Seniorcare Ageing Growth Engine (SAGE) Initiative (2021) : Harnessing Innovation for India’s Ageing Population

Policy Update

Shruti Sethi

Background 

India is often described as a young nation, yet it is simultaneously becoming one of the world’s fastest-ageing nations. The country’s elderly population, those aged 60 and above, numbered 149 million as of 1 July, 2022 and is projected to double, reaching nearly 347 million by 2050, accounting for close to 20.8 percent of the total population (United Nations Population Fund).

The UNFPA’s India Ageing Report 2023, prepared in collaboration with the International Institute for Population Sciences (IIPS), projects that by 2046, the elderly population will actually surpass the population of children aged 0–14 years, a demographic crossover that signals a fundamental reshaping of India’s social contract. The decadal growth rate of the elderly population currently stands at 41 percent, making this one of the fastest-growing demographic cohorts in the country.

It is against this backdrop that the Government of India launched the Seniorcare Ageing Growth Engine, better known as the SAGE initiative.

About SAGE

SAGE, which stands for Seniorcare Ageing Growth Engine, was launched in June 2021 by the Ministry of Social Justice and Empowerment. The initiative was announced by the then Minister of Social Justice and Empowerment, Thaawarchand Gehlot, along with Ministers of State – Ramdas Athawale and Rattan Lal Kataria. An accompanying SAGE portal was opened for applications on 5 June 2021.

At its core, SAGE is a startup-facing initiative designed to build a market-based eldercare ecosystem. The initiative aims to identify, evaluate, verify, aggregate and deliver products, solutions and services directly to senior citizens, giving them a wide choice of eldercare options suited to their requirements. The SAGE portal functions as a “one-stop access” platform for elderly care products and services provided by credible startups.

The sectors covered under SAGE are deliberately broad: health and healthcare services, housing and real estate management, care centres, financial management, legal services, travel and ticketing, food and nutrition, and digital and technological services. Startups are selected on the basis of the innovativeness and social relevance of their products and services, assessed by an independent screening committee of experts. Applications are received through the SAGE portal, with the National Institute of Social Defence (NISD), which is the technical arm of the Ministry, serving as the implementation body.

Eligibility criteria, as set out in NISD’s official Expression of Interest circular, require applicants to be incorporated in India for less than ten years, to have an annual turnover not exceeding ₹25 crore in any preceding financial year, and to be registered as a company, be it Private or Public, rather than a trust or Section 8 foundation.

The startup must also demonstrate genuine innovation: it cannot be a split-off from an existing business, and its products or services must be driven by technology or intellectual property in the realm of eldercare. Innovators recognised at national-level competitions such as the Smart India Hackathon are also eligible to apply, as are startups already functioning in the elderly segment that meet DPIIT startup norms.

A key financial feature of the initiative is equity support of up to ₹1 crore per selected startup, funded from the Senior Citizens’ Welfare Fund (SCWF) and routed through the SAGE Venture Fund, with IFCI Venture Capital Limited serving as the investment manager on behalf of the Ministry. The SAGE Venture Fund itself was formally launched in August 2022 as a SEBI-registered Category II Alternative Investment Fund (AIF). The government’s total equity stake in any supported startup is capped at 49 percent, preserving the startup’s private character and founder control. An overall allocation of ₹100 crore was assigned for promoting the silver economy under this programme on 4 June 2021. 

Rationale: The Case for a Market-Based Eldercare Approach

India’s conventional approach to eldercare has primarily operated through NGO-delivered services and government-run institutions. SAGE represents a deliberate expansion of this model, channeling the energy of the startup ecosystem toward an underserved demographic segment. Secretary of the Department of Social Justice, R. Subrahmanyam, noted at the launch that the government was expanding its scope beyond NGOs to generate multi-pronged interventions through innovative means.

The rationale draws on several structural realities. Significantly, the Atal Vayo Abhyuday Yojana (AVYAY) scheme document articulates the market-failure logic behind SAGE directly: it notes that profitability in eldercare startups is minimal because they are addressing a social issue and that institutional banking has historically been conservative in funding ventures in this segment, restricting access to commercial finance. These twin failures, i.e., low private returns and credit market exclusion, justify the government’s equity participation as a corrective intervention, not a subsidy in the conventional sense. 

Beyond this, the scale of need is far beyond what public provisioning alone can meet. Second, India’s startup ecosystem has demonstrated strong capacity for solving complex social problems at accessible price points. Third, the elderly themselves are increasingly diverse in their needs, from assistive devices and telemedicine to wealth management, legal aid and companionship platforms, making a pluralistic, startup-driven delivery model more adaptive than centralised provision.

What Makes SAGE Different from a Conventional Startup Incubator

It is worth being precise about what kind of instrument SAGE actually is, since this shapes how it should be judged. A conventional startup incubator typically offers mentorship, workspace and sometimes grant funding, with no expectation of financial return and limited government exposure to the startup’s performance. SAGE instead takes an equity position of up to ₹1 crore per startup, capped at 49 percent ownership through a SEBI-registered venture fund structure. This has two consequences that a grant-based model would not.

First, equity funding aligns the government’s incentives with the startup’s commercial survival, not just its social mission; the SCWF only recoups its outlay if the company succeeds and the equity appreciates or is bought out. Grants, by contrast, carry no such feedback loop and cannot be recycled into future cohorts. Second, equity participation subjects SAGE to the ordinary discipline of investment due diligence (via IFCI Venture as investment manager), which is arguably why the EEC evaluation process prioritises companies already showing market traction rather than early-stage ideas alone.

The trade-off is that an equity model is inherently selective: it favours startups with a plausible path to commercial scale and is less suited to funding ventures serving populations with little ability to pay, precisely the “missing middle” problem taken up later in this piece. Robust, verifiable comparisons with specific international eldercare-innovation programmes are difficult to source with confidence, so this comparison is best framed at the level of design logic : equity versus grant, selection versus subsidy, rather than claiming SAGE is modelled on, or superior to, any named foreign scheme.

SAGE in Practice: The January 2024 Evaluation and Achievements So Far

The Empowered Expert Committee (EEC) conducted a formal evaluation of applicant companies on 10th and 11th January 2024. The EEC comprised three independent members — Mathew Cherian, Saumyajit Roy and Dr. Elangovan Kariappan, alongside representatives from IFCI.

A total of 32 companies submitted applications and were invited to present, of which nine were recommended to advance directly to the next stage, having already demonstrated sufficient market traction. This group spanned a notably wide range of eldercare needs: at-home diagnostic kits (Neodocs), seat-lifting mobility devices for those with orthopaedic and muscular limitations (Translead Medtech), smart medication reminder systems (Medeassist Solutions/DoseTap), pre-packaged medicine delivery for elderly living alone (RxCo), emergency and vitals-monitoring smartwatches (WatchOut Wearables), a holistic care and dementia-monitoring platform (Anvayaa Kin Care), digital will-writing services (Digital Succession Solutions/Yellow), adaptive clothing for elders requiring carer assistance (Casajoya), and diabetic foot-monitoring technology (Feetwings).

The committee clearly prioritised commercial viability alongside eldercare relevance; the “already in traction” criterion was decisive for the nine fast-tracked companies. The range of shortlisted sectors – diagnostics, mobility, medication, legal, clothing, mental wellness, social engagement and VR  demonstrates that SAGE is not being reduced to a health-technology programme. The instruction to traditional caregiving firms to “increase innovation” reflects a deliberate attempt to push the market toward differentiated solutions rather than simply subsidising existing service delivery models.

Judged purely on process, SAGE has built real institutional infrastructure: a functioning application portal, an independent, credentialed evaluation committee, a dedicated SEBI-registered venture fund operational since August 2022, and the nine fast-tracked startups above. What is harder to establish is real-world reach: publicly available documentation does not disclose how many senior citizens have actually used SAGE-linked products, in how many states, or what proportion of funded startups have scaled beyond metro markets. Four years after launch, SAGE’s process-level achievements are easier to document than its welfare-level impact ; an asymmetry that makes a post-disbursement accountability framework a precondition for evaluating whether SAGE is working, not a cosmetic add-on. SAGE in the Policy Ecosystem

SAGE does not operate in isolation. As confirmed by the AVYAY Central Sector Scheme document (FY 2021–26), SAGE is one of five components within the AVYAY-CS framework, all funded from the Senior Citizens’ Welfare Fund (SCWF):

• Rashtriya Vayoshri Yojana (RVY): provides free assistive devices to senior citizens in BPL households or with monthly family income not exceeding ₹15,000
• Elderline (National Helpline for Senior Citizens, No. 14567): toll-free helpline providing information, guidance, emotional support, and field intervention in cases of abuse
• Training of Geriatric Care Givers: building a professional cadre of trained geriatric care workers through NISD-affiliated institutes, covering dementia, Parkinson’s, Alzheimer’s, depression, AYUSH/yoga practices, digital literacy and palliative care
• Other Initiatives for Senior Citizens: a flexible component covering community radio services, time-bank credit systems, human libraries, digital and financial literacy volunteering, and intergenerational bonding programmes

Beyond AVYAY-CS, the AVYAY umbrella scheme also includes the Integrated Programme for Senior Citizens (IPSrC), which funds old-age homes, continuous care homes, and Regional Resource and Training Centres; and the State Action Plan for Senior Citizens (SAPSrC), funded through Gross Budgetary Support. A separate initiative proposes channeling ₹5,000 crore in Corporate Social Responsibility (CSR) funds toward elderly care over five years through appraised project shelves, a target that, if realised, would hamper SAGE’s own ₹100 crore allocation.

Alongside these, Ayushman Bharat PM-JAY was expanded in 2024 to extend ₹5 lakh health coverage to all senior citizens aged 70 and above regardless of income; the SACRED portal connects elderly persons with private-sector employment opportunities; and the Pradhan Mantri Vaya Vandana Yojana (PMVVY) provides pension-linked financial security. The Maintenance and Welfare of Parents and Senior Citizens (MWPSC) Act, 2007, provides the legal framework for family-based maintenance obligations and mandatory old-age home registration.

Within this architecture, SAGE occupies a distinct niche: it is not a direct welfare transfer or a service delivery programme. Instead, it is a supply-side intervention, building the private-sector capacity to deliver eldercare, with the government acting as selector, verifier and minority equity co-investor.

Implementation and Coverage Gaps

Despite its structural promise, SAGE faces significant gaps when held against the welfare realities it is intended to address. HelpAge India’s 2024 report, based on a survey of 5,169 elderly respondents across 20 Tier I and II cities in ten states, gives a sense of the scale of these realities: 65 percent of elders are not financially secure with their current income and savings, only 29 percent have access to any social security scheme and 32 percent of elderly persons or their spouses live on an annual income below ₹50,000. On health, 54 percent suffer from two or more non-communicable diseases and 52 percent face at least one challenge in carrying out basic activities of daily living. 

The LASI (Longitudinal Ageing Survey in India) 2017–18 adds that over 80 percent of elderly individuals reported leading vulnerable and disconnected lives without adequate access to quality healthcare, financial security or social support, while approximately 18.7 percent live entirely without income. The feminisation of ageing adds another dimension: over 50 percent of elderly women are widowed, often facing social exclusion and property rights deficits.

Against this backdrop, four specific gaps stand out:

1. The digital divide is the most direct challenge to SAGE’s delivery model. HelpAge India’s 2024 report found that 59 percent of elderly respondents had no digital device, falling further to 26 percent for those aged 80 and above, with elderly women significantly more excluded than men. Only 1 in 5 could use devices independently, and telemedicine usage stood at just 1.5 percent. A programme that primarily funds apps, platforms and digital health tools must reckon with the fact that its intended beneficiaries are largely unreachable through these channels.

2. Financial vulnerability and the ‘missing middle’ pose a structural constraint. Only 29 percent of elderly persons have any social security coverage and those above BPL thresholds but unable to afford private services risk systematic exclusion from a market-based ecosystem. Startup products presuppose some capacity to pay and to exercise informed consumer choice, neither of which can be assumed for a large share of India’s elderly population.

3. Awareness is chronically low. Only 9 percent of elderly respondents were aware of the MWPSC Act, which is the primary legal instrument for elder protection (HelpAge India’s 2024 report). If awareness of a core legal safeguard is this limited, independent navigation of a startup marketplace is doubly constrained. Market-based delivery cannot substitute for last-mile outreach.

Accountability remains weak. The EEC process is reasonably structured, but there is no public framework tracking post-disbursement outcomes, whether funded startups reached low-income users, operated beyond metro markets, or delivered measurable welfare impact. Without this, SAGE risks functioning as a startup support programme rather than an eldercare intervention.

The Way Forward

Each of the gaps above points toward a fairly specific fix, and together they suggest a reasonable reform agenda for SAGE’s next phase:

• Build digital access intermediaries, not just digital products. Given that 59 percent of elderly respondents have no digital device and only 1 in 5 can use one independently, SAGE-funded solutions should be required to demonstrate an offline or assisted-access channel, for instance, partnerships with Common Service Centres, ASHA/Anganwadi workers or family-member-mediated interfaces as a condition of funding, rather than assuming direct elderly-user adoption.

• Introduce a tiered pricing or subsidy mandate for the “missing middle.” Startups receiving SAGE equity could be required to offer a reduced-cost tier for users above BPL thresholds but below a defined income ceiling, potentially cross-subsidised through the startup’s premium offerings, so that equity support doesn’t only reach elderly consumers who could already afford private eldercare.

• Bundle SAGE outreach with MWPSC awareness campaigns. Since only 9 percent of respondents know their rights under the MWPSC Act, SAGE’s own outreach infrastructure (portal, onboarded startups, NISD’s implementation network) could double as a distribution channel for legal literacy, for instance, requiring onboarded startups to include MWPSC information in their user onboarding.

• Publish a post-disbursement outcomes dashboard. At minimum, this would track the number of users reached per funded startup, geographic spread (metro versus non-metro), and continuation/survival rates of funded companies. Without this, it is not possible to distinguish a startup support programme from a genuine eldercare intervention and the Ministry has an interest in making that distinction, since it is precisely what would validate the equity-based model.

• Set an explicit non-metro reach target for future EEC cohorts, given that eldercare need is not concentrated in Tier I cities and the HelpAge sample itself was limited to Tier I and II urban centres.

Conclusion SAGE reflects a structurally sound policy instinct: that India’s eldercare challenge cannot be met by public institutions alone, and that the startup ecosystem is a genuine resource for social welfare if properly incentivised and channelled. The January 2024 EEC evaluation demonstrates that the selection mechanism has genuine rigour, and the breadth of shortlisted sectors ranging from adaptive clothing to digital wills to dementia monitoring suggests the initiative is resisting reduction to a narrow technology programme.

But SAGE’s market-based logic runs up against a population that largely has low-income, digitally excluded and unaware of its own legal entitlements. Without deliberate design choices weighting rural reach, serving the missing middle, building digital access intermediaries and tracking post-disbursement outcomes, the risk is that SAGE becomes a programme for the already partially served rather than a genuine intervention for India’s most vulnerable elderly. Whether it evolves into the latter will determine whether it earns its place in India’s ageing policy architecture.

References

1. Press Information Bureau, 4 June 2021. SAGE ( Seniorcare Ageing Growth Engine) initiative and SAGE portal to support India’s elderly launched by Shri Thaawarchand Gehlot. Ministry of Social Justice and Empowerment. Government of India.

2. Press Information Bureau. 26 July 2023. Outcome of SAGE Portal and Sacred Portal. Ministry of Social Justice and Empowerment, Government of India.

3. UNFPA India and IIPS. India Ageing Report 2023: Caring for Our Elders — Institutional Responses. New Delhi: UNFPA India, 2023. https://india.unfpa.org/sites/default/files/pub-pdf/20230926_india_ageing_report_2023_web_version_.pdf

4. International Institute for Population Sciences (IIPS), NPHCE, MoHFW, Harvard T. H. Chan School of Public Health (HSPH) and the University of Southern California (USC) 2020. Longitudinal Ageing Study in India (LASI) Wave 1, 2017-18, India Report, International Institute for Population Sciences, Mumbai.

5. Department of Social Justice and Empowerment, Government of India. “SAGE: Seniorcare Ageing Growth Engine.” https://scw.dosje.gov.in/seniorcare-ageing-growth-engine

IBEF. “Senior Care Ageing Growth Engine (SAGE) Initiative to Support the Elderly.” 17 June 2021.https://www.ibef.org/blogs/senior-care-ageing-growth-engine-sage-initiative-to-support-the-elderly

2. HelpAge India. 2024. Elder Abuse in India Report.

3. Elderly Care India. “Seniorcare Ageing Growth Engine (SAGE) — Support for Startups.”

4. Ministry of Social Justice and Empowerment. Government of India. Minutes of Meeting. Evaluation of SAGE by Empowered Expert Committee (EEC). January 2024 https://elderlycareindia.org/media/documents/Seniorcare-Ageing-Growth-Engine-SAGE.pdf

5. The CSR Journal. 2024. 65% of elders reported that they are financially not secure: Survey report

6. National Institute of Social Defence (NISD). SAGE: Expression of Interest. 2023. https://www.nisd.gov.in/announcement/Sage_Advertisement_2023.pdf

7. Ministry of Social Justice and Empowerment, Government of India. AVYAY — Central Sector Scheme: RVY, Elderline, Geriatric Care, Other Initiatives, SAGE. FY 2021–26. https://scw.dosje.gov.in/public/uploads/documents/AVYAY%20CS%20scheme%20(RVY,%20Elderline,%20Geriatric%20Care,%20Other%20initiatives,%20SAGE).pdf

8. Ministry of Social Justice and Empowerment, Government of India. AVYAY — Umbrella Scheme Document FY 2021–26 (including IPSrC Scheme). https://scw.dosje.gov.in/public/uploads/documents/AVYAY%20Scheme%20document%20FY%202021-26%20(including%20IPSrC%20scheme).pdf

9. IFCI Venture Capital Limited. “SAGE Venture Funds.”

https://www.ifciventure.com/sage-venture-funds/about-us.html

About The Contributor

Shruti Sethi is a Research & Editorial Intern at IMPRI. She holds a bachelor’s degree in Economics from St. Xavier’s University, Kolkata. Her research interests include Gender & Labour Economics.

Acknowledgement

The author extends her sincere gratitude to the IMPRI team for their expert guidance and constructive feedback throughout the process.

Reviewed by Nayanshi Jain and Madhesh Raj P R. 

Disclaimer

All views expressed in the article belong solely to the author and not necessarily to the organization.

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