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Review
. 2025 Jun;41(6):672-685.
doi: 10.1007/s12055-024-01813-7. Epub 2024 Oct 22.

Free surgery for CHD through philanthropy-a sustainable model?

Prabhatha Rashmi Murthy  1 , Sowmya Jandhyala  2 , Shaun Prasanth Setty  3 , Sreenivas Chodagam  2
Affiliations
Review

Free surgery for CHD through philanthropy-a sustainable model?

Prabhatha Rashmi Murthy et al. Indian J Thorac Cardiovasc Surg. 2025 Jun.

Abstract

Among the multiple challenges faced by children from low- and middle-income countries (LMICs) with congenital heart disease (CHD), the economics of care remains foremost, contributing significantly to morbidity and mortality. This paper evaluates the four existing finance models available for healthcare systems and proposes a new model-the GIVE model (government, institutions and individuals, values, and engagements)-as the fifth model for global sustainable healthcare systems. The paper presents an evaluation of a chain of three paediatric cardiac hospitals in India to assess the sustainability of their philanthropy-based operational model, through which surgeries are offered completely free of cost to children with CHD. The three Sri Sathya Sai Sanjeevani Centres for Child Heart Care in India have been proponents of this philanthropic model for over a decade. From February 2013 to January 2024, 19,684 patients with CHD received surgeries at no cost. The average cost of surgery was reported to be USD (United States Dollar) 1800. A case study of one of the Sanjeevani Centres showed that 23.8% of patients were in STAT Category 3 and above, as defined by the Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery, with an in-hospital mortality rate of 2.08%. The evaluation highlighted the institution's numerous strategies to enable sustainability in key aspects of operations, economics, and social impact. Despite challenges, the Sai Sanjeevani philanthropic model, which encompasses both economic and social impact, is dependable and can be replicated. The proposed GIVE model is recommended for adoption by LMICs as a global way forward to enable free CHD surgeries through sustained philanthropy, strengthened by a shared vision and collaborations.

Keywords: CHD; Congenital heart disease; Free healthcare; GIVE model; India; Low-middle income countries; Philanthropy; Sri Sathya Sai Sanjeevani; Sustainability.

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Conflict of interest statement

Competing interestsThe authors declare that there is no competing interest.

Figures

Fig. 1
Fig. 1
Sri Sathya Sai Sanjeevani Centres for Child Heart Care
Fig. 2
Fig. 2
Gender, age, and weight distribution of 2541 CHD surgeries in Sai Sanjeevani, Kharghar (May 19–Jan 24)
Fig. 3
Fig. 3
Graph of year on year growth of Pediatric Cardiac Surgeries at Sri Sathya Sai Sanjeevani Centres for Child Heart Care. Data considered up to 31 January, 2024
Fig. 4
Fig. 4
Sources of funds for Sai Sanjeevani Hospitals for 3 financial years. INR - Indian Rupee, M - Million
Fig. 5
Fig. 5
Feedback from beneficiary families on the potential financial risk averted
Fig. 6
Fig. 6
Feedback from beneficiary families on improvement in their child’s health post-surgery
Fig. 7
Fig. 7
Feedback from beneficiary families on impact of Sanjeevani Hospitals on them
See this image and copyright information in PMC

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