NGO plans to give every Pakistani access to good quality healthcare by 2020

A healthcare NGO, Naya Jeevan, has planned an innovative programme to provide every Pakistani access to good quality and affordable healthcare by the year 2020.

The Karachi-based organisation was launched in 2009 Naya Jeevan and operates a hybrid social enterprise — a not-for-profit social business combined with a for-profit business. According to its founder and CEO Asher Hasan, their organisation stands apart from the rest due to its innovative and systemic approach. It leverages existing networks and assets to embed within them a core health insurance plan providing value-enriched preventive health services.

Health plan

Naya Jeevan’s health plan is designed to target previously uninsured, formal and informal workers, affiliated with corporations and corporate value chains, and who are making less than $8 per day. The process involves creating a mutually beneficial organic link between the insurance companies, corporate entities and their workers with Naya Jeevan stepping in to cement this bond.

The core health insurance programme is underwritten by five insurance companies. Naya Jeevan makes it a viable option for corporations to be involved as it leverages economies-of-scale and risk-pooling by increasing access to care for thousands of enrolled low-income members. Low rates are negotiated with health insurance carriers, who have themselves negotiated low rates with the providers.

Apart from economies-of-scales, another factor that helps make the programme affordable and sustainable is the low-cost structure of healthcare in Pakistan. For example, a heart bypass surgery costs about $1,500. As such, the health plan is able to cover even catastrophic care that includes heart bypass surgery, for an insurance premium of only $2 per person per month.

The participating companies can choose to pay all or a portion of the insurance premium for affiliated and contract workers. Presently about 85 companies form part of the Naya Jeevan healthcare network.

Once the beneficiaries are insured, Naya Jeevan’s medical team conducts group training and orientation sessions for the beneficiaries to educate them on the use of the health card they would utilise to access the healthcare covered by the programme. They are also informed on the network of hospitals and subsidised diagnostic labs on their panel. An out-patient department (OPD) network is also run where the beneficiaries can use the health card to access the OPD’s of major hospitals on discounted rates.

Naya Jeevan has established a Health Rescue Fund that can support members on a case-by-case basis for treatments even beyond the scope of the insurance coverage. It also conducts optional training seminars for plan members on topics, such as early childhood development, food safety and handling, and general preventive healthcare. DoctHERS, a sister concern of Naya Jeevan, engages those female doctors that after graduation are not practicing and uses this available human capital by linking them up through tele-hosting hubs with communities in low-income urban localities and villages to provide basic diagnosis and prescription services.

Naya Jeevan’s operations are currently focused on Pakistan but they have plans to replicate in India, the US, and other locations. However, to significantly expand the spread of this model, it is felt that it can be adapted within the public sector, thus widely increasing its footprint to meet the healthcare needs of millions of low income Pakistanis.

Farhan Anwar is an urban planner and runs a non-profit organisation based in Karachi city focusing on urban sustainability issues

Published in The Express Tribune, April 20^th, 2015.