Tech care, kids: Here’s why there’s a rise in healthcare startups dedicated to youngsters

By Kunal Doley

Experts have repeatedly warned of an imminent third wave of the Covid-19 pandemic in India, with some projections marking children as vulnerable. This stems from the fact that alertness among people is slowly waning; schools and colleges are reopening in phases and the younger age groups, especially below 18 years—which comprise 41% of the country’s population, as per the 2011 Census—are yet to be vaccinated against the deadly coronavirus.

Even though there is no substantial data to back widespread fears that children will be hit more severely, concerns over their safety remain. “As the virus continues to evolve, this is going to be a major challenge for children…,” says a study titled ‘Covid-19 Third Wave Preparedness: Children’s Vulnerability and Recovery’ released by the National Institute of Disaster Management (NIDM) earlier this year.

“Children with Covid-19 infection have largely been seen to be asymptomatic or develop mild symptoms. But this becomes worrisome in case children have any comorbidity or other special needs. According to the ministry of health and family welfare, of all the children hospitalised due to Covid-19, 60-70% had comorbidities, or low immunity. Children have also been seen to develop MIS-C (Multisystem Inflammatory Syndrome), which is a rare but extremely serious condition developed post Covid recovery,” the study says.

Paediatric facilities—doctors, staff, equipment like ventilators, ambulances, etc—are nowhere close to what may be required in case a large number of children become infected, the NIDM study notes. According to a Parliamentary standing committee report in 2015, there is an 82% shortage of paediatricians in India’s primary health centres and up to 62.8% of positions for paediatricians in community health centres were vacant, the study adds.

So, are children really at risk?

Pandemics have tendency to wax and wane, and this is going to happen with the prevalent coronavirus as well, feels Delhi-based paeditrician Dr Gaurav Nigam, who is also the founder of Dr Dad, a startup that provides child health-related services and products. “It all depends on people’s behaviour and acceptance to protocols. The density of population in India further hinders the social distancing norms in a lot of scenarios. Festivals are ongoing and people are engaging in mass outings and marketing, schools are reopening, and there is the pandemic fatigue. If the right precautions are not taken, there is a chance of a rise in infections,” adds Nigam.

Dr Anand Lakshman, co-founder of AddressHealth, a Bengaluru-based primary healthcare provider for children, adds: “The virus has slowed down but is still active, which means 70-75% of children would have been exposed. Therefore, there won’t be a tsunami of cases among children, but we will continue to see cases among them, which will be largely mild to moderate, for the next few months.”

Lakshman, however, doesn’t agree with the projection that there will be a manifold increase in Covid-19 infections among children. “The supposition that kids aren’t vaccinated and hence they are the next target are flawed. Our second wave was unique as it was driven by the Delta variant, before any substantial vaccination coverage. The 4th National Sero-Prevalence Survey done by the ICMR [Indian Council of Medical Research] showed that kids are almost equally affected as adults (57.2% among 6-9 years, 61.6% 10-17 years and 62% among unvaccinated adults),” says the 47-year-old Mysore Medical College alumnus.

Many health experts had initially raised concerns about the possibility of a third wave affecting children more adversely than adults. However, recent scientific data suggests otherwise. The Indian Academy of Paediatrics found that there is no biological evidence that the current and the new Delta Plus variant will affect children more disproportionately than adults. The Lancet COVID-19 Commission India Task Force has also concluded that there is no current evidence that an anticipated third wave will target children specifically.
“But there is a cause for worry, if not panic, according to public health experts since the children below 18 years remain unvaccinated in India. Also, the existing pediatric health care facilities are not robust enough to treat children on a large scale,” the study by NIDM notes.

Rise of child healthcare startu-ps

After the coronavirus hit the country and subsequent lockdowns were imposed, people have been resorting to online mediums like never before. This is true not just for children’s educational activities but also for healthcare. “People want new information, good information and, more importantly, the right information,” says Dr Gaurav Nigam of Dr Dad.

Dr Dad witnessed more than double the traffic than other times after the second wave of Covid-19 swept India. “Considering the past surges in traffic, we think any calamity for that matter, where people are supposed to stay at home and get more time on their phones or computers with Internet, sites like ours get more hits,” explains Nigam, adding: “We also feel there is more active engagement happening in this sector as people start asking questions that they want answers to. They want us to cover certain topics during these times. Also, we are seeing a rise in our podcast audience.”

Agrees Swathy Rohit, founder-CEO of Health Basix, a Coimbatore-based pediatric healthcare platform. “Pediatric healthcare is highly fragmented. New technologies that are being added fragment the health experience even further. This impacts kids the most as gaps and overlaps are the main drivers of poor health. One in five kids is prediabetic; we have the fastest growing obese child population in the world, one in eight kids has a mental health need, over 20% are myopic, screen times are some of the highest in the world. We can go on with what we have observed with the kids in our country but if you ask around and see how parents perceive the situation, it’s usually met with apathy only because they don’t have data and information about their own child’s health. We have a lot of content coming at us every day, but it doesn’t stick unless it pertains directly to the child,” she adds.

Health Basix is a simple free-to-download app that helps maintain the child’s health record, a symptom checker and triage platform (book a doctor/hospital appointment, consult doctors virtually) to support parents and caregivers in better navigating healthcare services for children and a membership card to access preferential pricing of up to 30% off on their healthcare needs at hospitals, diagnostic labs and pharmacies.

Meanwhile, Dr Anand Lakshman and Dr Anoop Radhakrishnan’s AddressHealth was born out of their dream to do something in the field of healthcare that was “non-hospital centric”. “If you look at a computer, it has moved from large to small, mainframe to point of use. But healthcare, we feel, is still stuck in the mainframe. We are building big hospitals and hoping that people will come and occupy those hospitals. The idea that health should proactively be addressed, and that health needs to find non-hospital centric addresses, made us start up and found AddressHealth,” Lakshman adds.

AddressHealth offers school health programmes, including comprehensive health check-ups, tele-enabled and Covid-ready school medical rooms, online and offline health education and mental well-being programmes. “In 2019-20, just before the Covid-19 pandemic struck, we screened 170,000 children for common child health issues. We work with over 350 schools, private schools as well as government schools through CSR partnerships. We had Rs 7 crore in revenue that year,” adds Lakshman.

Is vaccination the way forward?

After much research and several rounds of consultations with statkeholders concerned, decks have now been cleared for children to be included in India’s Covid-19 vaccination drive.

Zydus Cadila’s vaccine—ZyCoV-D—has become the first indigenously manufactured, needle-free Covid-19 vaccine to be approved for people aged 12 years and above for emergency use in the country. Earlier on October 12, the Subject Expert Committee (SEC) had recommended Hyderabad-based Bharat Biotech’s Covaxin for emergency use for the age group of 2-18 years. However, the Drug Controller General of India (DCGI) is yet to give a go-ahead to Covaxin, as it has sought additional technical opinion.

The country is now turning its focus towards vaccinating children against the coronavirus, having already administered more than 920 million doses to adults among its population of nearly 1.4 billion.

“The Centre will decide the rollout of the Covid-19 vaccine for children below 18 on the basis of overall ‘scientific rationale’ and their supply,” Niti Aayog member (health) and India’s Covid-19 Task Force chief VK Paul recently said.

In a media interview, Paul said that although a “particular timeline” on when Covid-19 vaccination will commence for children in India cannot be provided currently, it will soon be rolled out.

Vaccines will surely provide relief in the children’s immune status, Dr Gaurav Nigam of Dr Dad says. He hopes things to get normal, “really fast so that the children who are inside their houses and are not able to enjoy nature can go out and feel more connected”. “It’s very important,” he says.

Not just Covid-19, over 3 million children die due to diseases that can be prevented easily by proper vaccination, says Neeraj Mehta, CEO and co-founder of ImmunifyMe, a cloud-based health-tech platform driven by its approach to bridge the immunisation gap among children.

“Yet one in every five children remains unimmunised across the globe and India remains the home of the largest number of unimmunised children,” Mehta adds.

ImmunifyMe started with a focus to reduce the immunisation gap among children. It realised that it was not possible to monitor the vaccination if the records were on paper. “Paper booklets are prone to get lost and mutilated. Once lost, there’s no way we can find the records. So, we developed a technology to digitise the immunisation records and provide better insights into monitoring vaccination and thereby reducing the immunisation gap,” says Mehta.

During the lockdown period of 2020, the regular immunisation was down by more than 90%, Mehta says. “It was then that we decided to also develop a mobile application that will not only help monitor vaccination but also help the parents understand the overall growth of their child,” he adds.

There are about 25 million children being born every year in India and most of them born in 2020 have missed out on their life-saving vaccines. ImmunifyMe now plans to launch a home vaccination programme to reach out to as many parents as possible in as many cities as possible. “We plan to onboard a million children and about 10,000 pediatricians across India by the end of the financial year 2021-22, creating an ecosystem of connected parents and HCPs,” Mehta adds.

With schools reopening, Lakshman of AddressHealth feels they would need to be geared up to make sure children’s health is accorded top priority. “We expect every school to have a Covid-ready medical room. We have created school preparedness guidelines and Covid protocols for schools. We are also geared up for vaccination programmes for children, should the government approve it, as we are already doing large-scale Covid vaccinations for teachers and parents,” he says.

“We expect that schools will invest more in health education for kids and mental well being, which has taken a big hit during the lockdown and school closures,” says Lakshman.

“What the government and school boards have been trying to stress over the last few years are finally seeing mass adoption. Covid-19 has brought about a huge change in the mindset of parents and schools—from reactive to proactive parenting,” Swathy Rohit of Health Basix adds.

HEALTHY GROWTH
Several Indian startups are trying to tap the healthcare space for kids. Here are a few of them

AddressHealth
Bengaluru
Founders:
Dr Anand Lakshman &
Dr Anoop Radhakrishnan
Started in: 2010
Operational in: Bengaluru, Pune, Delhi NCR and Hyderabad
What it does: It offers school health programmes including comprehensive health check-ups, tele-enabled and Covid-ready school medical rooms, online and offline health education and mental well-being programmes

Dr Dad
Delhi
Founders: Dr Gaurav Nigam
Started in: 2019
What it does: It provides child health-related services and products

Health Basix
Coimbatore
Founders: Swathy Rohit, Ramesh Krishnan
& Vishnu Prasath
Started in: 2021
Operational in: Bengaluru, Hyderabad, Chennai, Vijayawada, Coimbatore, Salem, Tirupur
What it does: It serves as a ‘front door’ that connects kids to the healthcare they need—from on-demand visits with licensed doctors to complex case consultations with top specialists

ImmunifyMe
Gurugram
Founders: Neeraj Mehta,
Dr Nadeera Nilupamali & Sudheera Lakmal
Started in: 2017
Operational in: India, Chile, Sri Lanka, Rwanda, Malawi, Tanzania, Republic of Benin, and some other African countries
What it does: It provides paperless solutions for vaccination records and improves early childhood development through growth monitoring and milestone tracking