rural dev.pdf

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Leveraging Inormation and CommunicationTechnologies or Sustainable Development

in Rural India

A Case Study on Indias Rural Technology

and Business Incubator (RTBI)

August 2008

Center for Health and Aging


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Published in the United States o America by

The National Bureau o Asian Research

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2008 by The National Bureau o Asian

Research

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National Bureau o Asian Research.

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do not necessarily reect the views o the

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Printed in the United States o America.

Cover photos property of NBR. Photo of Dr. AshokJhunjhunwala by Mark Weeks. All other photos

courtesty ofRTBI.

Edited by Claire Topal and Benjamin Gadbaw.Designed byBenjamin Gadbaw.


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A Case Study on Indias Rural Technology and Business Incubator (RTBI) 1

ContentsIntroduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

RTBI: Genesis and Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

The Health o a Nation: Indias Rural-Urban Gap. . . . . . . . . . . . . . . . . . . . . . 4

The Story o an Early Incident:Discovery through Misunderstanding . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Technology Innovation and Social Development in Rural India:

Lessons Learned . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

1. Rural areas require innovations that take into accountlocal contexts

2. Entrepreneurship is key to sustainable development

3. Diversity o input is critical to innovation

4. IT is the tool, not the goal

The Rural Setting: A Snapshot. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Stephens Story:

Gaining Skills, Building Condence, Making an Entryand Leaving an Impression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

A Picture o Success . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Continuing Challenges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

A rural health clinic whichpractices TraditionalMedicine in the villageo Keelasevalpatti, TamilNadu, India.


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2 Leveraging Information and Communication Technologies for Social Development in Rural India

Very oten outsiders think, Oh, people in

the vi l lages are just not ready to accept

technology as a tool or improving theirquality o lie. It s too complicated or them.

But that is the wrong conclusion. We have to

understand the minds o the vi l lagers, their

local contexts, and why they behave the way

they do. We cannot assume that they are

responding in a certain way because they areunable or unwill ing to accept technology, or

because they dont want better healthcare. In

act, it is quite rare that the y reuse anything

that is sae, beneicial , and aordable.

Dr. Ashok Jhunjhunwala, Founder and Chairman, RBI.

Inormation technologycan reach villages ar rommajor cities including theSirukoodalpatti Village in

Tamil Nadu, India.


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population is considered by some to be entrenched in a cycle o poverty and helplessness, proessors at

II Chennai, spearheaded by Dr. Ashok Jhunjhunwala (RBIs Chairman), appreciate this populations

desire or social change, as well as the large potential market it represents. RBI was thus created to

help empower rural populations with the inrastructure, unding, and mentorship necessary to create

sustainable businesses with a social, as well as nancial, benet to the communities in which theyoperate.

While its ounders recognize that an exclusive ocus on technology will not solve the problems o

rural India alone, RBI operates on the premise that the socio-economic needs o rural Indians can

be addressed through a tangible, market-driven, and adaptive technological approach tailored to local

community circumstances and based in the villages themselves. All o RBIs objectives are aligned with

serving unique rural contexts.

o date, RBI has successully incubated our ventures (DesiCrew, ROPE, Intelizon, and Uniphore) and

continues work in seven districts in the state o amil Nadu, each o which serves as a dierent piloting

The Health o a Nation: Indias Rural-Urban Gap

Rural India makes up almost 70 percent o Indiaspopulation and holds 60 percent o the workorce.

Te gap between rural and urban, and rich and

poor, is increasing, as evidenced by the stark

dierences in the health status and access to

health services or populations in both areas.

Agriculture remains the primary economic

driver in rural India and constitutes 60 percent

o the workorce o the whole country, yet it only

contributes to 20 percent o GDP. While urban

India houses only a small percentage o the

overall workorce, it is still the major driver othe economy, and thereore, controls and benets

rst rom new opportunities and improvements

in technology, liestyle, and healthcare.

Te ocus o health policy in India has shied rom comprehensive, universal healthcare to targeted program-based healthcare,

with the public domain conned to amily planning, immunization, selected disease surveillance, and medical education and

research. Larger outpatient care has become almost exclusively a private health sector monopoly, and the hospital sector is

increasingly surrendering to the market. Te decline o public investments and expenditures in the health sector since 1992

has urther weakened the public health sector, adversely aecting poor and other vulnerable sections o society. Out-o-pocket

expenditures account or 80 percent o Indias spending on healthcare. Regrettably, healthcare costs and health-related debt

are skyrocketing, which in turn drives millions o people urther into poverty each year.

Tis socio-economic imbalance between rural and urban India demands immediate attention. Capital ows, population

shis, and oreign trade are a ew actors that play a prominent role in controlling economies in both rural and urban areas.

How eectively we manage these actors remains an unanswered question.

Egattur Village, Thiruvallur District.


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The Story o an

Early Incident:Discovery through

Misunderstanding

The voice o Dr. Ashok Jhunjhunwala,

Founder and Chairman, RTBI.

Very oen outsiders think, Oh, people in the villages are just not ready to accept technology as a tool or improving theirquality o lie. Its too complicated or them.

But that is the wrong conclusion. We have to understand the minds o the villagers, their local contexts, and why they

behave the way they do. We cannot assume that they are responding in a certain way because they are unable or unwilling

to accept technology, or because they dont want better healthcare. In act, it is quite rare that they reuse anything that is

sae, benecial, and aordable.

My colleagues at the Institute o Inormation echnology, Madras developed a portable medical kit that could help bring

quality healthcare to remote areas o India. One day, we took it to a rural village and set it up in the center. As we

connected the kit to a computer and set up the patient chair, a crowd o villagers gathered. Everyone was interested; one

man practically ell over his riends in order to get a better look. A ew o us decided to demonstrate in order to show the

villagers how the kit worked.

Our product was a neurosynaptics medical kit that measured body temperature, blood pressure, pulse rate, and ECG, and

we had connected it remotely to a doctor in a city. As a result, rural residents could benet rom a real-time consultation

with a physician without the long, arduous, and expensive journey to the nearest hospital.

One o our technicians sat down to demonstrate. We attached the kits sensors to his skin and turned on the machine. His

blood pressure was normal. Ten the villagers said, Proessor, you do it! So I sat down and, ortunately, my blood pressure

and temperature were also normal. When I got up, I again noticed the curious villager, who seemed even more curious

than beore. His eyes were wide with excitement, and he kept trying to get as close to the kit as possible. So I called to him:

Ok, you sit down now. Its your turn. We will have the doctor to examine you.

As soon as the curious man heard this he said, Not me, not me... And he backed away and then disappeared rom thecrowd. We called to a second person standing nearby and asked him to sit down. Not today, he shook his head, Maybe

some other day. He didnt move. We tried to cajole a couple more people, but no one would sit down. What was happening,

we wondered? We created an easy, aordable way or villages to receive medical care, and yet they do not seem to want to

take advantage o it!

We then asked the internet kiosk operator or the village to try the machine. We had communicated with him many times

and he had no reason not to trust us. Since he worked with us on a regular basis, we thought, surely he would not reuse.

When I asked him to sit down, I noticed a terried look in his eyes. He looked at me grimly and replied, No sir, not me. Not


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today. When I started to gently push him to sit on the chair, I saw him touching the instrument very lightly and renetically

with his ngertips beore backing away entirely.

As we drove awayperplexed by what had just occurreda realization struck me. We had made a drastic error.

Electrical connections and voltages in the villages are rarely controlled: Tey can be extremely low and then become

dangerously high with no warning. It is quite common or a villager to experience many mild but painul electrical shocks

every year. Te way villagers deal with this is that when they work with electrical goods rst they quickly, lightly touch the

equipment with their ngertips. Ten, i they eel a mild electrical shock they withdraw. I they eel nothing, they continue

their work.

But there we were asking villagers to sit on the chair with electrical equipment wrapped around their bodies. In the villagers

minds, it was common sense not to connect your body to anything that is also connected to electricity. When we tried to get

villagers to test out our neurosynaptics kit, we were essentially asking them to risk their personal saety.

And we realized that this would simply never workregardless o how good our technology was, and regardless o how

much it could oer the village. It is a given that electrical installations will be very poor in the villages, and regardless

o eorts to change that, villagers will simply not eel secure with electrical equipment. What do we do about this? my

team asked. Although it took us a ew hours to gure out, the solution was as simple as changing our design so that the

connection between all the equipment was wireless. We then ran the medical kit through a battery.

Aer rebuilding the kit, we returned to the village. We placed the medical kit away rom the computer on a separate table

so that the villagers could see that there was no wire between them. Everyone saw that the medical kit was not connected to

an electrical socket. Suddenly, we

had volunteers. As a result o this

simple design input, we overcame

initial resistance.

Now, about 75 percent o

villagers in amil Nadu receive

tele-consultations, thereby

signicantly reducing the need

to travel to urban areas or

healthcare. Another signicant

impact is that patients approach

healthcare much earlier in the

disease liecycle.

Unless you understand the

minds o the villagers, youwould probably think that the

villagers are very reluctant to use

technology, even though that is

not at all so.Health Practitioner using telemedicine to examine patient.


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innovations and applications, a keen entrepreneurial spirit, and alignment with RBIs goals. Tese goals

include:

1. Leveraging inormation and communication technologies (IC) that improve the general

welare o underserved communities using a social development approach;

2. Supporting the incubation o young entrepreneurs who strive to build inclusive, rural business

models where local communities receive the bulk o the return on investment; and

3. Facilitating communication and interaction between urban and rural India to advance new

socially responsible business paradigms.

RBI then collaborates with entrepreneurs to achieve these goals by conducting comprehensive

market research, as well as providing mentoring services, inrastructure support, identity and branding

development, and loans and seed unding.

Technology Innovation and SocialDevelopment in Rural India:

Lessons Learned

Lesson 1: Rural areas require technological innovations that

take into account local contextsTe previous story illustrates the importance o understanding local contexts and local mindsets when

trying to implement development solutions. Te act that rural areas require solutions that take intoaccount local contexts should not be news to any reader. And yet this lesson is implemented in theory

with much greater ease than it is implemented in practice. While it is unreasonable to expect every

rural citizen to become an I entrepreneur, it is equally unreasonable to expect all outsider product and

business development to yield perect solutions. Without an understanding o the context and needs

on the ground, even the best intentions will lead to misunderstandings and missed

opportunities.

Any technological solution meant to serve rural villages in Indiawhether it targets

health, education, or agriculturemust take into account the challenges and realities o

day-to-day lie in those villages. Just as RBI ounders learned rst-hand that villagers

have a well-ounded ear o electrical hook-ups, entrepreneurs in general must not

assume that every innovation is the right innovation or rural markets.

Te rst step in making an innovation eective is to ensure that it is appropriate. In

other words, the solution must not require a more advanced inrastructure than the

one that is currently available in the village to unction. Like the LED lights described

in the box below, innovations must not create a dependence on external or non-

renewable resources, as is sometimes the case when new technologies are introduced

into local contexts. In addition, the solution must not require drastic behavior shis

rom villagers.

Appropriate

+

Accessible

+Afordable

=

Efective

Rural Solution


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Second, a solution must be accessible. Te parts, knowledge, and skills to operate and use the innovation

must be readily available. It must also be aordable; i the villager cannot aord to pay or a solution, then

that product or service is highly unlikely to become a business that can be sustained without grants, loans,

or donations. RBI works closely with IIs eNet Group to develop solutions that take into account these

key elements. Once a prototype has been created and tested, RBI provides the research support andmarket analysis expertise to help develop it into a sustainable business.

Lesson 2: Entrepreneurship is key to sustainable developmentTe sustainability requirement is key not only to ensuring a lasting impact, but it is also critical to RBIs

social development goal. A sustainable solution means that the innovation is aordable, appropriate, and

accessible and that it becomes integrated into daily lie, reeing up hands and minds to develop additional

solutions and innovate independently.

o achieve this, RBI maintains a paradigm o sustainability throughout its entire incubation process,

rom the entrepreneurs who are selected to the way in which the partnership evolves.

Te Entrepreneur. RBIs entrepreneurs possess a proven appreciation o the primacy o the ruralcontext in enterprise creation and thereore possess a willingness to work with the village community to

identiy appropriate areas o ocus. Tey also understand

and appreciate the villagers unique skills and capabilities

that new innovations could leverage. Importantly, RBI

entrepreneurs exhibit proven business acumen through

their previous endeavors.

Te entrepreneurial spirit is a quality that, while dicult

to dene, is well understood and sought aer by RBIs

team. It eatures a synergy with RBIs vision, the work

ethic to persevere through dicult set-backs, as well asclarity o mind and a keen understanding o the countless

opportunities the rural market provides. In addition,

entrepreneurs must possess less tangible qualities like

humility and integrity that help them win the villagers

trust.

For the entrepreneur, the hoped-or return on investment

is not just nancial; by contrast many could make

much higher wages through employment in the private

sector. Instead, they choose to innovate with a return-

on-investment (ROI) goal being social development

and improvements in quality o lie or Indias ruralpopulations.

Te Partnership. One o the benets o takingsuch care in selecting suitable incubatees is that, rom

the very outset o the incubation process, RBI places

a great amount o the responsibility or the success o

the business venture in the hands o the entrepreneur.

Even beore approaching the eNet Group and RBI,

entrepreneurs have proven their commitment to and

An accessible solution

My company created the Zonlight, an extremely compact,

energy efcient, and cost eective solar LED based task-

light. The light does not require electricity and provides

light or villagers in their homes at night.

The white light enables people to utilize time ater sunsetor income-generating activities like blacksmithing and

weaving, as well as or household chores like cooking

and grinding. Importantly, the light provides a way or

children to study at night and is bright enough that they

will not strain their eyes. The light is environmentally

riendly and has reduced villagers dependence on the

electrical grid.

Mr. Rama Thombara, a shopkeeper rom Ranshet Village

in Maharashtra, uses Zonlight in his shop and at home or

5 hours every day. He has stopped using kerosene lamps

and torches, which can cause res.

Mr. Harsha Langhya Lendi, a armer rom the same village,

uses Zonlight at home and in the elds or more than 8

hours every day. As a result, he saves 6 Rupees everyday

on kerosene usage. He expects to nish paying or this

product in our months.

- KUSHANT UPPAL, CEO, Intelizon Energy


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engagement with Indias villages as they develop innovative

business solutions. RBI then works closely with them to

set priorities and goals that take into account villagers

challenges, aspirations, and requirements.

Meeting all these requirements does not come at the

expense o quality. By contrast, RBI and its incubatees

work hard to ensure the highest quality standards at every

stage o work. Nevertheless, throughout the entire process,

RBI ensures that the entrepreneur maintains ownership

and agency over their venture. Tus, the process o

research, market analysis, piloting, validating, and scaling

is also one o mentorship, sharing o ideas, education, and

collaboration rather than simply a service RBI provides to

ensure nancial success.

Once a venture is ready to enter the market, theentrepreneur makes the nal decision whether to create an

independent business or partner with an existing organization. In either case, even aer the business

leaves the incubator and the Group, RBI maintains contact in the orm o mentorship and inormation

sharing, which helps guide the development o uture ventures. Indeed, a ventures independence

essentially represents a transition in the type o partnership the entrepreneur holds with RBI. Contact

remains constant, and lessons learned are still constantly ed back into RBIs archives and databanks

both through regular personal contact, as well as through Internet kiosks.

By remaining connected, RBI makes the process o achieving its mission an iterative one both by creating

businesses that empower rural India, as well as by remaining receptive to the lessons that can be learned

as those businesses operate independently in the market.

Lesson 3: Diversity o input is critical to

innovationRBIs evolving relationships with entrepreneurs and other partners

help strengthen an already broad and diverse network o people

committed to social development in India. Tese individuals

hail rom varied elds, such as energy, agriculture, education,

health, water management, and nance. Te thread that binds the

vision o this diverse group is their belie that inormation and

communication technology is a critical means or improving the

lives o the rural poor.

Te basis or welcoming such a broad scope o entrepreneurs stems

rom a recognition that closing the gap between Indias rich and

poor will require change that transcends sectors. o manage this

network, RBI maintains a core team o employees who coordinate

communication and collaboration between the dierent sectors.

Tis involves a continuous dialogue with entrepreneurs, virtual and

live discussion ora, and requent visits to the villages or all.

Discoveries in the ield

Sometimes we go into the eld with a xed

agenda, but then our experience there opens

up a completely new perspective or us. In one

scenario, our team was visiting a village to work

with armers in investigating the development

o insurance products or their livestock.

We discovered that the livestock itsel acts as aninormal insurance product or them. So when

their produce crop ails, they make a living rom

their livestock. We ound this to be especially

true or marginal and small sized armers.

- AGRICULTURE TEAM MEMBER, RTBI.

Patient rom the village oKeelasevalpatti receivingexam rom HealthPractitioner.


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A weekly, in-person sharing orum or all incubatees helps transer learning rom the diverse venture teams

across the dierent sectors o incubation. Business proessionals, practicing entrepreneurs, technology

specialists, and designers are invited to these discussions or greater exposure and inclusivity. As a result,

members constantly explore the overlap and transerability o lessons learned among the dierent venture

areasthrough both ormal and inormal ora. Furthermore, new teams are established as needed by

emerging venture sectors. Tis ramework allows RBI to remain a relatively small organization with low

overheard costs while at the same time leveraging a large network o individuals actively involved in a

number o local communities. Four key areas o RBIs work are described below.

Health. Rural India suers rom a high rate o mortality and preventable diseases largely as a result o

poor or non-existent health inrastructure. In addition, there is a lack o access to skilled and well-trainedphysicians. While India continues to churn out large numbers o well-trained doctors, the majority

choose to either go abroad or work in wealthy, urban areas. RBIs Health arm increases the availability o

quality care and access to aordable services. Importantly, ventures also emphasize the benets o disease

prevention, early detection, and early treatment.

One venture seeks to improve access to quality, comprehensive healthcare in rural areas by

establishing and managing a network o existing, non-ormal health practitioners. Tese

practitioners are selected and trained to address common health problems, as well as provide

essential preventive care. Tis process is acilitated through the use o IC.

The Rural Setting: A SnapshotTe challenges that villagers in remote areas o India, as well as in rural parts o many other countries, oen seem endless

and insurmountable.

Villages are located in isolated areas, ar rom basic education and health services. Such physical remoteness increases

villagers vulnerability to public and private corruption and requently leaves them helpless during times o ood or

drought. Additionally, there is oen no or, at best, unreliable public transportation to the nearest clinic or government ofce.

Electricity can be unreliable and, as illustrated in

the previous story, dangerous.

Furthermore, villagers are oen illiterate and

typically have very little or no money to pay or

education and healthcare. Tey must oen rely

on subsistence arming to meet everyday dietary

needs, and yet the land they live on is becoming

degradated and natural resources depleted.

While RBI recognizes these villagers as comprising

a market or innovation in their own right, RBI

seeks primarily to nourish entrepreneurship

and innovation that helps villagers address and

overcome the challenges above.Shopping in Indian market.


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IC is an enabler and must be used to acilitate business models that serve the needs o, and are relevant

and appropriate to, the potential customers they serve. Building around prior domain knowledge,

matching business ideas with the skills and interests o the local entrepreneurs, and exercising sensitivity

to geographic, socio-economic, and cultural contexts allows or more sustainable, organic growth.

IC is a key tool for RBI, as well as RBIs Entrepreneurs. One example o RBIs useo technology as a tool is its Internet kiosks, which serve as key communication hubs or RBI and its

incubatees.

Tese kiosks include essential equipment, such as a wireless signal receiver, a PC with necessary

soware and peripherals, and battery back-up. Te rst kiosks oered only Internet and phone services

to villagers, but aer adopting digital cameras and other hardware, kiosks expanded to acilitate more

services. Villagers use the kiosks to communicate with relatives in cities and conduct research on health

and agriculture issues, as well as seek new employment opportunities in the region. Kiosk operators are

local men and women rom the villages themselves, who typically have at least a 12th grade education

and enough motivation to run their own businesses. Te villagers pay or the kiosk services they use at a

discounted rate.

In recent years, these kiosks have also increasingly

served as telemedicine hubs and online education

portals, bringing to rural villages tools and

interaction previously only available in urban areas.

For example, the kiosk in the Nemanthapatti village

in the Sivagangai District began by providing video

conerencing services to help villagers connect with

their relatives residing abroad. In recent years, the

kiosk expanded its services to oer health training,

education, and inormation on passport and visa

status, as well as bus and train ticketing.

Given the unreliability o electric power throughout

India, uninterrupted power supply (UPS) units and

battery back-ups have proven essential. Wireless

base-stations are used in rural regions where laying

long cables would be prohibitively expensive. Tey

provide medium-speed upload and download

capabilities along with simultaneous telephone

services. Basic inrastructure also includes tall towers with a 25 km line-o-sight range. Te technology

may not be considered state-o-the-art, but it is adapted to unction reasonably well in village contexts.

A Picture o SuccessDr. Ashok Jhunjhunwala originally conceived o RBI with a distinct vision: to create wealth in rural

India by addressing social challenges, such as lack o access to education and training, clean water, basic

health services, and market knowledge. Success at RBI, as the organization grows and matures over time,

will be dened by the extent to which this vision is achieved and brought to scale through partnerships

and the passion o individuals, with IC as the primary tool. Tis includes: 1) seeing that Indias rural

populations have their most basic needs ullled, and 2) creating a broad network o people and businesses

Commuters in village street.


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dedicated to leveraging technology to increase the quality o lie in rural India by empowering villagers

themselves.

Founded in 2006, RBI is a young organization. In the coming years, as more ventures mature, RBI

hopes to be able to measure impact beyond statistics on the uptake o their services and the number o

projects that become independent. One way might be to measure impact o the ventures on rural GDP.

Another less tangible measure would be to benchmark villagers perceptions o and attitudes towards

these ventures over time.

Sustainability is a crucial element or improving the rural economy and addressing each communitys

unique needs. owards this end, RBI avors a business approach rather than a charity or subsidy

approach whose eects are short-lived. It is this understanding that inorms the conceptual oundation

or RBIs implementation and piloting methodologies.

Continuing ChallengesBuilding a foundation. Since RBI was ounded in 2006, manyo its operational processes are continuing to mature, making current

structures as much experiments as they are necessary processes. Tis

is helpul in the long-run by preventing RBI rom becoming wedded

to legacy systems that outlive their ecacy. It also means that the

work environment at RBI can be hectic and that success oen relies

on individual leadership and innovation.

Relationships: Managing continuously evolvingpartnerships. With such a vast network, RBI must manage adiverse set o relationships that is constantly shiing and growing.

Tis can be challenging when individuals come rom very dierent

backgrounds and geographies. Additionally, some partners may

transition rom entrepreneur to advisor, to eventually becoming a

under. RBI also works with a number o companies that contribute

unding or technology to business ventures.

ranslation: On-the-ground realities of achieving a broad vision. As every projectmanager knows, the on-the-ground realities o working in the eld oen present unexpected obstacles

and require constant creativity, fexibility, and unrelenting patience. While creating wealth in Indias rural

areas through social development is a vision that resonates strongly with everyone, RBI sta must think

practically at every step about how to translate that vision into everyday operations. Tis involves dealing

with on-the-ground problems while maintaining a broader set o principles or achieving success: Whatare the supporting technologies involved? Are there hidden costs to a certain approach? Does a certain

solution alleviate one problem but ultimately create new ones in other areas? Tese are all questions that

RBI sta must keep in mind while tackling specic problems through business solutions. Importantly,

being able to think rom the villagers perspective and embrace that mindset has proven to be a critical

part o success on the ground. Tis process is not always obvious, but the returns are extremely high.

Child playing in smallvillage in India.


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the national bureau of asian research

seattle and washington, d.c.

[email protected], www.nbr.org

1215 fourth avenue, suite 1600

seattle, washington 98161 usa

phone 2066327370, fax 2066327487

1301 pennsylvania avenue nw, suite 305

washington, d.c. 20004 usa

phone 2023479767, fax 2023479766

For more information about the work of RTBI, please contact:

Ms. Suma Prashant, Project Manager for Health at RTBI

(email: [email protected]).

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