In February 2018, the Government of India announced a massive public health insurance scheme extending coverage to 500 million citizens, in effect making it the world’s largest insurance program. To meet this target, the government will rely on technology to effectively scale services, monitor quality, and ensure accountability. While India has seen great strides in informational technology development and outsourcing, cellular phone penetration, cloud computing, and financial technology, the digital health ecosystem is in its nascent stages and has been waiting for a catalyst to seed the system. This National Health Protection Scheme is expected to provide just this impetus for widespread adoption. However, health data in India are mostly not digitized. In the few instances that they are, the data are not standardized, not interoperable, and not readily accessible to clinicians, researchers, or policymakers. While such barriers to easy health information exchange are hardly unique to India, the greenfield nature of India’s digital health infrastructure presents an excellent opportunity to avoid the pitfalls of complex, restrictive, digital health systems that have evolved elsewhere. We propose here a federated, patient-centric, application programming interface (API)–enabled health information ecosystem that leverages India’s near-universal mobile phone penetration, universal availability of unique ID systems, and evolving privacy and data protection laws. It builds on global best practices and promotes the adoption of human-centered design principles, data minimization, and open standard APIs. The recommendations are the result of 18 months of deliberations with multiple stakeholders in India and the US, including from academia, industry, and government.
Recent research has studied innovation in emerging economies. However, microlevel product development processes in these economies are relatively unexplored, and the mechanisms by which the emerging economy context might affect such processes are still unclear. In this paper, we explore the testing routines fundamental to product development in one emerging economy. Based on an exploratory field study of medical device development projects in India, we observe the frequent, iterative testing of prototypes in clinical settings and investigate the related learning process. The observed testing approach is distinctly different from the comparatively linear and sequential approach adopted by medical device development teams in developed countries like the United States. Further, we suggest that such testing is feasible in India because of the prevailing regulatory flexibility, the cognitive orientation of device development practitioners, and the normative orientation of medical professionals.
A debt trap occurs when someone takes on a high-interest rate loan and is barely able to pay back the interest, and thus perpetually finds themselves in debt (often by refinancing). Studying such practices is important for understanding financial decision-making of households in dire circumstances as well as for setting appropriate consumer protection policies. We conduct a simple experiment in three sites in which we paid off high-interest moneylender debt of individuals. Most borrowers returned to debt within six weeks. One to two years after intervention, treatment individuals were borrowing at the same rate as control households.
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Anjali Raina is the Executive Director of the Harvard Business School India Research Centre. In her leadership role at the IRC, Anjali focuses on building and maintaining relationships with senior business leaders in the region to facilitate the work of the center in research, educational programs, community building and faculty development.
Under Anjali’s leadership, the HBS IRC has facilitated the writing of over 168 case studies on Indian Business Practice and supported half a dozen research projects. Anjali has co-authored several case studies such as Aadhaar: India’s ‘Unique Identification’ System, TeamLease: Putting India to Work (II) Legally; Pratham – Every Child in School and Learning Well; Naina Lal Kidwai: Investing in Her Country; Tech Mahindra and the Acquisition of Satyam Computers (A); HN Agri Serve : Growing Prosperity as well as an HBR Article on The Ordinary Heroes of the Taj.
Anjali wears several additional hats. She is a Director on the Board of Harvard Business Publishing, India, the Regional President (Western Region) of NHRDN, an Advisor to The Akanksha Foundation, Trustee to LIFE Trust, an Advisory Member on the Board of HBS Club of India, and on the Advisory Board of the Indian Business School.
Prior to joining HBS IRC Anjali spent 15 years with Citigroup India, most recently as Country Director, before which she worked for more than a decade with ANZ Grindlays Bank PLC. Anjali holds an MBA from the Indian Institute of Management, Calcutta, a bachelor's degree (Eng. Hons) from Loreto College and is an alumnus of HBS having completed the Advanced Management Program.
HBS IRC - Conducting Research, Fostering Dialogue, Building Community