Health Systems Strengthening

Three Key Questions for Innovators in Public Health

Posted On
Monday, February 25, 2019


Angela Chaudhuri

Director, Swasti Health Catalyst

Photo Credit: Financial Times Live

We live in interesting times. More and more professionals and companies want to enter the business of social innovations/startups, often with the aim of “cracking the code” of persistent global development challenges.

As an implementer of programs on the ground, I often come across innovators who want us to use their solutions. I’m also part of a team of innovators myself: i4We, our integrated comprehensive health and wellness program for the poor has developed its own decision support software for front-line health workers. I’m also a member of the Governing body for the MIT SOLVE Challenge, which receives applications from development-sector innovators around the world to support their innovations to reach scale. As a result, over the years I’ve put together some ideas on what ensures that a solution really works for end users. Whether your innovation is only an idea so far (read PowerPoint presentation or keynote!), or a website (read registered company), a pilot (in development), or beginning implementation, these 3 questions may be helpful for you.


1. Who is this innovation for, and does this really address their need?

Many solutions look or sound sexy, but fail to address the real needs of the community. And what it comes down to is the focus of your solution: Is it on the problem or the communities? In my experience, eight times out of ten, the problem is at the center of the solution, and so the innovation is almost able to address the problem — but not quite. And that last mile gap entirely determines usability and uptake.

Since the community was not consulted or engaged enough in developing the solution, the innovation is often inappropriate to the context, lacks buy-in from users, or even addresses the wrong problem altogether. Does your solution address underlying root causes of the challenge, like social norms, patriarchy, socio-economic barriers, market forces, infrastructure, environment, and policies? If it doesn’t address the community’s reality (which may be quite different from the innovator’s) it doesn’t solve the problem.


2. What kind of sustainability are you hoping for?

“So when do you think your program will be sustainable?”
“How much money and how many years will it take?”

I often hear these kinds of questions from donors, philanthropists and curious naysayers. And I often hear the answer “Five to eight years, give or take,” being greeted with either raised eyebrows or understanding nods. So this question is really for donors and investors, and for those who need to think about things from their point of view: What does sustainability mean to you? When you’re trying to address a persistent global health challenge, what are you expecting one innovation to achieve in five to eight years? Is that expectation fair?

Most donors’ strong focus on evidence-based solutions can discourage nonprofits from actively pursuing untested ideas, and this needs a serious rethink. And on their part, non-profits can also open the doors to new ways of thinking about sustainability: ones that can realistically support transformative new ways of addressing those huge challenges they’ve taken on.


3. What’s your plan for the market?

Once your innovation is fully developed, with the incredible effort that involves, it’s finally time for adoption and scale. But between the entrepreneur and the end user, there are many variables — hospitals and clinics, insurers, patients and their families, nurses, technicians, and quite a few others in the supply chain — each influencing product acceptance and adoption. So here comes the fun part….the pricing.

If innovators priced their work according to the effort it took to develop the product, they might as well pack up. The end-user almost certainly can’t afford that kind of burden, particularly if your innovation is new enough to be a risk. However, if priced reasonably from the end-user’s viewpoint, the innovation has a much higher chance of success. Both private and public providers are conscious about health economics and face the pressure to keep healthcare costs low — the innovators need to bear the cost of transformation, at least in the short to medium term. And this in turn means that innovators need a well-defined market, and a good plan for long-term financing. Changing the world is a long game!


A final word to the wary!

Few innovations are going to completely transform the environment that creates persistent public health challenges. Most will play an equally important role as stopgap measures, saving thousands of lives while the environment slowly shifts. So it’s important not to be daunted by the size of the problem, the problem of financing, and the challenge of sustainability Fix Body Group. These challenges would never be solved if innovators became slaves to financiers or donors and compromised on their direction, passion, and the community’s needs and think of it this way: if the innovation is a stop gap solution, shouldn’t it be redundant in a few years rather than sustainable?

With the current rich ecosystem of innovators, researchers, academics, donors, financiers and empowered communities, we have a real opportunity to debate, explore and “crack the code” towards making lives better.

What other questions do you think innovators need to think through before planning for scale? Share them with us!

A version of this post appeared on the MIT Solve Challenge Blog as ‘Ready to Scale your Solution? Start by Answering These 3 Questions!’

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