When I heard about the Salient Advisory 2023 report Innovations in Digitizing Health Supply Chains in Africa, I was thrilled that nearly 350 innovators headquartered across 27 African countries are supporting governments to explore technology to improve health care delivery.
I’m always interested, both personally and professionally, to hear about the growing number of African entrepreneurs. As someone who grew up in a low-resource region (Buhera district, Zimbabwe), I was a beneficiary of innovations that improved community health services delivered by elderly community health workers, usually known as Mbuya Hutsanana (Hygiene Grannies). From a young age, I learned that innovations that deliver medicines closer to where people live could save many lives. My experience at VillageReach has also shown me that many promising innovations fail to integrate and scale, resulting in missed opportunities to transform supply chain outcomes.
Innovation in health care only adds value when it is integrated into health systems and implemented equitably at scale.
Innovation paradox
Funders are spending large amounts of money on innovations, but most of them don’t scale and sustain. The failure rate of new businesses is over 75 percent and more than 80 percent of new products in the private sector fail within six months. One reason for this is that governments, who are the stewards of the national health system, often have limited resources and are not always willing to invest in innovations unless they first have evidence of their value. Without the right buy-in, innovations remain an exciting idea rather than a real solution.
Success requires thinking beyond innovation development. It requires thinking about how new technology can positively impact health outcomes, how it can be implemented equitably and sustainably, and how it can be integrated into the broader health systems.
This is where organizations like VillageReach, which provides Technical Assistance (TA), can help.
Successful Innovation Integration
Organizations that provide TA have the existing relationships, approaches, and experience to integrate new technologies into the health system. They can act as a bridge between innovators and governments. Technical Assistance organizations are dedicated to the success of innovators, and I say this with confidence since I work for one. I want to see the nurses and Hygiene Grannies in Buhera and other communities gain access and training to tools that can help them save lives.
Innovators and their partners seeking to integrate their solutions into government-led systems can maximize impact by considering these three factors.
- Innovation must be fit for purpose or designed for the environment(s) where it will be implemented.It is essential that innovators not only demonstrate that the technology is effective and efficient but also make sure that it is culturally relevant and geographically appropriate. For example, adopting a new innovation may cause fear or reticence due to a country’s cultural or political situation, or a new innovation may not align with a country’s current health priorities, making the government unwilling to invest. Innovators need to do their research and be willing to refine their innovations. To facilitate implementation research and market access initiatives, they can either partner with an organization with deep experience in this field or conduct their own research within this area. Either way, they must incorporate these findings into the development and refinement of their innovations to create a path of least resistance to adoption. This thinking can also help create a flexible implementation environment that accommodates learning and adaptation vs. traditional procurement.
- Building trust and navigating interpersonal dynamics are critical for successful innovation implementation. It is imperative that innovators put the interests of governments ahead of their own. Innovations are frequently reduced or nullified by resistance on the part of recipients. These rejections can manifest in various ways, from subtle (or not-so-subtle) ignoring to being rejected or even expelled. The reason for this is that people are complex, and successful leaders realize that “soft skills” such as trustworthiness, collaboration, teamwork, etc., are essential for winning the hearts and minds of people, especially those with opposing views. TA organizations can facilitate and integrate innovations in a way that maximizes their use in various settings. Implementing new approaches and tools is largely a person-to-person activity – an art. Any interpersonal conflict between the innovator and the user can destroy any possibility of success, regardless of the applicability or effectiveness of the innovation in question.
- An implementation strategy needs to be developed alongside the innovation. Innovators need to plan where, when, and how they will implement their technology from the start. A lack of a clear implementation strategy is a fundamental problem when optimizing operations because long-term success and competitive advantage require a good strategy. While creating an implementation strategy is not difficult in itself, aligning it with the government’s goals and ways of working takes the most time and effort. Innovators must find TA partners already working in those areas to assist with implementation strategy and planning. Even if an innovation has gold-standard status, without forethought and planning around how to ensure it can be adaptable and sustainable, it may collect dust on a shelf.
We need more innovators in Africa, and they must be supported in a way that sets them up for success. I am happy that Salient is highlighting their work and building awareness. Now, TA organizations need to take it a step further to forge strong partnerships with innovators. Only then can we realize the full potential of these innovations to ensure quality health care can reach everyone.