innovation

{Photo credit: Maeghan Orton/Medic Mobile}Photo credit: Maeghan Orton/Medic Mobile

For more than a decade, health teams in over 40 countries have improved their performance using MSH’s Leadership Development Program (LDP) and the latest version, Leadership Development Program Plus (LDP+), which improves public health impact and scale-up. During the same period, there has been a tremendous expansion of information and communication technologies (ICTs) in health and mHealth interventions, particularly using mobile devices. This past year, two MSH-led projects—the Prevention Organizational Systems AIDS Care and Treatment (Pro-ACT) project in Nigeria and The Leadership, Management & Governance (LMG) Project—collaborated with LMG partner Medic Mobile to pair the LDP+ with a mobile application to systematically capture, collate, and report LDP+ results in near-real-time.

 {Photo credit: Amarachi Obinna-Nnadi/MSH}Dr. Zipporah Kpamor, MSH’s Nigeria Country Representative, speaking during the African Health Innovation meeting in Abuja, Nigeria.Photo credit: Amarachi Obinna-Nnadi/MSH

"Good leadership skills, flexible policies, and constant advocacy will improve health in Africa," said Dr. Zipporah Kpamor during her talk at the Africa Health Innovation meeting in Abuja, Nigeria, on May 7, 2014. As Management Sciences for Health (MSH’s) Nigeria Country Representative and project director for the US President's Emergency Plan for AIDS Relief (PEPFAR)-funded US Agency for International Development (USAID) project, Community-Based Support for Orphans and Vulnerable Children (CUBS), Zipporah is an expert on the conference’s theme: Leapfrogging development challenges to transform Africa’s health. 

Zipporah offered poignant insight on one of the meeting’s discussion topics: Leadership, policy, and advocacy for health in Africa:

 {Photo credit: Rui Pires}An Accredited Drug Store in Uganda. MSH, through the Sustainable Drug Sellers Initiative, is helping scale-up access to medicines in Tanzania, Uganda, and Liberia.Photo credit: Rui Pires

Interested in a career in innovation and international development? You’re in luck, says Ingrid Ahlgren in Devex: “the need for new and improved development ideas isn’t going anywhere, and neither are the positions to facilitate them.”

Ahlgren of Devex shares advice on common innovation roles, what's required to land a position, and more from innovation and global development experts, including MSH President & CEO Jonathan D. Quick and Mac Glovinsky of UNICEF. Innovation, “is a big buzzword right now,” says Glovinsky. He says, donors wanting innovation embedded in key functions of development are a key driver of increased attention.

Innovation in development doesn’t mean only new technology, says Quick:

People tend to talk about product and technology innovation, but that’s only half the story.

Screenshot of Heartfile website

When in 1995 entrepreneur Jeff Bezos launched Amazon.com from his garage in Seattle (USA), fewer than 1 in 200 people worldwide had internet access and online shopping was just a year old. Today, Bezos’ innovative website has made Amazon.com the world’s largest online retailer, with $60 billion in annual sales – $170 million a day. Online shoppers see Amazon.com as their primary interface—this is the technology innovation. Amazon.com and its accompanying vast information technology capabilities can predict what we want. It catalogues our searches and purchases, and gives us suggestions of what we want.

A brilliant example of the power of technology innovation – right? Only half right. What we don’t see is actually more profound: it’s the power of partnering technology innovation and systems innovation. If you thought Amazon’s secret sauce was simply the technology innovation, think again. In fact, it’s the systems innovation that makes Amazon work. 

[Systems model: Amazon.com] {Graphic by MSH}Systems model: Amazon.comGraphic by MSH

Dr. Jonathan Quick, President and CEO of MSH, tours with Dr. Christian Nzitimira, director of Kibagabaga Hospital in Rwanda. {Photo credit: Jon Jay/MSH.}Photo credit: Jon Jay/MSH.

In a postoperative ward of Kibagabaga Hospital, the district hospital serving Rwanda’s capital city of Kigali, Eric Bizimana sits up in bed. Bizimana, 25, had sought care after severe pain in his right leg forced him to stop work as a barber. He was diagnosed with a bone infection called osteomyelitis. Antibiotics alone couldn’t clear the infection. Without an operation to remove the diseased bone, Eric faced the possibility of losing his leg.

Eric was one of the 40 patients who enter Kibagabaga for surgery every day. In Rwanda’s tiered healthcare delivery system, patients are referred from local health centers up to the district hospital when their conditions require more complex care. Most babies are delivered at health centers, for example, but a woman suffering complications or who was expected to need a C-section would be referred to the district level.

Richard Horton moderates a panel on post-2015 development goals. {Photo credit: HSR-Symposium.org}Photo credit: HSR-Symposium.org

Last month, I joined over 1,800 participants from more than 100 countries in Beijing at the Second Global Symposium on Health Systems Research. We've made some concrete steps forward since we last met in Montreux, Switzerland, two years ago, among them the launch of a new research society Health Systems Global. Central topics of this year's discussions included: “Inclusion and Innovation towards Universal Health Coverage” (UHC), the symposium theme, and monitoring and evaluation.

A tray of supplies, including household vinegar, used for screening patients. Masufu Hospital, Uganda. {Photo credit: M. Miller/MSH.}Photo credit: M. Miller/MSH.

Using a basic household item like vinegar to screen for a deadly disease is one of those "Aha!" solutions that will save lives. I had never imagined that I’d get to see the procedure in action.

Cervical cancer kills some 250,000 women every year -- over 80 percent from low-income countries, according to the World Health Organization (WHO). Early diagnosis can save lives, but many health facilities in developing countries struggle to find a way to screen women in remote, overcrowded settings. Last year, The New York Times talked about the success of using vinegar as a cervical cancer diagnostic method in Thailand, and yesterday SHOTS, NPR's health blog documented its life-saving use in Botswana.

Doreen Nalweyiso happily holding her twins. {Photo credit: T. Athura/MSH.}Photo credit: T. Athura/MSH.

In July 2011, Doreen Nalweyiso, a 27-year-old woman living in Mpigi Town Council, Uganda attended her second antenatal visit at Mpigi Health Centre IV. She was surprised to be examined with an ultrasound machine--and even more shocked to be told that she was expecting twins!

“I was thrilled when the nurse showed me images of twins through the ultrasound TV scan. I had never experienced it in my lifetime,” she explained.

This was her first pregnancy and there was no history of twins in her family. Because carrying multiple fetuses can cause complications for both the mother and babies, Doreen received support from the health center throughout her pregnancy.

Since she knew her delivery could be complicated, Doreen traveled to Mpigi health facility to deliver by caesarian section.

If she hadn’t known she was carrying twins, Doreen might not have known to seek out specialized medical care during labor and delivery.

Frieda Komba, a licensed drug dispenser in Tanzania. {Photo credit: MSH.}Photo credit: MSH.

Each year over 10 million men, women, and children in developing countries die as a result of our collective failure to deliver available safe, affordable, and proven prevention and treatment. A recent analysis of innovations in products and practices for global health, from the Hepatitis B vaccine to use of skilled birth attendants, revealed virtually none of these life-saving interventions reaches much more than half their target population—even after as many as 28 years of availability. This reflects a vast gap between knowledge and action in global health.

Successful Health Systems Innovations

Low- and middle-income countries (LMIC) benefit from continued innovations in health products and health practices, such as use of misoprostol to prevent post-partum hemorrhage, and technologies such as internet-based mHealth applications to protect the poor from catastrophic health expenditures.  To ensure such innovations achieve large-scale, widespread coverage, they must be accompanied by much more effective health systems innovations.

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