British International Investment

Narayana Health

South AsiaConsumer - Health

Narayana Health is India’s largest affordable healthcare chain, operating a range of multi-speciality hospitals across the country.

Since its first facility was established in Bengaluru with 225 operational beds, it has grown to 24 hospitals, seven heart centres and a network of primary care facilities across India with a total of over 6,000 beds.

The company has been consistently held up as an innovator in affordable health models, particularly its ‘assembly line’ approach to achieve low-cost at scale. Its founder, Dr Devi Shetty has been described as the ‘Henry Ford of medicine’.

This investment was made when British International Investment was named CDC Group.

We have now exited this investment. This is what we achieved.

Achieved impact

In 2014, we made an equity investment of $48 million in Narayana Health, an Indian healthcare provider delivering high quality, affordable healthcare services to lower-income patients. In 2016, we worked with the company on a successful initial public offering (IPO) and it is now an Indian Fortune 500 company. In 2018 we committed a loan to implement energy efficiency and renewable energy interventions.

At the time of our investment, Narayana Health was serving around 1.5 million patients annually in 18 hospitals. By March 2020, when we exited the investment, Narayana Health was treating over 2.5 million patients annually and had reached nationally recognised quality accreditation across 21 hospitals. When we made our investment, the company employed over 12,500 people. Through its expansion programme, it expanded its workforce more than 1.5 times and became one of the largest employers in our portfolio at the time of exit.

During our investment, we worked closely with Narayana Health to implement high environmental and social management standards across their hospitals.

We also provided Narayana Health with a loan to implement various resource efficiency solutions across several of their hospitals. These solutions have helped reduce energy demand and install rooftop solar to provide the hospitals with low-carbon energy supply. This loan yielded more than 2200 megawatt hours (MWh) in energy savings annually and increased recycling rates of paper and plastic ten-fold.

Expected impact

In 2014, CDC invested $48 million in Narayana Health to increase access to low-cost healthcare in India.

In 2016, we worked with the company on a successful IPO and it is now an Indian Fortune 500 company. In 2018 we committed capital under our Resource Efficiency Facility to implement energy efficiency and renewable energy interventions.

Our investment supported the company in rolling out its pioneering low-cost healthcare solutions, to deliver quality care to more than 2 million patients including in underserved parts of Central and Eastern India. Around half of Narayana patients receive financial support for treatment, either from the firm itself or through government schemes.

The company has also worked closely with governments in India on schemes to expand access to care. This includes developing one of the world’s largest low-cost insurance schemes with the government of Karnataka, enabling millions of poor farmers to access healthcare for premiums of about $1 per month.

It is estimated that India needs over a million more trained nurses. Narayana recognises that nurses are an integral part of its healthcare delivery and is helping to fill that gap by building teaching hospitals and specialist nursing colleges, and training thousands of new nurses every year.

When we made our investment, the company employed over 12,500 people. Through its expansion programme, it is now on course to create at least 8,000 additional jobs.

Reporting and Complaints Mechanism

The Reporting and Complaints Mechanism allows anyone outside BII to report alleged breaches of the business integrity or environmental and social provisions of BII’s Policy on Responsible Investing. This includes breaches made by BII, a BII investee, or a portfolio company of a fund in which BII has invested. The Reporting and Complaints Mechanism Rules are available here. Reports and complaints can be submitted by email to [email protected] or by mail. See more details on our Reporting and Complaints Mechanism here.

For any other general enquiries contact us at [email protected]

  • Key facts

    Last updated

    When the last quarterly update of the website database occurred.

    :
    March 2024
    Project number

    An identifier number shared by investments in the same project.

    :
    D3252
    Status

    The current status of the investment (green flag for active and red flag for exited).

    :
    Exited
    Region

    The geographical region where the country is located. We currently invest in Africa, South Asia, South East Asia and the Caribbean. In 2023, BII’s investment mandate was extended allowing it to invest in regional funds linked to Ukraine, with the majority of activity expected to begin post-war. Investments outside these regions were made prior to 2012 under previous investment mandates.

    :
    South Asia
    Sector

    We prioritise those sectors that facilitate development and need our capital the most. Our priority sectors contribute towards many of the Sustainable Development Goals. They range from investing in the power infrastructure that will provide people with better access to electricity, to investing in financial institutions that direct capital to the individuals and businesses that need it the most.

    :
    Consumer - Health

    We provide capital in the following ways: directly – through direct equity, direct debt, guarantees and other non-intermediated financial instruments; and indirectly – principally through investment funds.

    For direct investments and fund investments, this is the date BII committed capital to the investments. This is typically the date on which legal agreements are signed by all parties.

    For the portfolio companies of our fund investments, this is the date (either the month or the quarter) on which the fund committed capital to the portfolio company.

    For direct equity investments, this is the date at which British International Investment exited the investment.

    For debt investments, this is the date at which the final debt repayment was made.

    For funds, this is the date at which the fund was terminated.

    For underlying fund investments, this is the date at which the fund manager exited the investment.

    The total amount committed, per financial instrument, per investment, on the date BII becomes subject to a binding legal obligation to provide funding or assume a contingent liability. This information is provided in US dollars.

    For direct investments, this is the amount that BII has committed to the business or project. For fund investments, this is the amount BII has committed to the fund.

    The currency in which the investment was made.

    Investment type :
    Debt
    Start date :
    October 2018
    End date :
    February 2023
    Amount :
    $1.25m
    Currency of investment :
    INR
    Domicile

    The company or investment fund’s place of incorporation.

    :
    India

Related investments made by BII into this company:

Investment name Commitment Region Sector Start date Status
Investment 01 $48.24m South Asia Consumer - Health December 2014 Exited

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