[Startup Bharat] How healthcare startups in Tier II and III cities are solving the problem of access in their hometowns

There is only one doctor available for 11,082 people in India. In rural India, people have to walk over five to 10 km to get access to quality healthcare. However, several startups from Tier II and III cities are changing this dismal scenario.

[Startup Bharat] How healthcare startups in Tier II and III cities are solving the problem of access in their hometowns

Wednesday June 05, 2019,

5 min Read

Reality hit home for Ayush Mishra when he was in his hometown, Bareilly, Uttar Pradesh, and had met with a near fatal accident. Finding medical attention proved to be nearly impossible. 

That’s when he experienced first hand the demand-supply gap in healthcare in small towns and villages in India where many have to walk five to 10 km to reach the nearest healthcare facility. 

It is no secret that access to affordable quality healthcare in India is a challenge. According to the National Health Profile data of 2018, there is one allopathic government doctor available for 11,082 people in India, while the recommended ratio is one for a thousand people.

Looking at this problem, several startups have come up with unique solutions. And it the same problem that led Ayush to start Tattvan e-clinic in 2017. It is a telemedicine healthcare clinic that aims to transform healthcare services in remote regions across India and other parts of Asia.

Healthcare Startups Tier II and III India

There is a pronounced demand-supply gap in healthcare in small towns and villages in India.

Providing access 

While Tattvan is based out of Gurugram, the problem of healthcare and its accessibility is being solved by many startups from the Tier II and III cities itself. 

“It just isn’t the access to healthcare facilities but also access to the right form or kind of treatment,” says Dr Kiran Kanthi, a practising anaesthesiologist. 

“Over eight lakh newborn babies die in India every year. Many from neonatal jaundice. If they get the right treatment at the right time, they can be saved,” says Kiran. 

It is to change this status quo that he launched Lifetron Innovations, a medtech startup based out of Hubli, Karnataka. He has built a low-cost, portable, bedside neonatal phototherapy unit that can be used in any kind of rural or remote healthcare setup.  

Kiran has also been running a neonatal nursing care centre for over 20 years in Bagalkot, North Karnataka. His nursing home is one of the few in rural Karnataka that has a neonatal intensive care unit equipped with phototherapy treatment.

A report in IBEF suggests that the current supply of healthcare providers in Tier II and III cities are mostly dominated by doctor-owned small to mid-sized centres offering a few basic specialities. 

And startup founders believe that there is a need for reliable and portable devices in Tier II and III cities, which not only provide access but also make testing reliable and easy. 

"While this facility (phototherapy device) is easily available in most large hospitals, newborns in rural areas often don’t have access to this facility, which can easily prevent unnecessary deaths,” Kiran says.

The need for reliable medical devices in the country is also growing. There are larger organisations like GE Healthcare, Phillips, and Davin building portable equipment too, but not many are available in remote rural areas. 

Healthcare in Tier II and III cities

Amitabh Kant inaugurating Lifetron's phototherapy device

Giving proper facilities 

But what makes these startups more interesting is that they are founded by doctors or technology experts. 

Audiologists T Udayraga Kiran and Remya Uday, Founders of Nautilus, have developed a booth-less portable audiometer to conduct hearing tests. The product also provides a tele-audiology model to help patients remotely determine their hearing. 

“The problem in most rural areas is that there aren’t proper diagnosis facilities available. And without proper diagnosis, you don’t have proper care and treatment. Hence, many people think hearing aids don’t work. It isn’t the problem with the device, it is a problem of diagnosis. Getting people to understand the importance of hearing tests is challenging,” says Uday. 

Uday also explains that there is a need to get the right hearing tests in a safe, portable, and reliable manner in Tier II and III India.


The traditional audiology test equipment costs Rs 10 lakh, while Nautilus’ device costs Rs 2 lakh. The price drop also makes it easier for hospitals and healthcare centres in Tier II and III India to be able to afford it. 

Clearly, being clued in the unique problems small towns face has helped these startups efficiently address healthcare gaps.

“Where these startups really add value lies in their first-hand understanding of the unique problems that the semi-rural population faces and their ability to tackle challenges that don’t exist in bigger cities,” explains Padmaja Ruparel, President and Co-founder at IAN and Founding Partner at IAN Fund. 

Healthcare in Tier II and III cities

NR Narayana Murthy testing Nautilis Device

Devices that matter 

These startups aren’t just restricted to neonatal or auditory care. There are startups like Bagmo, based out of Kochi, which is working towards prevention of deaths during pregnancy due to non-availability of blood in rural India. 

Founded in March 2017 by IIT-Madras alumnus Ashfaq Ashraf and friends Anas Dalinatakam and Arshad KA, Bagmo has developed a blood bag monitoring device, called Bagmo.

The device monitors the temperature of blood bags during transportation and storage. The B2B company aims to reduce wastage at blood storage centres, and improve logistics and communication issues. 

Another startup, Waferchips, based out of Technopark in Kollam, is using IoT (Internet of Things) to solve for healthcare sector using delicate chips and self-designed hardware.

Healthcare startups in Tier II and III cities

Bagmo's device monitors the temperature of blood bags during transportation and storage.

Connectivity and growth 

These startups are also getting global national attention. Initially bootstrapped, Waferchips has received support from the Kerala Startup Mission and Maker Village. The startup has also received funding from Bharat Petroleum Corporation Limited in 2018

Nautilus Hearing won the Karnataka government’s ELEVATE 100 Programme, through which it raised an undisclosed round of funding. The startup has completed preliminary tests, and will soon start clinical trials. The team tested the device at the All India Institute of Speech and Hearing in Mysuru. 

Last March, Lifetrons’ equipment was inaugurated by NITI Aayog CEO Amitabh Kant. 

IAN's Padmaja believes that founders from small towns and cities of India tend to be more tenacious and understand the problems better than founders from metro cities. “They have the drive to make it work and are focused on making money and making it big.”

Whether all these startups will solve the accessibility problem is yet to be known, but they definitely are on the way to doing so.