Sudarshan Hanumappa

Karuna Trust

Karuna Trust is transforming government primary healthcare centres (PHCs) into hubs of ‘last mile’ healthcare service deliverers at a lower cost and of higher quality.

Focus: Health
Geographic Area of Impact: India
Model: Leveraged non-profit
Number of Direct Beneficiaries: 1,036,000 (2013)
Annual Budget: USD 3.3 million (2013)
Percentage Earned Revenue: 10% (2013)

The Social Problem
Government owned Public Health Centres form the backbone of India’s last-mile healthcare delivery service. They are the first point of contact between rural communities and the State’s formal healthcare system. However, across India, PHCs are afflicted by inefficient administration, poor infrastructure, absent medical staff and rampant corruption.

Innovation and Activities
The Karuna Trust has pioneered a Public Private Partnership (PPP) model that brings the government, the village community and the social enterprise together to deliver high quality primary healthcare to rural India. The government invests in upgrading infrastructure and pays for the efficient running of the PHCs whilst Karuna Trust brings in management systems and disruptive health innovations. Village councils hold their PHCs accountable for reporting higher health outcomes and functioning as zero-corruption zones. All services are provided free of charge for patients. Fees, if any, are charged on a no-profit basis. Through the Village Council, the community is able to be an active stakeholder that participates in the planning and monitoring of the PHC’s functioning instead of being a passive recipient of inadequate services.

Karuna Trust has revitalised 67 PHCs across 7 states, half of which reach remote corners of North-East India. With ISO certification, trained medical and administrative teams, zero-absenteeism, mobile medical units, an efficient supply chain of essential medicines and a citizen’s help desk, PHCs run by Karuna Trust have raised the bar for primary healthcare service in India. Going beyond the scope of what a government PHC is mandated to do, Karuna Trust expands the roster of services by integrating a range of care including eye and dental care, mental health, emergency services and community-based health insurance. To counter the problem of poor drug management, Karuna leverages mobile phone applications to track and manage drug supply across PHCs. It has entered into multiple partnerships with social enterprises to bring low-cost high-impact technologies such as birthing kits and infant warmers to their PHCs. It also runs a nursing school that trains local girls and provides them a livelihood opportunity.

To date, the organisation has served more than a million patients at a cost of USD 2.4 per person per year and reports health outcomes that are amongst the highest in the country. In the next three years, Karuna Trust plans to scale up its PPP model to serve 2 million people. This will be achieved through increasing number of PHCs under direct management, training local partners in PHC management and using technology including tele medicine.

The Entrepreneur
In 1986, Dr Sudarshan founded Karuna Trust in response to the alarming incidences of leprosy in the Yelandur Taluk of Karnataka, a tribal settlement. He worked with his team to control the disease and successfully brought down the incidence of leprosy from 21.4 per 1000 people to less than 0.28, almost eradicating it. For the next 3 decades, he worked to create healthcare access to some of the most remote, tribal regions in India. He is the recipient of Right to Livelihood Award (1994) by the Right to Livelihood Foundation in Sweden and the Padma Shri (2000), the fourth highest civilian award in India.