Access to healthcare, education and economic empowerment to live a sustainable life is the biggest challenge for people living in rural Maharashtra. Despite these villages being just 100-150 km away from Mumbai, there are meagre healthcare, sanitation, education and employment facilities available. Women and children in these villages suffer from various deficiencies, including Vitamin A, D, anaemia, calcium, protein, etc., leading to poor immunity, menstrual problems, osteoporosis, thyroid and more, calling for immediate and urgent rehabilitation of this community. Roche Diagnostics India, through its Project Roshni, has adopted several villages to offer equitable access to healthcare while improving disease awareness, sanitation, livelihood support and childhood education. CSR Mandate speaks to Manjira Sharma, Head of CSR, Roche Diagnostics India, about how Project Roshni has transformed the lives of the people of Sonawe and Saphale.
As a company, when did Roche start implementing CSR initiatives?
Sustainability is integrated into our corporate vision, values, operating standards and guidelines. As a global healthcare company, we are committed to supporting a number of the 17 United Nations Sustainable Development Goals (SDGs) in line with our business strategy, in particular, SDG 3, which aims to ensure healthy lives and promote wellbeing.
Recognising that diagnostics is integral to building a strong health system and promoting wellbeing, we launched the Global Access Programme in 2014 to enable access to reliable testing solutions for patients in low- and low-middle income countries (LMICs). As part of this programme, our goal is to use innovative solutions and leverage world-class expertise to establish diagnostics as a frontline defence against diseases such as HIV/AIDS, Tuberculosis (TB), Hepatitis B and C (HBV and HCV), COVID-19 and Human Papillomavirus (HPV)/Cervical Cancer.
Guided by the values of integrity, courage and passion, we are committed to improving lives through impactful CSR initiatives. The vision for all our CSR activities is to create a sustainable model that improves access to healthcare and creates a long-term impact on targeted beneficiaries. With this vision in mind, we partnered with Society for Human and Environmental Development (SHED) to initiate our flagship initiative, Project Roshni, healthcare access and livelihood empowerment programme for women in the Palghar district of Maharashtra.
Along the same lines, we at Roche Diagnostics India & Neighbouring Markets (RDIN) have been involved in CSR activities to enable sustainable access to world-class diagnostics for the people who need them, when they need them, no matter where they live.
In 2015, we initiated Project Roshni and adopted 17 tribal clusters in the Palghar district of Maharashtra, where we found a pressing need for social upliftment and health interventions.
How do you approach CSR?
Guided by the values of integrity, courage and passion, we are committed to improving lives through impactful CSR initiatives. The vision for all our CSR activities is to create a sustainable model that improves access to healthcare and creates a long-term impact on targeted beneficiaries. With this vision in mind, we partnered with Society for Human and Environmental Development (SHED) to initiate our flagship initiative, Project Roshni, healthcare access and livelihood empowerment programme for women in the Palghar district of Maharashtra.
What are the flagship initiatives undertaken by the company? What is the goal and vision of the company as it implements these initiatives?
With our focus on ‘Doing Now What Patients Need Next’, and innovation driving the development of all healthcare solutions, we are uniquely positioned to create sustainable value for millions worldwide. Sustainability is of paramount importance to us. Therefore, our efforts through all CSR activities are to build a 
sustainable world and ensure access to health, education and financial empowerment.
Project Roshni aims to improve access to healthcare and empower people to live sustainable lives. It mainly covers:
- Anaemi
a screening and management programme. - Screening and management of ailments such as Thyroid, Diabetes, bone health – Vitamin D, menstrual issues and skin diseases.
- Promotion of health and wellbeing through the provision of nutritional support.
Lively support through skill development and training.- Health education.
- Promotion of education among children, especially girls.
- Rainwater harvesting, irrigation and borewell facilities to resolve the water crisis.
- Pandemic support through the distribution of rations to needy families.
- Farming and agricultural support.
A mere 100-150 km away from the financial capital of India, Palghar district has poor access to healthcare, education and economic empowerment. Healthcare, sanitation, education and employment facilities available are meagre. Women and children in these villages suffer from various deficiencies including Vitamin A, D, anaemia, malnutrition etc., leading to ailments, such as poor immunity, menstrual problems, osteoporosis, thyroid and more.
Do you collaborate and partner with other stakeholders regarding these initiatives? Could you shed light on who these partners are?
Yes, we do partner with NGOs as these organisations help us find areas of critical need and facilitate the smooth functioning of our CSR programmes. Our partner for Project Roshni is SHED. It is a voluntary, non-profit organisation that works to transform the lives of underprivileged children and youth residing in the slums of Mumbai. The society was founded in 1982 to improve the living conditions of slum dwellers through education, healthcare, and nutrition.
Where are Roche’s CSR projects and initiatives being implemented? Why did you choose to work in these regions?
Our focus at present is Palghar, Maharashtra. We operate in 17 padas or clusters in the two villages of Saphale and Sonave in the Palghar district to offer equitable access to healthcare while improving disease awareness, sanitation, livelihood support and access to education.
A mere 100-150 km away from the financial capital of India, Palghar district has poor access to healthcare, education and economic empowerment. Healthcare, sanitation, education and employment facilities available are meagre. Women and children in these villages suffer from various deficiencies including Vitamin A, D, anaemia, malnutrition etc., leading to ailments, such as poor immunity, menstrual problems, osteoporosis, thyroid and more.
What are the various healthcare initiatives under Project Roshni?
These are the measures we have taken to empower, uplift and build a healthy community in the district:
- Regular health screening for Haemoglobin (HB) count, thyroid, diabetes and menstrual health for 750 women from 2015
- Provide nutrition and healthcare support to women by way of doctor visits, free medicine distribution and nutrition support
- Awareness programmes on healthy nutrition and women’s hygiene
- Monthly distribution of foodgrains, millets and fortified cereals for 300 women
- Given the unprecedented circumstances due to the widespread COVID-19, we supported 295 needy families in the Saphale region affected by the lockdown (100 farmers with no livelihood, 62 Asha workers, 133 daily wages labourers) by distributing rice of 10 kg, wheat flour of 10 kg, oil – 1 litre, salt – 1 packet, tur dal – 1 kg, sugar – 1 kg, tea powder – ¼ kg, pulses – 2 kg, nachni (ragi/millet) – 1 kg, jaggery – ½ kg, soap – six pieces, and more.
- Create awareness on COVID-19 precautions and vaccination; arranged vaccination for more than 3000 beneficiaries.
How are the villagers in Palghar able to access healthcare through this Project?
Our team members and that from SHED work closely to ensure people are accessible to basic healthcare. Since 2016, doctors have visited these villages three times a week, wherein women, children and those who need medical aid are attended to and provided with medicines, counselling and other support.
We also help the village with ambulance support if people need secondary and tertiary care. We conduct monthly health camps to ensure timely screening of ailments like anaemia, thyroid, diabetes, and menstrual health.
How is anaemia affecting the population of Palghar? What is the percentage of men and women affected by this disease? How is this percentage compared to other regions of the country?
According to the 2019-21 National Family Health Survey (NFHS-5), 21 per cent of women in Maharashtra are underweight. Undernutrition is particularly common in the younger age groups (especially age 15-19), in rural areas for women, and among Scheduled Tribes. Anaemia is particularly high among rural women aged 15-19, and women from the Scheduled Tribes. Women and children, especially in the villages in the Palghar district, suffer from various deficiencies including Vitamin A, and D, anaemia (haemoglobin count as low as 7), low calcium, malnutrition, etc., leading to ailments such as poor immunity, and menstrual problems, thyroid and more.
When we initiated Project Roshni in 2015, we found around 700 women were having HB levels as low as 6 and 7. With proper nutritional support, medication, regular screening, constant health awareness and education initiatives, today, around 220 women are maintaining their HB levels above 12, which is the normal range, as per World Health Organisation.
We chose to initiate Project Roshni in Maharashtra after seeing the number of women needing intervention. We intend to add more villages where such intervention is needed.
Since 2015, our project has touched the lives of more than 5000 women by providing them access to healthcare, health interventions, food security, increased nutritional intake, education and livelihood support. Improvement in the status of women’s health has led to a decline in common infectious diseases, improved menstrual health, family health and education levels of children. Women with normal HB levels can give birth to healthy babies. Pre-term and infant mortality have reduced by 64 per cent from the 2015 levels.
What are the various steps taken by Roche to combat anaemia in Palghar? How many have been helped through your efforts since you started? What is the transformation witnessed in them?
Our key interventions include nutritional support to tribal women through the monthly distribution of fortified foodgrains, millets, and cereals. We conduct regular monthly health check-ups to screen against anaemia, thyroid and other disorders.
Over the last six years, out of 700 women who were severely anaemic, 220 women have now maintained their HB level above 12 for over two years, and less than 3 per cent remain severely anaemic.
Sheela, a 30-year-old beneficiary of our Roshni Project was diagnosed with severe anaemia in 2015. Her HB levels were as low as 6.9. She got married ten years ago and has been unable to conceive. She became a beneficiary under the Anaemia Management Programme. She was treated for anaemia and other issues. With these health issues rectified, Sheela’s dream of becoming a mother finally came to pass when she gave birth to a healthy child. Over time, Sheela’s trust in the doctors increased exponentially. She started volunteering for Project Roshni and ensured that she took control of her health and wellbeing. For the past two years, Sheela has been able to maintain her HB levels above 12 and live a healthy life. She has enrolled herself in the Kitchen Garden Produce Programme and has begun earning a decent income.
Vaishali Babadi, 28, was severely anaemic. She was part of the Roshni Haemoglobin Management Programme. She was also illiterate and faced extreme financial difficulties as she had no outside support in this area. Through regular interactions with the volunteers of Project Roshni, she was determined to improve her health and become financially independent. With the nutritional support, medication and timely intervention that Roshni offered, she recovered and has now joined the skill development training and become a member of the SHG. Today, Vaishali is financially independent and earns ~ Rs 8000 per month and is a strong pillar for the overall wellbeing of her family. She has also encouraged her daughter to attend school. They are happy and do not have any financial burden as a family. Vaishali credits the comprehensive Roshni Project as a catalyst for her transformation and those of other women.
Another example is Nita Bhuyal, a 28-year-old tribal woman suffering from anaemia. She and her four-member family are extremely poor. She became a beneficiary of Project Roshni in 2017 and since then has received a lot of support and empowerment from our team. Her husband lost his job a couple of years back, so she had to become the breadwinner. Nita took help from the Roshni team and got herself trained under the Kitchen Garden Produce Programme. Our volunteers helped her get appropriate land with enough water supply and aided her in starting her business. Within a year, Nita’s financial condition improved. She also began training other women to start their businesses.
Another example is Sudhakar Shankarrao Chimne, a 74-year-old man and resident from Jalna, Maharashtra who was diagnosed with Stage 4 stomach cancer. Sudhakar was the sole breadwinner of his family. His earnings were below 50k per annum. His family tried to gather money for his treatment from various sources but failed to get the needed support. They were not even eligible for aid under any government scheme or the Chief Minister Relief Fund. They approached us for help. We took up the matter and facilitated the required treatment, care and support. The overall expense came up to Rs 9,06,239. It was worth every penny as Sudhakar, though under treatment, has made vast improvements and is slowly getting back on with his life.
Could you shed light on how the various health initiatives have impacted the present and future generations?
Since 2015, our project has touched the lives of more than 5000 women by providing them access to healthcare, health interventions, food security, increased nutritional intake, education and livelihood support. Improvement in the status of women’s health has led to a decline in common infectious diseases, improved menstrual health, family health and education levels of children. Women with normal HB levels can give birth to healthy babies. Pre-term and infant mortality have reduced by 64 per cent from the 2015 levels.
Local and seasonal produce is the best solution to help locals maintain good health. Yes, we understand the importance and the role vitamins play to get back on track towards better health. Do you also conduct seminars, workshops and training so they benefit from expert advice and guidance in this area?
Providing vitamin supplements as an immediate and necessary intervention was important as these women were severely underweight and anaemic. However, over the years, with regular nutritional support, health education, and sessions on preparing healthy meals, we can reduce the dependency on vitamin supplements. The idea here is to detect, provide immediate medical aid and then empower them to eat and live healthy in the most self-sustainable manner.
When we initially started the anaemia management programme, apart from the lack of education on health and hygiene, one of the biggest challenges was poverty. Therefore, three years ago, Project Roshni began skill development programmes to impart livelihood training to the women of the Saphale and Sonave districts, and training for women in beautician courses, handicraft creation, tailoring and kitchen garden produce to ensure a decent livelihood for their families.
What food security measures are you undertaking, and what is the outcome thus far?
Through Project Roshni, we have ensured that at all times, women and children in these villages have physical, social, and economic access to sufficient, safe, and nutritious food that meets their food preferences and dietary needs for an active and healthy life.
As part of our project, we provide around 420 beneficiaries with year-round nutritional support that includes the distribution of fortified cereals, millets and pulses. Our team also conduct sessions to help anaemic women understand the significance of a healthy diet. Through various cooking sessions, we teach women simple recipes to encourage them to adopt healthy cooking habits.
Similarly, during the pandemic, we provided nearly 300 families with monthly rations to ensure their wellbeing and sustenance.
Is the poverty level in this district directly impacting people’s health? How are you mitigating this problem to help people come out of poverty?
Yes, when we initially started the anaemia management programme, apart from the lack of education on health and hygiene, one of the biggest challenges was poverty. Therefore, three years ago, Project Roshni began skill development programmes to impart livelihood training to the women of the Saphale and Sonave districts, and training for women in beautician courses, handicraft creation, tailoring and 
kitchen garden produce to ensure a decent livelihood for their families.
In 2021-22, 50 families owning one acre or 0.5 acres of land and having water facilities became part of this programme. Along with counselling and selection of farmers, our team started documenting work in places such as getting “Satbara” and other details regarding land to help the farmers own their lands 
and obtain a farmer’s certificate. Apart from this, our team arranged for soil testing at these farms to help improve soil quality to ensure better farming opportunities.
We also started a Self-Help Group that educates women on various government schemes such as life insurance, girl child schemes, Adivasi schemes, etc., and saving techniques to enhance their financial 
stability.
In 2021-22, there were around 11 sessions conducted under the Self-Help Group programme for 232 women in 30 communities focusing on financial literacy, importance and information on banking and 
government welfare schemes. SHGs play a very important role in each woman’s life, inculcating the habit of saving and regular deposits.
These programmes have resulted in a 30-35 per cent increase in the standard of living and financial stability since the 2018 levels.
To summarise our experience and the impact Project Roshni has created through various health, livelihood and upliftment initiatives, we can happily say that in the last seven years, we have seen the transformation in these villages and their inhabitants. We see the changing mindset, growing inclination for education, upliftment and improving health trajectory.
What are the societal issues facing women in tribal areas?
Poverty, lack of education and unequal status in the family has led to deprivation in terms of food and nutrition, health, and even financial support for the Palghar women. Moreover, superstitions and an orthodox mindset have kept them away from access to basic health, education and sanitation. Through Project Roshni, our volunteers are working to educate and empower both men and women in this region to uplift the community and ensure its holistic development.
What are your insights on gender related-issues and impact numbers on how solutions are evaluated?
To summarise our experience and the impact Project Roshni has created through various health, livelihood and upliftment initiatives, we can happily say that in the last seven years, we have seen the transformation in these villages and their inhabitants. We see the changing mindset, growing inclination for education, upliftment and improving health trajectory.
Since 2015, our project has touched the lives of more than 5000 women, and that does not stop here. Going forward, we will be adopting more remote clusters to improve their health trajectory.
How can Project Roshni be scaled and duplicated in other parts of the country to create an impact?
Project Roshni was designed to be a replicable model and has focussed on addressing basic requirements for health and livelihood support to promote an overall sustainable life.
Different districts across the country grapple with different issues, and it is important to focus CSR efforts on targeted issues and track their impact. Once the basic problem is largely solved or substantially improved, efforts can be directed at peripheral problems that also need resolving to create a larger impact and deliver on the promise of overall development.
For instance, we focused only on anaemia management through nutritional support during the first three years of Project Roshni. We also coordinated our efforts with the established system, viz, the ASHA workers. However, from 2018, we directed efforts towards children’s education, livelihood support, and water management, as all these issues impact the overall quality of life of the beneficiaries. We are confident that others can replicate this same model across India.
You are also involved in providing financial and healthcare aid to cancer patients. How have these aids transformed the patients and their families?
The cost of healthcare when it comes to cancer treatment is extremely high. We all know that cancer can push families into poverty. As an organisation, our larger vision is to ensure that no patient is deprived of healthcare, and that is what we are doing here.
The Government has been proactive in improving access through various initiatives under the Ayushman Bharat Scheme that aims to reduce Out of Pocket (OOP) expenditure and create access to secondary and tertiary care for approximately 50 crore beneficiaries. There is also noteworthy work done by both the Government and private sector to highlight the significance of early screening and timely intervention of diseases.
What is Roche’s roadmap in this area?
The current healthcare scenario in India is unique with a fair balance of opportunities and challenges. At Roche, our mission is to inspire people, transform healthcare in India and care for every patient’s life through sustainable and innovative solutions. We focus on improving the lives of patients and their families by ensuring that patients are diagnosed and treated with innovative solutions. Our approach is focused on disease awareness, screening and early diagnosis and building diagnostic capacity. Unlike many of our peers, we are present in 450 cities across India. Our industry-leading menu of tests, including novel biomarkers and advanced tests, provides access to advanced diagnostics in smaller cities in India.
Speaking from experience, what are your thoughts on the present healthcare status in the country? What can be done to improve it?
Most of India’s 1.3 billion population spends out-of-pocket for their healthcare needs. There is a consistent rise in the burden of non-communicable diseases accounting for more than 60 per cent of deaths in the country. This is expected to grow, fuelled by the increasing incidence of diabetes, cancer and cardiovascular disease. In keeping with this, India needs to ensure equitable access to healthcare by building a more reliable and responsive infrastructure. There has been an urgent demand of managing the ever-increasing pressure on healthcare by providing an affordable supply of services across geographic and socioeconomic boundaries.
However, all is not all doom and gloom. The Government has been proactive in improving access through various initiatives under the Ayushman Bharat Scheme that aims to reduce Out of Pocket (OOP) expenditure and create access to secondary and tertiary care for approximately 50 crore beneficiaries. There is also noteworthy work done by both the Government and private sector to highlight the significance of early screening and timely intervention of diseases.
Moreover, the pandemic has brought to light the need for people to focus on preventive healthcare. This is where companies like us can be crucial contributors. Through real good CSR work and purposeful mission, corporates can make a difference. With a concerted effort, India’s healthcare landscape can slowly and steadily move towards a healthier future.