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Khushi Baby: Origins*

CASE STUDY, ENTREPRENEURSHIP & STARTUPS
ET Cases - FLAME, 13 Pages
AUTHOR(S) : Manali Mundra, student at Malaviya National Institute of Technology Jaipur, Ganesh N Prabhu, Professor of Strategy, Indian Institute of Management Bangalore

Case Preview

Khushi Baby: Origins

 

“The current paper-based system to track the health status of patients is outdated and cumbersome. Records are easily lost or damaged, and the lack of patient-specificity makes it nearly impossible to deliver right care. Moreover, many mothers do not understand the importance of vaccines and do not return to the immunization camps; as a result, children fall through the cracks and are left susceptible to disease. At Khushi Baby, we are working to ensure that each pregnant woman and child’s health is tracked to the last mile so that millions of deaths can be averted.”

– Ruchit Nagar, Founder, Khushi Baby

Idea

Khushi Baby aims to decentralize the medical records of babies with the help of wearable technology to solve two problems in rural areas – low levels of immunization of babies due to the inability of health workers to reach remote places and misplaced medical records of babies.

The idea of the Khushi Baby project was formed when Indian-American student Ruchit Nagar (Ruchit), was working on a course assignment at the Yale Center for Engineering Innovation and Design. The Yale students were tasked with finding an innovative solution to address the world’s vaccine gap and were assigned to random teams of four each across the three phases – research, ideation and prototyping.

The team’s prototyping group (which included Ruchit) picked up the research area of ‘vaccine data and ensuring accountability’ and came up with the specific idea of a wearable reminder for immunizations. Their basic prototype was then enhanced to include a whole system of data collection and community engagement. The wearable device became an offline medical record whose usage could be promoted through campaigns in rural areas....................

Field Trial

While the Khushi Baby concept was very clear, it had to be proven on the field. This needed a field trial. With funds from the Thorne Prize, the Khushi Baby founding team was able to visit India, meet with Seva Mandir and work alongside COO Mohammed Shahnawaz (Shahnawaz). Importantly, the team was able to gather feedback on the form factor and test their system’s beta while getting approval from Seva Mandir for a longer term pilot study. To fund the pilot study, the Khushi Baby team raised a successful Kickstarter round ($31,500) and Shahnawaz, a PhD scholar at the Indian Institute of Health Management Research, Jaipur, was awarded the Johns Hopkins Future Health Systems Young Research Grant ($22,000) – a grant to fund research on future health systems by young researchers.........

Startup

While the field trial was going on and showing reasonably positive results, Ruchit was planning on the start-up organization that would scale-up this initiative across Rajasthan state and impact more lives. Before starting up as a not-for-profit venture, Ruchit had been deeply worried about two issues.

The first issue was the team composition and their commitment to the project as three of the student members were leaving for full-time occupations at the culmination of their course at Yale University. Through word-of-mouth and some cold e-mailing..........

Awareness

Successful implementation of ‘new to the world’ initiatives requires creating awareness. The Khushi Baby team had to create awareness within the complex ecosystem of stakeholders to ensure smooth and effective implementation of the idea which in turn would lead to a positive impact. For the mother, awareness meant receiving the necklace for her baby with regular voice call reminders in the local dialect in the voice of the local health worker............

Training Interns

Given the lack of adequate funds to employ enough full-time employees, the Khushi Baby team explored the option of recruiting undergraduate interns who would be willing to work with them only for the learning experience. Khushi Baby regularly recruited unpaid interns to work on the key areas of technology, field research, external funding and development. Interns were recruited from local colleges and were assigned to the three different activities based on their core strengths, their local language skills and their educational qualifications. As of 2017, Khushi Baby had four Research Interns, four Technical Interns and three Development Interns. As a practice, as soon as possible after joining Khushi Baby, all new interns and new team members (if any) were taken to see an immunization or antenatal care camp........

Operations

The Khushi Baby initiative requires the direct support and buy-in of multiple stakeholders. Most importantly it requires support from the local healthcare authorities for its effective implementation. So the first step by the Khushi Baby team when entering any new district is to meet the healthcare authorities to create awareness about how it works and to get their support. The team coordinates with the healthcare authority support structure to support onboarding and refresher training for nurses. Often the health system could cover some of their operating costs. The operations are summarized below: .............

Awards and Support

The Khushi Baby project had to initially operate with a shoe-string budget till the team was able to prove the concept, its technical effectiveness and show its acceptability to the target population. The team managed many minor costs on its own and got important work done by interns and volunteers.

Over the years, a number of awards and recognitions have spurred the Khushi Baby team forward as well as funded the Khushi baby initiative. Since the users (parents) do not pay for the necklace and government funds are limited, the Khushi Baby team has been using its own award based funding to demonstrate the concept so that it can spread far and wide.............

Funding and Costs

While the many awards have given a strong push to their initiative, the Khushi Baby team is now looking at new ways by which its growing activities can be funded consistently and sustainably.

The total landed cost of each Khushi Baby pendant is $0.94. By 2017, the company had imported 4,500 pendants with about 2000 pendants ordered per year. Shipping to India from China costs $150 for order lots of 1,000 necklaces and the custom duty paid is $15 per 1,000 necklace import order...........

Design

Design thinking has been critical in the Khushi Baby project. Though the field prototype effort started with designing a method to track child immunization records, they soon realized in the field that the nurses had to maintain many other records on a paper logbook that was prone to errors. So, they returned to the drawing board to redesign their software platform to be more comprehensive and eliminate the paper records completely..........

Khushi Baby 2.0 System

Their intensive design and redesign effort led eventually to the redesigned Khushi Baby 2.0 system that had many new features that went beyond just infant immunization records. The new system has a Maternal Health Module and meets all the National Health Monitoring Standards..........

Partners

The Khushi Baby 2.0 system is a culmination of a long run effort by the team as well as the involvement and contribution of a number of significant partners. Apart from Seva Mandir that enabled the pilot implementation in Udaipur, Khushi Baby has partnered with a number of agencies across the world such as UNICEF Innovation, PCH International, ARM and Andela..........

Vision for the Future

Khushi Baby intends to adopt a Software as a Service (SaaS) model with the government’s Ministry of Health as the primary customer. The company’s approach requires top-down buy-in from the Central Ministry of Health to implement its system for the ANM health workers on the front line. In parallel, the team is looking to validate and prove the company’s model in multiple government contexts outside the trial it did with Seva Mandir. It’s slow district-wise growth may soon be catalyzed as several Indian districts have approached it to pilot its approach.........

Assignment Questions

I. Identify and assess each major product-market decision taken at Khushi Baby and suggest the possible and better alternatives to those major decisions, if any.
II. How should Khushi Baby plan for better growth and reach? Identify its major challenges.
III. ............

Exhibits

Exhibit I: Khushi Baby Pendant

Exhibit II: Khushi Baby Team in 2017

Exhibit III: Khushi Baby System Shown on Kickstarter Campaign

Exhibit IV: Khushi Baby Financials (2014-2017)

 

 

Teaching Note Preview

Khushi Baby: Origins

 

Synopsis

The case describes an interesting and innovative social enterprise startup that seeks to make an impact by reducing infant and child mortality among the rural poor in India. The initiative starts as a student project at Yale University, USA and the initial cash awards won by the team provides initial funding for a pilot project in India. Khushi Baby is currently a not-for-profit venture from Rajasthan, India that introduced an innovative low cost waterproof pendant for babies that is embedded with a Near Field Communication (NFC) computer chip with the baby’s entire immunization records. It replaces the paper-based system where records are easily lost or damaged and parents often forget to report to the immunization camps leaving children susceptible to disease. The pendant has a robust black threaded necklace which is like the traditional black thread tied around babies to ward-off the evil eye and is thus never removed by mothers. The pendant is scanned with a smartphone application by healthcare workers on visits to administer vaccines and the data is uploaded to a cloud server when the health worker returns to the city.

Khushi Baby aims to decentralize medical records to solve two problems – one, low levels of immunization of babies due to the inability of health workers to reach remote places and two, misplaced medical records of babies. Khushi Baby’s founder, Ruchit Nagar (Ruchit) was part of a student team at Yale that developed a prototype of a wearable reminder for immunizations. The idea and prototype won the Thorne Prize for Social Innovation in Health and with the prize money, Khushi Baby was launched in May 2014. The system was field tested in Udaipur with Seva Mandir, a local volunteer organization. The early prototype was enhanced to include comprehensive data collection and community engagement through effective publicity in rural areas and cell phone voice call reminders. This case study describes how the founders created a network of volunteer supporters and built credibility among the health officials. It also describes the startup challenges in detail and covers bootstrapping methods used at the startup stage given that most funding on the project came through awards won by the founders. With only four full time employees, seven part time employees and sixteen full time contract workers, the team has to grow both in size and reach. Students discuss on the tradeoffs in planning for growth.

Pedagogical Objectives

This case illustrates a bootstrap startup process and illustrates the difficulties of running a social enterprise where the user does not and cannot pay the bills. While Khushi Baby team has been able to build visibility and received many awards, they have to find a sustainable source of funding and support for an ongoing activity that meets several compelling social objectives. Since this is an early stage case, a number of potential new product and new market opportunities can be identified by students for the base product and their feasibility and viability can be examined. Business model, innovation and business strategy linkages can be explained with the help of this case. The case also illustrates many dilemmas and tradeoffs identified in the process of product development and launch. It is also useful as an assignment case.

Case Positioning and Setting

This case study can be used in:

• BBA and MBA courses in social entrepreneurship and product innovation.
• Strategy sessions on inclusive business models.

Assignment Questions

I. Identify and assess each major product-market decision taken at Khushi Baby and suggest the possible and better alternatives to those major decisions, if any.
II....................

...................

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Abstract

Khushi Baby is a not-for-profit venture from Rajasthan, India, that introduced an innovative low cost waterproof pendant for babies that is embedded with a Near Field Communication (NFC) Computer Chip with the baby’s entire immunization records. It replaces the paper-based system where records are easily lost or damaged and parents often forget to report to the immunization camps leaving children susceptible to disease. The pendant has a robust black threaded necklace which is like the traditional black thread tied around babies to ward off the evil eye and is thus never removed by mothers. The pendant is scanned with a smartphone application by healthcare workers on visits to administer vaccines and the data is uploaded to a cloud server when the health worker returns to the city.

Khushi Baby aims to decentralize medical records to solve two problems – one, low levels of immunization of babies due to the inability of health workers to reach remote places and two, misplaced medical records of babies by their parents. Khushi Baby’s founder, Ruchit Nagar (Ruchit), was part of a student team at Yale University that developed a prototype of a wearable reminder for immunizations. The idea and prototype won the Thorne Prize for Social Innovation in Health and with the prize money, Khushi Baby was launched in May 2014. The system was field-tested in Udaipur with Seva Mandir, a local volunteer organization. The early prototype was enhanced to include comprehensive data collection and community engagement through effective publicity in rural areas and cell phone voice call reminders. “We are working to ensure that each pregnant woman and child’s health is tracked to the last mile so that millions of deaths can be averted”, says Ruchit. With only four full time employees, seven part time employees and sixteen full time contractors, the team has to grow both in size and reach.

Pedagogical Objectives

This case illustrates a bootstrap startup process and the difficulties of running a social enterprise where the user does not and cannot pay the bills. While Khushi Baby team has been able to build visibility and received many awards, they have to find a sustainable source of funding and support for an ongoing activity that meets several compelling social objectives. Since this is an early stage case, a number of potential new product and new market opportunities can be identified by students for the base product and their feasibility and viability can be examined. Business model, innovation and business strategy linkages can be explained with the help of this case. The case also illustrates many dilemmas and tradeoffs identified in the process of product development and launch. It is also useful as an assignment case.


Case Positioning and Setting

This case study can be used in:

  • BBA and MBA courses in social entrepreneurship and product innovation.
  • Strategy sessions on inclusive business models.

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