iKure: Building stronger care pathways for communities across India

The first patients are already waiting by the time Pranati Karan reaches the village.

A canvas medical bag hangs over one shoulder. Inside are a blood pressure monitor, a glucometer and the diagnostic tools she relies on throughout the day. In her hand is a smartphone, where every consultation is recorded before she walks to the next household.

Most mornings follow a familiar route. She checks the blood pressure of an elderly man who has become one of her regular patients, sees a pregnant woman for an antenatal follow-up and stops by a family where diabetes has become part of everyday life. Before travelling to her next visit, she records the details of each consultation in WHIMS – iKure’s digital platform, the Wireless Health Incident Monitoring System. The platform keeps patient information in one place, helping the care team track follow-up and make referrals when needed.

The villages she serves lie in the Sundarbans, a vast delta in southern West Bengal where rivers divide communities more often than roads connect them. During the monsoon, boat crossings replace short journeys by road, and a hospital that appears close on a map can take several hours to reach.

The challenges facing the Sundarbans are far from unique. India has made significant progress in strengthening primary healthcare through its government programs, where primary care is intended to meet 80–90% of people's healthcare needs [1]. The greater challenge often comes afterwards: ensuring that people continue receiving care over time, particularly when managing chronic conditions such as diabetes and hypertension.

When technology met reality

When Sujay Santra, Founder and CEO, iKure Techsoft founded the organization in Kolkata in 2010, it looked very different. After twelve years at IBM and Oracle as a solutions architect, he believed technology could help close some of the gaps separating underserved communities from quality healthcare. The first version of iKure reflected that background, focusing on digital health solutions for governments, companies and healthcare providers. The field quickly challenged that assumption.

During a conversation with Philips Foundation, Sujay reflected on how those early years changed his thinking. "We understood that technology is not good enough on its own to create the right kind of impact."

In the communities where iKure worked, obstacles rarely arrived all at once. Visiting a clinic could mean losing a day's wages. During the monsoon, rivers became difficult to cross. Medicines were not always available when they were needed, and another appointment required another journey. None of these challenges seemed insurmountable on their own, yet together they gradually weakened the connection between patients and the healthcare system.

Fifteen years is a long time in digital health. Technologies change, funding priorities shift and promising pilots come and go. iKure spent those years refining the same model. Instead of expanding rapidly into new countries, the organization focused on adapting its approach to different parts of India. What worked in the Sundarbans also had to work in the smaller towns of Jharkhand, the rural districts of Odisha and communities with different languages, disease burdens and healthcare systems.

But for Sujay, scale has never been measured by the number of clinics." Unless it is strengthening our core, we don't do that," he said. "We have stopped chasing projects that don't contribute to building a sustainable model."

Sujay believes the next challenge lies in preparing community health workers for technologies that barely existed a decade ago. Artificial intelligence and portable diagnostics are becoming part of primary healthcare, while training often struggles to keep pace. Building those skills, he said, is a continuous process. As healthcare evolves, community health workers need ongoing opportunities to learn and adapt.

World Diabetes Foundation arrived at a similar conclusion from a different starting point. After more than two decades of strengthening diabetes prevention and care across low- and middle-income countries, it had repeatedly encountered the same challenge: helping people remain connected to care long after diagnosis. In iKure it recognized a model built around that very principle: community-based care supported by trusted relationships, longitudinal health records and digital tools that help sustain care over time.

Together with We Share Forward Foundation, our shared conviction led to the creation of ImpactBridge [2], a collaborative investment platform supporting organizations that have already demonstrated their ability to strengthen healthcare systems in practice. More than a source of capital, it reflects a belief that durable change is built by recognizing what works, helping it grow responsibly, and ensuring that others can learn from it.