Built for India. Available to the world.
Engineered for any city, municipal, state, or federal health system — anywhere a mandate has to pass through multiple tiers of government before it reaches anyone it was meant to help. Each tier carries a different piece of the accountability, with different constraints, different incentives, and a different reason to call us.
Everyone below is solving a different problem with the same programme.
A national ministry, a state health department, a municipal corporation, and a multilateral funder can all be talking about the same scheme — and still need entirely different things from ONRAV, because each one is accountable for a different piece of whether it actually works.
National & federal ministries, scheme bodies
The context
A national ministry designs a scheme once and expects it implemented consistently by every state that adopts it — states with wildly different administrative capacity, legacy systems, and political incentives. India's own Ayushman Bharat Digital Mission illustrates the pattern at national scale: 90 crore ABHA health accounts issued, and yet Uttar Pradesh alone holds more than double the accounts of Rajasthan or Maharashtra. The mandate was identical everywhere. The outcome wasn't — because a national platform can specify the rules but can't itself build the last-mile capacity to follow them.
Source: the adoption-gap brief →What ONRAV brings
Architecture and interoperability standards a state can't quietly deviate from; cross-state adoption tracking that surfaces the Uttar Pradesh-sized gaps while they're still fixable; and claims-integrity systems built for the failure modes national schemes actually have — like the 7.5 lakh PM-JAY beneficiaries the CAG found registered against a single placeholder mobile number.
- National scheme architecture & interoperability standards
- Cross-state adoption & performance tracking
- Fraud, duplication & claims-integrity systems
- National registry design (ABDM-adjacent & scheme-specific)
- Centrally sponsored scheme rollout playbooks for state adoption
- Independent technical audit ahead of CAG or parliamentary review
State & provincial health departments
The context
In India's constitutional structure, public health sits largely with the states — which means a state health department carries the budget line, the delivery mandate, and the political accountability for a scheme it usually didn't design. It inherits a national platform, a state-specific implementation gap, and a legislature that will ask why the numbers don't match the announcement. This is the tier that owns the largest share of both the opportunity and the exposure.
What ONRAV brings
HMIS and registry systems built for the state's actual facility network, not a generic template; real-time visibility into beds, stock, and workforce that a Health Secretary can stand behind in the assembly; and disbursement tracking that shows, credibly, where the state's health budget actually went.
- Health scheme enrollment & eligibility systems
- HMIS modernisation across district & facility levels
- Real-time bed, stock, and workforce visibility
- Disbursement tracking against the state health budget
- District-level performance dashboards for the Health Secretary's office
- Legacy system integration with existing state IT infrastructure
Municipal corporations & city governments
The context
India's 74th Constitutional Amendment gave urban local bodies — municipal corporations, municipalities, nagar panchayats — constitutional standing over public health and sanitation within their city. What it didn't reliably give them was the financing or technical capacity to match that mandate: research on the Amendment's implementation describes accountability resting with local bodies "not backed by either adequate finances or the capacity for planning and management," a gap that has persisted for three decades. A municipal health officer is often the tier closest to the citizen and the furthest from the resources.
Source: Empowering Urban Local Bodies in India — 74th Amendment analysisWhat ONRAV brings
Digitisation scoped to what a municipal budget can actually sustain, not a state-scale system with a city-scale price tag; outbreak and surveillance pipelines that work across fragmented facility ownership — municipal dispensaries, state PHCs, and private clinics all reporting into one city; and integration with state and national registries so a city isn't left maintaining its own disconnected island.
- Urban PHC & dispensary network digitisation
- Outbreak & surveillance reporting pipelines
- Interoperability with state and national registries
- Ward-level service delivery dashboards
- Lightweight systems sized to municipal budget and staffing reality
- Coordination tooling across municipal, state, and private facilities in one city
Multilateral & bilateral institutions
The context
Organisations like the Global Fund, GAVI, and the World Bank increasingly finance health programmes through results-based financing — paying out after pre-agreed results are achieved and independently verified, rather than against activity alone. That model only works if verification is real: the Global Fund runs Local Fund Agents specifically to monitor grant implementation on the ground, because a funder's own reporting and a grantee's self-reported numbers are not the same thing, and everyone involved knows it.
Source: Global Financing Facility — Focus on ResultsWhat ONRAV brings
An independent technology layer between a grantee's claims and a funder's disbursement decision — built the way a Local Fund Agent's mandate is built, but as infrastructure rather than a periodic site visit. Traceability that follows a grant from the funding agreement to the facility it was meant to reach, so "results-based" financing is based on results a funder can actually verify.
- Independent monitoring & verification layers
- Disbursement-linked results tracking
- Grant-to-ground traceability audits
- Third-party technical due diligence on grantee systems
- Results-based financing verification infrastructure
- Portfolio-level dashboards across multiple grantee programmes
The tier that funds and governs isn't the only one that calls us.
Three more kinds of institution show up in the same programmes, usually alongside a government client above rather than instead of one.
NGOs & non-profit implementers
Organisations delivering a government programme on the ground — an implementation partner for a state scheme, or a grantee reporting to a funder — need the same traceability their government and funder counterparts do, from the other side of the relationship.
Academic & research institutions
Public health schools and research bodies studying programme outcomes, evaluating digital health interventions, or advising on policy design, where independent, well-structured data is the actual deliverable.
Private sector partners
Hospital networks, diagnostic chains, and health-tech vendors that need to integrate cleanly with a government scheme's registries and reporting requirements — without becoming the reason a state's interoperability standard breaks.
ONRAV's primary geography is India, where the scale of federal, state, and municipal health administration is large enough to be its own discipline. The Mandate-to-Ground Framework is built for that structure specifically — a national mandate implemented through states, which implement through districts, which implement through facilities. Any country with a comparable federal or multi-tier health system, and the same distance problem between policy and the ground, is in scope.
Recognise your institution above?
Tell us which tier of government or funding you're working from, and what programme brought you here — that's usually enough for a useful first conversation.
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