Breakthrough Champion: Sunita Nadhamuni on leveraging technology for global health

When Sunita Nadhamuni landed her first job after earning a master’s degree in electrical engineering and computer science from Rensselaer Polytechnic Institute in Connecticut, she knew she wanted to give back. Her ample salary made her wonder what people back home in India could do with the money.

After considering ways to give back, she started a volunteer organization to raise money for rural development in India and began learning about social issues over her weekends. Wanting to do more, she relocated to India with her family a few years later. For over a decade, she worked in the development sector to help educate children on civic issues and support community water and sanitation projects, before venturing into healthcare. Now, she is the head of global social innovation at Dell Technologies. One of its flagship programs she started is Digital LifeCare, which enables India’s primary healthcare system to screen for and manage diabetes, hypertension and cancer. As of Jan. 31, 2022, the digital platform built by her team is being used in 33 states and 593 districts, with more than 135 million people digitally enrolled.

Nadhamuni is a Breakthrough Champion in part because she combines her technology experience with her social mission to drive human progress. She spoke to Perspectives about her career journey and her best advice for upcoming entrepreneurs leveraging technology to address complex social issues.

You’ve worked in a host of spheres–tech, water sanitation and now healthcare. What led you to the detection and prevention of non-communicable diseases?

Nadhamuni with healthcare nursing officers

While working in the development sector, whether it was education, water or sanitation, I realized that you need to fix the system of governance to provide access to basic needs at scale and with quality. Having worked in the tech sector, I was inspired by the speed of digital transformation and thought a lot about how it could be applied to solve social problems.

At the same time, Dell management in India was looking at leveraging the company’s core strengths of technology and talent to build end-to-end solutions to help address large-scale social issues. There was an alignment, and I joined the company. We decided to focus on an area with challenges that technology could help solve and chose healthcare. My research led us to realize that the best way to improve health outcomes and lower health costs was to strengthen the first touchpoint—the primary healthcare system.

In India, the primary healthcare system comprises more than a million community health workers across the country. Providing digital tools to these health workers was an exciting opportunity to apply technology at scale to improve health outcomes. Digital LifeCare was born in 2014, co-created with a rural development non-profit organization called Karuna Trust.

Why did you decide to focus on non-communicable diseases?

Nadhamuni and her team

India has gone through an epidemiological transition from communicable diseases like typhoid and cholera to non-communicable diseases (NCDs) like cardiovascular diseases and cancers, with 61% of the deaths caused by NCDs since 2016. The government was looking at preventive screening to identify and identify manage NCDs for improved health outcomes in the population. The government of India partnered with Dell and Tata Trusts on the NCD IT system for the National NCD program. Based on Digital LifeCare, it helps community health workers and doctors to screen and treat India’s population over the age of 30 years for five common NCDs—hypertension, diabetes and oral, cervical and breast cancers.

Can you talk about your experience as CEO of Arghyam, focused on water and sanitation issues in India. Why is that important to you?

Arghyam is a charitable foundation for sustainable water management, where we support NGOs and initiatives across India. I learned a lot from my time at Arghyam, especially from doing field visits in remote villages all over the country. We saw a variety of cultural, socio-economic and geographic landscapes which influenced the community’s access and agency over water resources. I also learned to listen, ask them about their problems and study community-based, traditional water harvesting structures in arid deserts, flood areas and mountain springs, some dating back thousands of years. Those eight years showed me the power of contextual community initiatives. People need to be involved in solving their own problems, or it isn’t sustainable.

Looking back, what do you think makes an ambitious project like Digital LifeCare successful?

Nadhamuni and HNOs

To make any large-scale, technology-based solution successful, you need three ingredients: the tech/process innovation designed to address the problem, scale and ability to execute.

While our innovation is tech-based, we worked on building a deep understanding of the domain and collaboration with stakeholders to innovate processes. For example, we would go to the rural health centers and sit with health workers and go through each mobile screen, and then follow them during their village home visits to understand their daily routine. I’ve trained more than 500 health workers in our early days and gained massively from those interactions. We learned that giving the health worker a way to track individuals in her app—who needed to be screened, who hadn’t completed their follow-ups—made her life much easier, so we built those features.

It seems like collaboration and teamwork played a huge role in this endeavor.

Absolutely. Preventive screening of the entire population at the national level is a project of a huge scale. You need to partner with government or large institutional networks on their national programs that are designed to reach hundreds of millions of people. To do this collaboration requires patience, but also agility to deal with unexpected changes. For instance, we had to integrate with the government’s new health identity system at very short notice; we had to move very quickly and re-prioritize our roadmap to comply.

To execute the program successfully, we had to develop the expertise and ability to work with the central government on policy and planning like data privacy policy; and state and district officials on program administration. For instance, the state health commissioner was running a two-month screening campaign and required daily performance monitoring reports for her reviews, and we had to do a lot of juggling and managing jobs at the data center so that the commissioner got the reports on time . We also had to work with field workers to train and support them for good usage of the app and take their inputs to design new features.

What is your best advice for those interested in careers that merge technology with healthcare?

For any entrepreneur getting into this space, the three things you may want to consider. First, pick an area you’re passionate about and equip yourself with the knowledge about that sector. Study it in depth, from policy to practice, through field-visits and interactions with communities and practitioners to understand the core problems. Second, find the right non-profit organization working on this sector and partner with it. Make its mission your mission. Finally, your technology solutions should be co-created with end-users which requires listening with an open mind. Be ready for multiple iterations of deploying and then refining your software. You succeed when they succeed.

Breakthrough Champions is a series on Perspectives profiling Dell employees doing extraordinary things to advance digital transformation. The series is inspired by Dell’s “Breakthrough” platform and the belief that progress happens at the intersection of people and technology.

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