As the
countdown to the Millennium Development Goals begins, ideas are circulating for scalable solutions that improve lives at the base
of the pyramid (the 4 billion people living below the global poverty line) and beyond. Several of the Millennium Development goals directly
relate to healthcare and interest in reverse innovation is palpable.
Reverse innovation (also known as trickle up innovation) is first seen in the developing world before spreading to more developed markets. Reverse innovation, particularly in the healthcare sector, is not new- current antimalarials draw their origins from Chinese medicine. Variolation in Africa and Asia was a precursor to modern inoculation and vaccination.
According
to Patricia Mechael, Executive Director of the mHealth Alliance,
mobile health is a perfect example of reverse innovation, as "more people
have prioritised mobile technologies than even the tech companies
anticipated." The developed world was slow to adopt healthcare
delivery through mobile because of prior investments in computers and
electronic records. Developing countries had limited infrastructure in place
and these lower barriers to entry helped mHealth take off. Mobile health
has been used to provide services for a number of demographics and healthcare
issues- from maternal health to ageing populations.
Barbara
Bush, CEO and co-Founder of Global Health Corps, described the Global Health
Corps fellowship program, which was deliberately designed to facilitate reverse
innovation. Each US-based fellow is placed with a partner fellow serving
internationally in the same organisation, creating a fellowship team that
shares best practices from Burundi, Malawi, Rwanda, Uganda and Zambia with
the United States. Through the fellowship, one organisation adopted
a community health worker model in Newark, New Jersey, implementing a
popular public health model across Africa.
Kirsten
Gagnaire, Global Director of the Mobile Alliance for Maternal Action
(MAMA), leads a public-private partnership that provides
relevant information to pregnant women and local healthcare workers. After
reaching over 530,000 individuals in South Asia and Africa, MAMA is gathering
the attention of high profile partners from the developed world. MAMA is
currently exploring a partnership with Sesame Street to provide joint messaging
for families.
Both
Gagnaire and Mechael shared best practices on facilitating reverse innovation.
Mechael suggests moving away from pilots in an approach to thinking at scale
from the outset. "While pilots were useful in the early days of
mHealth, thinking in terms of pilots does not translate well
to implementation at scale. We need to design for scale from the
outset," says Mechael.
One of the
keys to designing at scale from the outset is a participatory design process.
Inclusive processes need to include beneficiaries to ensure relevance and
buy-in. According to Mechael, "Whether or not people feel like a
technology has been designed for them determines whether or not they will use
it."
Gagnaire
recommends rapid prototyping in order to adapt their model to local needs and
account for nuanced differences. "We don't just translate- we localise the
content and target local myths. We look at the literacy rate and the level of
comfort with technology," says Gagnaire. Her organisation relies heavily on focus groups
with their target audience. In these focus groups, MAMA tests variables such
as content, tone of voice, and even background noises to understand what
resonates best with local women in the target demographic. MAMA experiments
with multiple iterations and is continuously updating its messaging.
The
Millennium Development Goals’ deadline is 2015 and significant progress has yet
to be made. Reverse innovation will be a key element of meeting those targets and
help to improve healthcare for the developed world as well.
