25 Oct CEO Woman: Reinventing Health Care in Bangladesh
Lawyer-turned-entrepreneur Sylvana Sinha marries tech with humanity to bring top-quality care to the country of her roots
By Kimberly Olson
While Sylvana Sinha’s family was visiting Bangladesh for the wedding of a relative, her mother needed an emergency appendectomy. Her mother was being treated at one of the best hospitals in the country, yet the surgery was delayed, and she endured serious post-op complications. For Sinha, the experience was eye-opening. Despite Bangladesh’s impressive economic growth in recent decades, it appeared that no amount of money could supply access to quality health care.
As a result, thousands of Bangladeshis were leaving the country every day to obtain quality health care abroad—taking with them billions of dollars annually. Sinha, who was born and raised in the United States, became focused on finding a way to democratize quality health care in Bangladesh, where her parents were born.
In 2018, she launched Praava Health, based in Dhaka, Bangladesh’s capital, to deliver quality health care grounded in trust. Thanks to Praava’s fully integrated “click-and-brick” outpatient care model, patients can use a mobile app to access their medical records, ask a question, or make an appointment anytime.
When the COVID-19 pandemic arrived in Bangladesh, Praava was the first government-approved private lab to offer testing. The organization also quickly rolled out Praanno, a digital concierge product that advised patients who didn’t require hospitalization how to manage COVID at home. During the first six months of the pandemic, 86 percent of COVID-19 patients who used Praanno were able to recover at home, compared with 49 percent nationally.
Praava is now the fastest-growing consumer health care company in Bangladesh, with plans to build about 30 facilities throughout the country in coming years.
Sinha is actually a lawyer by training. Prior to founding and becoming chair and CEO of Praava Health, she was an associate at Weil, Gotshal & Manges and at Hogan Lovells, and worked as a management consultant at Boston Consulting Group and PricewaterhouseCoopers. She served in various roles at the World Bank in Kabul, Afghanistan, and in New York. She has also served as a social protection specialist at the International Labour Organization, a United Nations agency, and as a foreign policy advisor to the 2008 presidential campaign of then-Senator Barack Obama.
Sinha is a board member at PATH—a global health nonprofit—and a member of both the Council on Foreign Relations and the World Economic Forum’s UHC2030 Private Sector Constituency. She graduated from Columbia Law School, earned a master’s degree in public administration and international development from Harvard Kennedy School, and has a bachelor of arts (with honors) in economics and philosophy from Wellesley College.
Diversity Woman: Where did you get your drive?
Sylvana Sinha: My parents were instrumental in encouraging me to achieve my potential. They were immigrants and set an example with the ambition of that journey. And they were a living example of the possibilities that hard work could create. I was ingrained with the belief that you can do anything. There is something extraordinary about entering the world with that belief, however life might try to beat it out of you. That confidence lives inside of me.
DW: What challenges did you face while launching Praava?
SS: I’d never worked in health care, so I applied my consulting skill set to solve a problem. I was forced to approach it with a lot of humility. I literally took a course on emerging market health-care entrepreneurship and another on how to start a company. I went on a global listening tour to learn the operations of health care, starting in Bangladesh, talking to operators, investors, public health professionals, medical professionals. And in Bangladesh, I talked to patients because I wanted to understand their perspective.
Bangladesh is actually doing better on social development indicators than any other country in the region. And to be fair, life expectancy is higher in Bangladesh than in parts of New York City and San Francisco, two of the wealthiest parts of one of the wealthiest countries in the world. So there are lessons from within and outside of Bangladesh that we applied to our model.
DW: How did you build your team?
SS: I surrounded myself with people who had depth of expertise that I did not—people who had worked in health-care quality management, in health technology globally and in Bangladesh, people who had started health-care businesses in other countries. Sharing what motivates me helped me attract the right kind of people to help build this company.
DW: As an entrepreneur, what has surprised you the most?
SS: The inefficiency of capital markets. We proved the economics of the business in 10 months, but it didn’t lead to investors immediately coming. Eighty percent of venture dollars go to companies headquartered in New York, Massachusetts, and California, although those markets certainly don’t have a monopoly on innovation. Even if you’re in Detroit or Atlanta, you have a harder time raising capital.
We know that women entrepreneurs are rewarded with less than 2 percent of venture dollars, and most of that is still in the United States. In emerging markets, the Silicon Valley model of “build and investors will come” doesn’t really work. And maybe there are some good things about that. A lot of companies getting venture funding in the West maybe are premature in doing so. Because we’re in an environment where there’s scarcity of capital, we’re forced to be really scrappy and build a resilient business. That’s a positive lesson but definitely isn’t the way that I thought things were going to play out.
DW: What sets Praava apart?
SS: We’re building a better patient experience. Whenever any of us goes to the doctor, we’re feeling vulnerable, so it comes down to the dignity and respect with which we treat our patients.
The average amount of time doctors spend with patients is 48 seconds in Bangladesh. At Praava, you’re guaranteed 15 minutes with your doctor. There’s clinical evidence that when patients are engaged in the management of their health, clinical outcomes are better. In Bangladesh, unfortunately, you do what the doctor tells you, and you’re not encouraged to ask questions. At Praava, in every exam room there’s a wall hanging that says, “Mr. Google is not your doctor. Make sure you ask your doctor these five questions.” We encourage patients to engage as much as possible.
The dignity and respect piece is in creating affordable access to quality health care. When we entered the market, there were only four international-standard labs for a country of 170 million people, which is absurd. To put that into context, the United States has 3,400 times that level of international-standard labs per capita. So we are creating high-quality patient experiences that create better outcomes so patients can stay in good health at home.
DW: Are there any upcoming initiatives that you’re especially excited about?
SS: We’re launching a new version of our app. Through your phone, you will see all your medical records. You can get pharmaceutical products delivered. You can order lab testing to your home within five hours of placing an order; someone can come to your house and collect your sample.
DW: Describe your workplace culture.
SS: I strongly agree with Peter Drucker’s statement that “culture eats strategy for breakfast.” So we have invested heavily in building a company culture where every employee feels empowered to carry forward our vision. There’s clear evidence that businesses that prioritize their employees first, even before their customers, achieve better financial outcomes and dramatically outperform the S&P 500, for example.
DW: Why should women helm more health-care organizations?
SS: Less than 13 percent of CEOs of health-care organizations in the United States are women, despite the fact that 65 percent of health workers are women and 80 percent of household health-care decisions are made by women. We need women leading organizations because women are 50 percent of the population and are overrepresented when it comes to [making purchasing decisions about] certain types of products.
DW: What do you want female entrepreneurs to know?
SS: There’s a huge economy happening outside of the United States, and huge opportunities for women entrepreneurs in these markets. If women were to participate at the same level as men, we could add as much as $28 trillion to the global economy within two or three years.
DW: Any parting words?
SS: We’re very lucky to have served nearly half a million patients in Bangladesh to date, but we have 170 million people in our country, so I’d like to think we’re just getting started. DW