Informal providers gather for a meeting with hospital staff and researchers outside of Dhaka, Bangladesh. Photo by: Alex Robinson / Center for Health Market Innovations

The application of innovative models in international development has captured the attention of program implementers, funders, researchers and policymakers alike. Numerous innovations have been conceived and launched, however, there are many obstacles to identifying and accelerating the spread of innovative policies and practices that improve the lives of the poor.

Throughout our five years documenting and tracking innovations across health, education, and water, sanitation and hygiene, we noted that there were few examples of programs reaching scale. Innovations have potential for impact, but many of them face challenges of quality, affordability and sustainability, which limit their potential to scale and adapt. We also noted promising models seeking to scale require iteration to learn and improve upon their practices, but the cost of learning can be steep, and available sources of funding do not always align with programs’ “learning” needs.

Results for Development Institute has launched a series of innovation platforms — including the Center for Health Market Innovations, the Center for Education Innovations, and Innovations in WASH — to address these critical challenges and find new approaches to creating system-level change and diffusing promising components of programs beyond scaling one or two organizations. Early on, we realized that our simple mandate translated into a very complex set of activities. When we set out to document innovative programs, we found that the tools available for obtaining and spreading information about innovations were lacking. There was little information on which innovations work well and “how and why” these models are working. And few steps had been made toward and obvious way of addressing these deficiencies.

The evolution of our work in health, education and WASH has shown that while our activities resulting in the scale-up of individual innovations are necessary and important, the effects of connecting multiple organizations to funders, governments and each other has a much greater impact on the broader innovation ecosystem. We’ve learned a lot about what innovators and other actors need to drive successful innovations forward.

The five C’s reflect the lessons we’ve learned in this process and the essential approaches for anyone working to transform promising innovations into opportunities for social change.

1. Core components.

While we began documenting innovative models, we saw stakeholder demand for guidance to develop coordinated, comprehensive and long-term approaches that go beyond the effects of scaling one organization to create system-level change through the identification of proven practices and “core components,” such as the use of telemedicine to bridge access challenges or training of community health workers to deliver maternal health services.

Highlighting these “core components” of innovation, in addition to specific innovators that have applied this concept, can help adapt that innovation to a new context. CHMI has already launched some initial work in this area — for example, recognizing that many organizations and individuals want to find and adapt relevant promising practices from others.

Few program models, though, are replicable in their entirety. R4D has launched a framework that seeks to facilitate the transfer of innovation. Organizations are now using the R4D adaptation framework to better understand the steps necessary to adapt innovations to new contexts.

2. Continuous learning.

In the process of understanding “what works” in innovation, we have learned that most programs are really still works in progress. Promising models seeking to scale require iteration to learn and improve upon their practices, but the cost of learning can be steep, and available sources of funding do not always align with programs’ learning needs.

We’ve supported such process by bringing multiple organizations together for face-to-face learning exchanges, which are designed to provide targeted learning opportunities for innovators. R4D also has a new approach to program monitoring, evaluation, and learning called the Learning Lab. R4D is working with select health and education programs to focus monitoring and evaluation efforts at an earlier stage of the program cycle, by putting structured learning, experimentation and feedback at the heart of program design, piloting and scale-up efforts.

3. Co-creation and collaboration.

Few existing opportunities allow programs themselves to take ownership of the learning process and work collaboratively with peers who face some of the same challenges and with funders looking to engage in the problem-solving process. To make true progress, we must engage collaboratively with innovators and across sectors.

We have found that innovators — sometimes even people working on similar problems or models in the same city — don’t know each other. Collaborative networks bring together groups of innovators working on similar models to collectively problem-solve and publicly document their lessons.

In the past year, we experimented with a group of primary care innovators who have now produced a primary care innovators handbook as a way to share tacit knowledge gained in the field. Other network examples include multisectoral groups seeking to address a particular problem through government and private sector collaboration.

We have measured the great opportunity for people working on similar innovations to learn a lot from each other. The global institutions working with many innovators can be mediators to help them find each other and offer platforms for interaction.

4. Country innovation partners.

We work through a global network of country-based organizations. Our partners act as facilitators of key local and regional actors, carrying out the dual role of connecting programs to opportunities and encouraging system-level change. Our country innovation partners have added value at the country level in several distinct ways: raising awareness about the potential of innovations; creating large, in-country networks that leverage global learning and lower barriers to collaboration; leveraging our platforms, networks and other work to amplify the impact of their own and others’ efforts; and working with governments and funders to foster the uptake of promising innovations.

As part of their work, partners have developed a number of country-level mechanisms to source and support programs, such as competitions, innovation hackathons and pitch series aimed at fostering country-level support to innovations among donors, investors and policymakers. These locally driven efforts have generated new awareness of what works and sparked increased momentum around the potential of innovations.

5. Copycats.

If we are truly ready to scale innovation and move beyond just a few organizations doing well, we need to create copycats. Currently, we are systematically identifying receptor sites through the lens of adaptation and replication of innovations.

How do we find organizations that can be good copycats?  These organizations play a slightly different role than the initial innovators but are no less important in strengthening entire systems or industries that are able to engage with the government and other ecosystem players.

We have found that to help countries build highly performing health and education systems that serve the poor, we need larger industries of providers that go beyond one or two successful organizations. Copycats should be encouraged as a way of promoting promising models and vibrant systems and industries.

Our work over the past five years has taught us the importance of working directly with innovators, country and regional partners, researchers and governments to understand how innovations can gain success and get to scale. This group of stakeholders represents the sixth “C” of building vibrant innovation ecosystems — community. We hope you’ll join ours.

To read additional content on innovation, go to Focus On: Innovation in partnership with Philips.

The views in this opinion piece do not necessarily reflect Devex's editorial views.

About the author

  • Gina Lagomarsino

    Gina Lagomarsino is the president and CEO at Results for Development (R4D), which works with change agents around the globe to create self-sustaining systems that support healthy, educated people. She also has extensive experience designing health system reforms to strengthen equity, quality and efficiency. As one of the original co-founders and managing directors at R4D, she was instrumental in developing several key partnerships, including the Primary Health Care Performance Initiative, the Center for Health Market Innovations, and the Joint Learning Network for Universal Health Coverage.