It’s increasingly accepted that major improvements in global health require participation and collaboration of many actors, both public and private. After all, in many countries private providers are the first stop for people falling sick with malaria, tuberculosis, acute respiratory infections or other common but serious afflictions.
At the Center for Health Market Innovations, we want health markets to achieve their potential in reducing child and maternal mortality and other national health goals. To this end, we identify organizations — nonprofits, social enterprises, companies and governments — applying promising new approaches to improve the health of their communities. We have identified close to 1,300 such organizations, all of which are profiled in our online database. But many of these entities are not meeting their potential due to a lack of financing, poor access to technical expertise, limited support from governments to fund care for the poor, and other barriers. They need to scale up, so they can reach more people, and do it cost-effectively.
So we spend a considerable amount of time thinking about how to scale the impact of innovations and unleash a lot of untapped potential. Here are five things we’ve learned since we launched CHMI four years ago:
1. More support should be directed at scaling and improving some of the promising models emerging in primary care. Extending access to primary health care is a pressing priority for many countries. Yet promising primary care businesses that serve the poor are struggling to scale. A concerted effort to help these businesses succeed could lead to greater impact, not just for one primary care business, but for health systems as a whole.
To that end, the Bill & Melinda Gates Foundation is now directing considerable attention and financing to primary care, and others including Save the Children UK, GlaxoSmithKline and Novo Nordisk are supporting research to understand rapid routes to scale for primary health care initiatives.
2. Sharing lessons learned about common challenges may be just as important as improving access to funding. Funding and visibility opportunities (such as competitions and challenge funds, which have lately proliferated) have been successful in building momentum for some health priorities. But taking a handful of promising organizations to scale may not be enough to unlock the potential of a whole industry and impact millions of people. Ensuring that learning about what works comes from funded organizations, and sharing that learning widely, may be one of the biggest contributions the global development community can make.
Leaders from our CHMI Primary Care Learning Collaborative — made up of five rapidly growing nonprofit and social enterprises providing primary care in Kenya, Burundi and India — published their five principles for patient-centered innovation.
3. We should encourage adaptation of what is working from one context to another. Helping an innovative organization get bigger is not the only way to scale innovation. The Center for Health Market Innovations has been working to identify the “active ingredients” in innovative programs so that other organizations can customize them to meet their own circumstances. Encouraging this process can and should happen more often. That’s why the CHMI Learning Exchange offers small grants for managers to travel and learn from other innovators. With the help of this support, the Afghan Community Research & Empowerment Organization for Development is sending a delegate this fall to Operation ASHA in Delhi to adapt elements of their technology-based TB patient tracking and treatment system.
4. A well-developed set of health metrics more effectively tracks the results of health enterprises so that impact investors, donors and governments can compare performance. Nonprofits and enterprises need to be able to track their performance, both for the sake of good management and to provide hard data to help stakeholders assess their investments in such businesses. The comprehensive set of IRIS health metrics launched by CHMI earlier this year in conjunction with the Global Impact Investing Network is a good example. A 2012 survey of impact investors showed that 98 percent of them thought that impact measurement was important to the development of the industry.
5. Health care organizations serving low-income communities should consider collaborating with their national, regional and local governments to achieve greater impact. People often put the public and private sectors in separate silos but it doesn’t have to be that way. The two sectors can learn and benefit from each other. Government may directly finance services or adopt some of the innovations developed by the private sector. In Nigeria, for instance, government leaders searching for creative solutions for improving health care are tapping into a new alliance that channels $24 million in local private support to national health priorities. CHMI’s partner in Nigeria, Solina Health, is helping the alliance harness the power of innovation.
Many are working to create a global innovation infrastructure that can ably scale up health solutions. We’ve partnered with some of the bold thinkers in the space: Grand challenges like USAID’s Saving Lives at Birth, award platforms like the Skoll Foundation, impact investors like Toniic, and online fundraising sites like GlobalGiving.
Meanwhile, our partners in places like India, Nigeria, Kenya, Pakistan and South Africa are providing innovators with the support they need to succeed and serve more people. As in Nigeria, they are also working to share key practices (“active ingredients” — that secret sauce) that help organizations reach more people with better health services.
There are many promising pro-poor business models in emerging economies around the world with untapped potential to improve health. Let’s do more to realize that potential.
For more thoughts about getting health businesses to scale, check out “Beyond the Pioneer: Getting Inclusive Industries to Scale,” published by Monitor Inclusive Markets.
Healthy Means is an online conversation hosted by Devex in partnership with Concern Worldwide, Gavi, GlaxoSmithKline, International Federation of Pharmaceutical Manufacturers & Associations, International Federation of Red Cross and Red Crescent Societies, Johnson & Johnson and the United Nations Population Fund to showcase new ideas and ways we can work together to expand health care and live better lives.