Why foreign startups often suffer in India
Localization matters for cultural acceptance and long term success.
At Secocha Ventures, we study technologies being adopted in the US and look for players in other parts of the world that are taking their home court advantage with those technologies.
An example:
In the US there are approx. 30 million people suffering from diabetes and Livongo, Virta Health, Cecilia Health and a host of other players are going after the same market. On the other side of the world, India has more than 100 million people suffering from diabetes in a market that’s vastly different from the US and therefore difficult for these players to crack. This gives entrepreneurs like Khushboo Aggarwal, founder of Zyla Health, an unfair advantage to build a chronic care management platform that is tailored to the local needs. But before we delve into that, a bit of background on the disease itself.
Before the advent of insulin in 1921, being diagnosed with diabetes was a death sentence. For centuries, even diagnosing diabetes was a challenge to begin with — ancient Indians tested for it by looking at whether ants were attracted to a person’s “sweet urine” — and the treatments were terribly inefficient. Some of the recommended treatments through history included overfeeding to compensate for loss of fluid weight on one end of the spectrum, to starvation diets at the other end.
In 1921, the discovery of insulin, and then again in 1982 of Humulin (synthetic insulin), significantly improved the lives of people with diabetes. However, insulin isn’t a wonder drug. If you are using insulin, you should still see your endocrinologist every 3 or 4 months; otherwise, it’s every 6 months. But therein lies the problem.
This is where technology companies have been chipping away and building systems to allow for personalized 24/7 continuous care. But one size will not fit all. The localized cultural, insurance & medical norms need to be taken into consideration when building such a solution. Khushboo has cracked that with Zyla Health for India. Here’s how:
Localization.
(1) India is a self-pay market, unlike the US, which is insurance led. That’s the single biggest shift in product positioning for a health tech company to think about when planning their GTM strategy. Therefore, B2C takes precedence over B2B efforts. Zyla has built their product with this in mind from the beginning.
(2) Culturally, in India, it is common to have family members play an active role in healthcare for a loved one. Zyla approaches this by involving them in the patient’s progress and leveraging WhatsApp effectively for deeper connections with patients & their loved ones. Imagine trying that in the USA! It would be impossible due to HIPAA regulations. Luckily, this is not the case in India, which also happens to be the single largest market for WhatsApp with 400 million users who use the app as the default method of communication with friends, family and every commerce transaction. A tele-health company that does not build on this penetration would not succeed.
(3) One final distinction is the territorial nature of doctor — patient relationships in India. PCPs (referred to as family doctors in India) will not take it kindly if another healthcare provider changes a patient’s medications without consulting them — an unwritten language among providers that they must respect each others’ turfs. Zyla solves for this by involving the treating doctor within their communication flow.
These are just a few examples of product features that a global player (without the proper attention and understanding of a local culture) would likely not have thought of. Hence, we find opportunities that take successful technology businesses with global applications and implement them elsewhere with a healthy dose of localization very exciting.
Combine that with the frugal-minded approach that we see so prevalent in developing countries, it’s no wonder that Zyla Health has been able to cross 10k paying users with 1/50th of the capital of its counterparts in the USA!
We at Secocha are excited to partner with Khushboo to bring chronic care management to the next 100 million patients.
