TY - JOUR AB - Purpose–The access to high quality, a reliable and affordable basic healthcare service is one of the key challenges facing the rural and semi‐urban population lying at base of the pyramid (BoP) in India. Realizing this as a social challenge and an economic opportunity (shared value), there has been an emergence of healthcare service providers who have bundled entrepreneurial attitude and passion with available scarce resources to design and implement cost‐effective, reliable and scalable market solutions for the BoP. The purpose of this research paper is to understand the underlying operating principles of these self‐sustainable business models aimed at providing healthcare services to the BoP segment in India.Design/methodology/approach–The empirical context involves the use of case study research methodology, where the source of data is published case studies and the company websites of four healthcare organizations who have made a socio‐economic difference in the lives of the rural and semi‐urban population lying at the BoP in India.Findings–The analysis and findings reflect the key operating principles for sustainable healthcare business ventures at the BoP. These include focus on 4A's (accessible, affordable, acceptable and awareness), local engagement, local skills building, learning by experiment, flexible organizational structure, dynamic leadership, technology integration and scalability.Research limitations/implications–This research study has focused mainly on the published case studies as source of data.Originality/value–The intent is to understand and bring forth the learning and guiding principles, which act as a catalyst for the future researchers and business ventures engaged in BoP context. VL - 12 IS - 4 SN - 1472-0701 DO - 10.1108/14720701211267847 UR - https://doi.org/10.1108/14720701211267847 AU - Esposito Mark AU - Kapoor Amit AU - Goyal Sandeep ED - Gilbert Lenssen ED - Luk Van Wassenhove ED - Simon Pickard ED - Joris‐Johann Lenssen PY - 2012 Y1 - 2012/01/01 TI - Enabling healthcare services for the rural and semi‐urban segments in India: when shared value meets the bottom of the pyramid T2 - Corporate Governance: The international journal of business in society PB - Emerald Group Publishing Limited SP - 514 EP - 533 Y2 - 2024/04/25 ER -