Recently, I went to South India to learn about scaling health care services across large, low-income populations. While the businesses are "offline," there is at least one significant similarity to many web-based businesses: leveraging social networks in order to acquire trust, gain customers and generate revenue. Here are just some of the ventures we visited:

• Scojo: low-cost reading glasses. The company has an innovative microfranchise model for training entrepreneurs (low-income individuals, generally women) how to identify problems with vision in order identify prospective buyers and sell the eye glasses. Interesting learnings were: How do find your entrepreneurs and educate them? How do you get low-income entrepreneurs to be willing to pay the upfront costs of the glasses and training? How will buyers overcome the negative stigma associated with glasses? One really interesting take away was the importance of style despite the consumer they were targeting.

• Medicine Shoppe: traditionally served the high-income population, but is expanding its pharmacies/clinics to low income communities in India. This has required completely rethinking how they approach medical services. For example, after finding no business was coming in they removed all the windows and doors from the pharmacies/clinics in the low income areas - with them there, it looked too strange to the local residents and they would not enter.

• 1298: Dial 1298 Ambulance is a private ambulance company. Their business model is especially interesting. It's services are provided at a premium to affluent populations and at no cost to the poor. Scaling up operations in India is challenging - the wealthy and poor live in different areas, separated by traffic and bad roads.

One core focus for many of the organizations was on leveraging already established channels of distribution in order to tap remote / distributed populations. Unlike most developed areas, technology is not always an option for acquiring customers. 

If you're interested in more details, here is a write-up on our trip Southern India.