GHIC 2020: Global Health & Innovation Conference
April 4-5, 2020
Yale University, New Haven, CT

Unite For Sight's 2011 Global Health & Innovation Conference

Blog Report by Catherine Thomas, Unite For Sight Global Health Leadership Intern

Community-Level Social Enterprise Pitches - Ideas in Development

Social Enterprise Pitches are ideas in the brainstorming or early implementation stage. Selected participants presented their new idea in the format of a 5-minute social enterprise pitch. Following the pitch, there was a 5-minute period for questions and answers, as well as feedback from the audience. The presenters were directed to focus their presentations on the problem that they are working to solve, the evidence basis for their idea, the expected impact, as well as plans for measuring outcomes, and not just outputs.

I was eagerly anticipating this session because, for the past few months, I had kept hearing and reading emails about Project Muso and Nyaya Health.  Their stories appealed to premed and medical students aspiring to participate in the (exponentially) growing field of global health and, as such, theses stories were being spread through all sorts of media.  They were the tales of young (pre)medical students establishing remarkably successful clinics and community development projects in Mali and Nepal, respectively, that have demonstrated best practices in healthcare delivery and positive health outcomes. 

Currently a medical student at University of California at San Francisco, Jessica Beckerman co-founded with Ari Johnson Project Muso Ladamunen (“The Project for the Empowered Woman”) in Mali in 2005.  A Partner Project of Partners in Health, Project Muso takes a more holistic view of health, incorporating the social determinants of health—the social, political, and economic conditions in which people live.  With this perspective, Project Muso actively addresses the root causes of illness, specifically poverty and gender inequality, by combining healthcare delivery with microfinance projects, community mobilization, and education.  Its approach has been inspired by that of Partners in Health, and I was most glad to hear that they are not only providing healthcare and programs for the region in which they work, but are also working with the Malian government to strengthen the national healthcare system.  I have always thought that an NGO should ultimately strive to eventually be no longer needed by a community. An NGO should strengthen the capacities and eliminate underlying vulnerabilities of communities so that they are empowered to lead their own development. This idea seems fundamental to all of Project Muso’s projects.

In her presentation, Beckerman focused on Project Muso’s strategy to reduce malaria and associated child mortality. Their model applies three primary tactics: community health workers, a solidarity fund, and the strengthening of clinical infrastructure.  The CHWs visit homes to help prevent, diagnose, and treat malaria, and the solidarity fund is intended to increase healthcare access for the poor. With this model, Project Muso plans to reduce child mortality by 50% within five years by increasing the rates of treated bednet use, the number of children receiving treatment within 24 hours of symptom onset, and the number of pregnant mothers receiving prophylactic malaria therapy.  On the latter two fronts, Project Muso has seen tremendous progress.  Within the first two years (2008-2010) of its program, the %age of children being treated for malaria within 24 hours of symptom onset has tripled from 14% to 45%, and health care consultations have increased by 136%.  According to Joia Mukherjee of Partners In Health, prevalence of malaria in children under five years old has decreased from 46% to 26% and child mortality has declined in the region.  Project Muso’s strategy of combining structural and health interventions is certainly proving effective. 

Another Partner Project of Partners in Health, Nyaya Health was founded in 2006 by Sanjay Basu, Duncan Smith-Rohrberg, and Jason Andrews.  Centered in Accham, Nepal, Nyaya Health works to develop healthcare systems and to provide free healthcare to the most impoverished regions of Nepal and of South Asia more broadly.  Prior to the establishment of Nyaya Health’s Bayalpata Hospital, the quarter million people living in Accham had no access to a doctor.  The hospital focuses on providing accessible services to the poorest and most marginalized patients. Moreover, Nyaya Health aims to develop a replicable model for the effective delivery of healthcare in regions afflicted with poverty, war, and isolation.  In order to be most effective and sustainable, the model entails the employment of all local staff who are provided with support and training from volunteer public health experts from the U.S. and Nepal.  

Nyaya Health’s current Executive Vice President Bibhav Acharya delivered the Social Enterprise Pitch about Nyaya Health’s model.  Specifically, he discussed the organization’s “open source” approach which entails full disclosure of all organizational documents to their donors and the public. To be completely transparent and accountable, Nyaya Health publishes their budget, clinical protocols, operations, outcomes data, activities, and plans online.  They have an online “wiki” to facilitate access of information.  From this database, I was able to learn that over the past few years, the organization has kept its overhead costs down to an impressive 1% of the total budget.  However, Acharya noted that ensuring transparency and accountability presents special challenges, as does increasing the community’s trust of the organization to ensure uptake of services.   Gender inequality, he noted, contributes a significant hurdle to reaching all of the community. When there are meetings with the local community members, usually only the upper caste, literate males participate.  In higher positions of power in this society, they represent the voice of the community.  However, Nyaya Health has been trying to combat both gender and caste discrimination by hiring and providing for these more vulnerable groups. For example, Nyaya Health hires local women, including dalits (those of the lowest caste), to be community health workers.  It constantly monitors pre- and post-intervention data which keeps track of female and dalit representation and service utilization by different groups.  By constantly collecting feedback from the community and monitoring the quality and outcomes of their services, Nyaya Health is able to be more responsive to the needs of the community and to measure its impact.  Both Nyaya Health and Project Muso provide models that appropriately adapt to the conditions and needs of the communities in which they work.

During this session, I was also able to learn about a few innovative technologies. Kate Rademacher of FHI discussed the contraceptive implant Sino-Implant (II), which is a highly effective and less expensive alternative to similar products.  Lasting four years, Sino-Implant (II)/Zarin is $16 less than Jadelle (which lasts 5 years) and $12 less than Implanon (which lasts 4 years).  Sino-Implant (II) is now under review in ten countries and complies with all international standards of quality.  Thus far, over $7 million has been saved from the almost half million units already bought.  Family planning is essential to achieving many goals in health and development, and more cost-effective methods are always in need.  Of course, there were questions raised about the implantation and removal of the device in low-resource areas that have limited health infrastructure.  As with most contraceptive methods, ethical questions were raised as well.  However, based on the presentation, this implant seems to have potential as an improved alterative to existing products.

Another area equally important to development is green energy.  Shayne McQuade delivered a pitch on Voltaic Systems, a company which has developed backpacks and bags with solar panels for charging electronic devices.  The bags themselves are made of recyclable materials, such as soda cans, and are thus more environmentally-friendly consumer products.  But Voltaic Systems is taking these products farther—literally.  Voltaic is now developing small panels that can be used to power cell phones, radios, and lights in remote, low-resources areas in non-industrialized countries.  McQuade noted that in Africa, kerosene is the most used lighting source and has many disadvantages including its high cost, harmful fumes, low light intensity, and environmental damage.  Instead of wasting money and harming themselves and the environment, these communities could use the solar panels made by Voltaic.  For these purposes, Voltaic has made a variety of solar powered flashlights, lamps, and torches.  Moreover, McQuade described the design elements of one of their flashlights which should make it attractive to rural clients, including how it is durable, waterproof, cost-effective, and versatile in the ways it could be used—as a flashlight or ceiling light.  It seems that these solar panels provide benefits in multiple areas of development through the elimination of noxious fumes, reduction of environmental damage, and cost savings for low-income areas.  Moreover, individuals could be more productive with the added hours of adequate light and would be better able to access information, and even healthcare, with enhanced capacity to charge and use cell phones.

Lastly, we heard from a former Medecins Sans Frontieres doctor Deborah Van Dyke. Van Dyke founded Global Health Media Project in order to educate health care providers about certain medical procedures in remote areas using videos. She noted that healthcare information and training is often limited or inaccessible in many non-industrialized regions.  So, Van Dyke’s idea is to create step-by-step tutorial videos which fit the needs of the healthcare providers.  For example, Global Health Media Project is currently working in the Dominican Republic on a video about newborn practices. Future video projects include birth, wound care, and infection prevention. These videos will be distributed through the internet and could even be watched on smart phones.  Based in evidence, this project will be evaluated on improvements in knowledge, skills, attitudes, and clinical practices of healthcare providers. Yet again, we are seeing an example of the infinite number of ways that technology can be used to improve healthcare delivery.

Overall, the speakers in this session were tremendously impressive with their backgrounds, ideas, and drive. They have taken the newest tools and evidence in global health and applied them to new situations.  I look forward to following their progress.