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Photographs by RA Chandroo

Good Businesses 2013

Fruits of labour
With low-cost birthing kits, Ayzh holds out hope for rural women

S Sen

I have always wanted to give back to women, especially rural women, who have so little to call their own" — Zubaida Bai, co-founder

For Zubaida Bai, like most people, statistics meant little more than numbers. Until she nearly became one herself. A serious and prolonged infection during the birth of her first child jolted her into thinking about the risk millions of women face worldwide and not just in India, and what she could do about it. A May 2012 fact sheet by World Health Organisation (WHO) estimated that around 800 women were dying every day from preventable causes and complications related to pregnancy and childbirth, and 99% of these occur in developing countries. In fact, two-thirds of women in Indian villages give birth at home without the help of skilled attendants.

Zubaida seeks to stem this shameful statistic with a simple solution to reduce infections that lead to fatalities during childbirth. Janma, a $2-birthing kit overseas and ₹150 in India, contains simple essential tools recommended by WHO to provide sanitation and sterility at the time of childbirth. The idea behind Janma is that every woman should have a safe, clean, and hygienic delivery, whether she delivers at home, at a primary health care centre or in a hospital.

The size of a paperback, this life-saving kit contains a sterile birthing sheet, a blood absorbing under-pad, a chord clamp, a surgical blade, a bar of soap/ sanitiser, wipes and gloves and basic medication. All this comes in an eco-friendly jute bag that the mother can later use as a purse. The kit comes from Ayzh (pronounced as ‘eyes’), a social venture that the 32-year-old engineer-entrepreneur founded in 2009, to provide health and livelihood solutions to underprivileged women.

Growing up in a middle class household in Chennai, Zubaida saw from close quarters the social and economic hardships women face in India. “I saw my mother struggling financially. Several of my friends were married very early and couldn’t pursue higher education because of lack of funds,” she says. Zubaida was more fortunate, though. After her engineering degree from Chennai, she went on to do her MS (product development and design) from the Dalama University in Sweden on a full scholarship. At 24, she married Habib Anwar and moved to Canada for some time. When the information technology firm he worked for wanted to set up operations in India, Habib jumped at the prospect, and they relocated to Chennai. Upon their return, Zubaida joined Rural Innovations Network, where she worked on product innovation, assisting individuals and organisations to make their product ideas commercially viable. 

After four years, she found herself getting increasingly frustrated with the fact that genuinely good products weren’t able to succeed in the market. Habib, too, was tired of corporate life, and decided to join her. With Zubaida’s background in product innovation and her exposure to various projects, and Habib’s financial expertise, they decided to reach out to rural communities. “I have always wanted to find a way to give back to women, especially rural women, who have so little to call of their own,” says Zubaida. 

Habib echoes her sentiments, adding, “I had similar experiences when I was growing up and have often been amazed at the hardships my mother had to put up with.” Around that time, a chance meeting with a professor in Boston during a conference they were attending, led them both to do an MBA in Social and Sustainable Enterprises from the Colorado State University in Fort Collins. “Since I managed to get a full scholarship first, I got to do the MBA first,” laughs Zubaida. In 2009, they first registered Ayzh in the US. 

Baby steps

On a field trip to south India while pursuing her MBA, Zubaida contracted an infection due to unsanitary conditions during the delivery of her first child, and spent a year recovering from it. This led Habib and Zubaida to consider maternal health as an area of focus. They spoke extensively with maternal health professionals, and researched the market for products that catered to this segment. The crude methods being used in rural India for childbirth were hardly up to the required safety and hygiene standards. “There was this one place in Rajasthan, where Zubaida was aghast at seeing Topaz blades being used [to cut the umbilical cord],” recalls Habib. The only safe alternatives were branded and expensive products. Janma was born from these deliberations, with a simple business plan to make it work. 

Returning to India in 2010, their first step was to register Ayzh in India as well, and launch it with a working capital of around ₹14.5 lakh. “It was a combination of the prize money we won for Janma at various business plan competitions in the US, and our meagre savings. We even had to pawn some of Zubaida’s jewellery,” says Habib. To start with, Ayzh partnered with the panchayat of Kuthambakkam, a small village in the outskirts of Chennai, training three of its women to assemble the birthing kits. Janma was thus born.

The first order of 100 kits came from Mediscon Hospital, a private hospital catering to the slum population in Bengaluru. “They are still one of our big customers,” points out Habib. Ayzh pitched Janma at every meet of maternal health champions, and targeted NGOs and private sector hospitals catering to the rural and urban poor, and patients from lower middle class groups. They also reached out to government-run institutions, initially. But with limited resources — a small budget and just the two of them doing everything — the couple could sell only 8,000 kits in 2011. 

The same year, Zubaida was selected for the Ashoka Foundation’s Young Champion for Maternal Health fellowship. This opened up new doors for Ayzh globally and in India. She met Catherine Hall of the US-based The Birthing Project, who took Janma to Ghana, Uganda and Malawi in Africa. The fellowship also cast a spotlight on Ayzh and in 2012, it received funding from undisclosed social impact institutional investors, who also serve on Ayzh’s advisory board. 

Ayzh markets Janma to the institutional sector only. It has two types of customers: medical institutions such as hospital pharmacies, healthcare centres and rural clinics; and non-profit aid organisations that work on women and child health-related issues in developing countries. Its focus is on private hospitals serving low to middle income groups. These, according to Zubaida, deliver 70% of primary healthcare in rural areas. It also reaches out to non-proprietary public enterprises, and non-profits such as the Karuna Trust.

In India, Janma is made available in all four southern states, in addition to Arunachal Pradesh and Mumbai. It also has a large market in Nigeria, Tanzania, Ghana, Malawi and Uganda in Africa, where the company sells almost as many units as it does in India. Janma is sold online by Path, a US-based non-profit that operates in India as well. Ayzh has sold about 20,000 Janma kits till date and the numbers are adding up fast, with 13,000 units sold in the first quarter of CY13.

“We expect to add another 50,000 to this number by the end of this year,” says Zubaida, without revealing current revenue numbers. “We expect to break even in another two years,” adds Habib. Ayzh is seeking an additional $800,000 in a second round of start-up funding, to expand its product line, sales team and sustain operations until it achieves breakeven by 2015.  

Growing up

Ayzh is staffed by a handful of people and continues to run a tight ship. The number of women assembling Janma has gone up, though only to 12. “There is no money to hire anyone,” laughs Habib, who handles finance and accounts, while Zubaida is in charge of marketing. She’s aided by a marketing manager in India, and one in the US, targeting American charities and UN-related procurement agencies. Ayzh relies on word-of-mouth publicity for Janma. Both Habib and Zubaida say that they make it a point to be present at all major forums where maternal health and mortality are the key issues. 

To keep overheads low, Ayzh makes and supplies Janma kits to order. Raw materials are sourced from local pharmaceutical companies. Habib explains that at current volumes, a dedicated assembling unit does not make sense. Surprisingly, Ayzh has not moved to patent Janma. “We feel it’s pointless; any determined person can make a copy of the birthing kit,” says Zubaida.

The key to Ayzh’s success lies in innovating regularly, admits Zubaida: “When you have a really small budget, you learn to be creative.” For instance, while conceptualising Janma, the eco-friendly jute bag was just an afterthought, but it’s now in great demand. “It has become a gift for the mothers,” says Zubaida. Consequently, she invests considerable time and resources on product development. It’s a three-stage process starting with identification of a need through field visits, working on a prototype, and sharing it with potential customers for feedback. The final product is designed by a professional design firm. Ayzh currently works with the US-based Catapult Design, and several other individual designers. 

For 2014, it is looking to increase volumes by penetrating north India and offshore production to expand its reach overseas. After the response to Janma in Africa, Ayzh is also exploring options of setting up base there. Consultations are on with government and tax experts on the feasibility of setting up a similar manufacturing model in a country in east Africa. Zubaida is also putting the finishing touches to her next social landmark product Shishu — a new born-care kit, due for launch in the beginning of 2014. Thanks to her, the statistics could tell a very different story now.

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