In urban slums across India, families face many impossible choices. A single hospital visit can consume months of income.

With no insurance and minimal savings, many are forced to borrow from informal lenders who charge interest rates as high as 200%. For women, the stakes are even higher: many delay treatment, miss essential antenatal care, or step away from paid work during illness.

Health shocks are the greatest financial threat to families working to escape poverty. Globally, more than one billion people are pushed into poverty each year due to unexpected medical costs. For households already living on the margins, without affordable financing, a single emergency can erase years of progress.

This is why Opportunity launched a Health Finance pilot in Mumbai and Pune with local partner Uplift Mutuals. Now in its third year, the program continues to scale and improve, delivering promising results for the low‑income communities it serves.

Affordable health finance and holistic care

This innovative approach combines quality primary care with affordable health finance products at Health Finance Hubs.

1. Emergency Medical Loans: low‑interest, unsecured loans approved within one to two days for emergencies, childbirth, or essential care.
2. Health Savings Accounts & Maternity Wallets: dedicated savings tools that help women plan and save for predictable health needs like childbirth, children’s healthcare, and education. Supported with financial literacy and preventative health.
3. Community‑governed Health Mutual Insurance: affordable, women‑led insurance protecting families from medical shocks for as little as A$11 per year, with members co‑managing claims and surplus funds.
4. Primary care in the community: each hub includes a doctor providing free or low‑cost consultations, reducing reliance on expensive hospital visits.
5. 24/7 care navigation helpline: round‑the‑clock support helping families access entitlements, find fairly‑priced facilities, and avoid unnecessary expenses.

Early pilot results

Year two results confirm our approach is working.

Key outputs:

• 1,458 affordable Emergency Medical Loans provided to low-income families
• 596 Health Savings Accounts opened – mostly ‘maternity wallets’
• 3,179 people covered with Health Mutuals Insurance
• 50,000+ people seen by a doctor in community clinics

Outcomes:

• Over 70% of loans provided to women
• 99% loan repayment rate – proving health loans are viable and sustainable
• 100% of loans bundled with mutual health insurance in 2025
• More than 60% reduction in out-of-pocket costs
• Increased safe deliveries and antenatal care completion
• As loans are repaid they are loaned again – reaching more families in need

Saving for health, securing the future

Swara lives with her husband and their two young children, Priyash (6) and Kartiki (3), in a crowded one‑room home in a Mumbai slum. Far from their extended family in Goa, they lack the informal support many rely on during crises. Her husband earns a modest income while Swara manages the home, always aware that even a brief illness can threaten their stability.

She first learned about Health Savings Accounts from Uplift’s Health Program Officers, who visit her neighbourhood to share information about savings, insurance and preventative health. Wanting to prepare for her children’s medical expenses, Swara opened an account. “I might need it for health or education,” she explained. “That’s why I wanted a separate savings account.”

Saving for health gives her a sense of control and comfort. Asked about the future, Swara smiles. Her son dreams of joining the army and her daughter wants to become a police officer. Swara continues to save, determined to protect her children’s future and help them pursue their dreams.

Health Finance – a practical and scalable solution

Health shocks remain one of the biggest threats to families like Swara’s who are working their way out of poverty. Health Finance offers a practical, holistic and scalable solution that protects both health and livelihoods.

With plans to expand Health Finance Hubs, Opportunity aims to reach tens of thousands more people with affordable care and financial protection.