health Centers (CHCs) across Karnataka to operationalise tele-ophthalmology in a hub and spoke model. In these centres, optometrists would capture and upload retinal images on a cloud-based digital platform, allowing ophthalmologists at district hospitals to review the images at their convenience and recommend follow-up actions for patients. This model allows for easy access and timely referral for retinal conditions at the periphery and given the high patient volumes at these centres, the auto refractometer assists optometrists in quickly optimising prescriptions, thereby reducing the turnaround time.

Scaling in public health demands evidence from real-world settings, optimization of workflows and resources, and clear demonstrations of improvements and benefits over existing eye screening methods, along with the ability to build capacity within the system at scale. It must show volume and agility with improved quality of healthcare delivery. This deployment in KA’s public health settings aims to generate such evidence. It will help scale this initiative to the entire KA state and integrate technology-driven solutions into wider public health settings.

As ACT For Health, we look forward to catalysing Forus to drive an improvement in the accessibility and quality of eye care, especially among underserved populations like school children and rural populations. At a larger level, we also expect that the use of AI and telemedicine platforms will also boost the capacity to manage and treat eye conditions effectively at the primary care level. Our ongoing commitment to this initiative is aimed at creating a sustainable and scalable model of eye care that aligns with our mission to enhance the quality of life through appropriate healthcare innovation!

ACT For Health welcomes Evolve to its portfolio

Posted on August 8, 2024November 17, 2024 by Purvi

India’s mental health crisis affects over 197 million people, with 70-90% of mental illnesses remaining untreated. This silent epidemic disproportionately impacts marginalized groups, including the LGBTQIA+ community, who are three times more likely to attempt suicide. Factors such as over-pathologization, deep-seated stigma, and a shortage of trained queer-affirmative therapists contribute to the disparity in mental health care for the queer community.

To address these challenges, ACT For Health is proud to support Evolve—a digital mental health platform specifically designed for the LGBTQIA+ community. Evolve aims to improve mental health outcomes for the queer community by addressing ‘minority stress’ and positively shifting user habits and behaviours through its 3Cs approach: Content, Community, and Coaching. This method offers customised support, including wellness resources, community support groups, and queer-affirmative therapy, addressing key issues like sexual and reproductive health, gender dysphoria, and violence, among others.

Digital platforms like Evolve are promising because they provide confidential, remote access to care with fewer resources. Tailoring support to LGBTQIA+ needs has proven effective, yet interventions in India remain limited. Evolve’s mobile-first and tailored approach shows strong potential for offering accessible, affordable, and high-quality services.

ACT’s support will enable Evolve to expand its base by over 100,000 users in India and enhance its offerings through vernacular content and B2B2C partnerships with NGOs, CSR initiatives, and corporates. This initiative aims to position Evolve as the leading mental health resource for the LGBTQIA+ community and improve access for underserved communities. We are excited to support Evolve’s mission to deliver better mental health outcomes to more than a million people!