People 'n' Issues

Health policy must be future-fit

May 8th, 2017
Innovation in the business, economic and government environments is at a rapid pace, and although many sectors are keeping up with it, the public health sector is lagging, writes VALTER ADAO, Digital Africa leader, Deloitte.
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The metabolism of innovation in the current business, economic and government environment, from a delivery perspective, is at a pace never seen before.  However, the public health sector has lagged significantly behind. It is not the only sector in this situation.

Large successful global organisations have started to show symptoms of not being able to keep up with the rates of change in technology and the innovations required to remain at the forefront of new developments.  Research has shown that fewer than 5 per cent of category leading organisations are ahead of the market and leading their peer group with self-developed innovations.  It doesn’t mean that they don’t value innovation, but rather suggests that they have discovered more effective ways to harness the innovation potential of the collective, start-ups and institutions which are smaller, nimble and able to act efficiently in creating and testing value creating innovations.

There are numerous examples of this, from Unilever’s open innovation platforms, in which they work with communities and entrepreneurs to solve their customers and society’s biggest challenges, and GE would partner with Quirky in 2013, and proceeded to give then full access to their patent inventory.

It’s this new type of problem solving and approach to innovation that is separating, leading organisations from followers.

If disruption is the new norm of the 4th industrial revolution, then observing, partnering, enabling and investing is the fast track to successful innovation implementations.

What can ministries of health in Africa learn from this new approach to being on the forefront and implementation of innovation?

Here are a few facts to consider:

  • The African continent is not homogenous.  As a whole it has registered positive economic growth over the last five years (2012-2016), with the few exceptions being countries that experienced political tensions or were heavily reliant on resources. Rates of growth are also not uniform and range from above 9% for countries such as Ethiopia and Cote d’Ivoire to less than 1% in South Africa.  It would suggest that tailor-made, culturally sensitive solutions are required in different regions of the continent to achieve the desired outcomes.
  • There is significant urbanisation happening across all major African cities.  The population living in urban areas increased from just 28.1% in 1995 to 37.7% in 2015 and is expected to be over 50% by 2030 (which is already case in many of the continents leading economies).  This holds several advantages namely:
    • Whilst cause and effect cannot be clearly demonstrated there is a clear indication that a higher urbanised population correlates with better economic fundamentals
    • A geographically concentrated population allows for improved targeting of healthcare upliftment initiatives and healthcare infrastructure development
    • With a newly urbanised populations, targeted healthcare programs have access to parochial knowledge of rural healthcare needs and challenges in concentrated and easily accessible format.  This creates an ideal environment for the POCing (proof of concept) of many variations of an initiative before significant investments are made.  This will significantly influence the positive healthcare outcomes of investments into this sector
  • The diversity of the continent continues if we explore the respective healthcare sectors.
    • Significant inroads have been made in reducing instance of communicable disease around the continent – although it remains a significant challenge. Non-communicable disease that is typically related to more “modern” lifestyles is also on the increase. Neglected tropical disease such as Malaria has also remained stubbornly pervasive in West Africa. Adopting regionalised and/or localised strategies for addressing key health concerns is likely to be necessary for improving outcomes in the future.
    • Clear differences in the decision and capacity to address key health concerns can also be seen across the African continent. The two largest economies on the continent, South Africa and Nigeria are by far the largest spenders on healthcare with figures of USD 28 billion and USD 18 billion respectively noted in 2015.  The East Africa region is however growing fastest of all regions in Sub-Saharan Africa and putting considerable emphasis on healthcare investment.
    • In conclusion, we have regions where the spend in healthcare as a percentage of GDP is at the some of the lowest levels seen globally.  These regions require basic investment initiatives. However, in regions like Nigeria and South Africa where healthcare is the highest on the continent, healthcare outcome are still poor. This would speak to a need for improved, sophisticated and efficient deployment of healthcare spend, innovations and investments in those regions
    • Reversing the later trend and seeking to boost and optimise the efficiency of healthcare spend is critical because of the further economic benefits this will likely yield.

Accepting that the region needs continued attention to address either the lack of investment into healthcare infrastructure and services and to improve healthcare outcomes where the investment is sufficient, would suggest the need for more sophisticated and innovative deployment of healthcare investments and solutions.

Learning from leading organisations that have changed their approach to innovation, perhaps it’s time for ministries of health to capitalise on these wider innovation trends. The deviation from the traditional Public-Private Partnership models is that government would not be the recipient, owner, implementer and perhaps even the investor into these solutions.  Government would rather play a leading role in identifying the healthcare challenges to be solved, defining the design constraints within which solutions should be created, monitoring and evaluating the desired outcomes, and reducing  restrictive regulations to allow for the rapid and scaled deployment of solutions.

The recipients of these solutions would be citizens; and the ownership and investment into these solutions would in term lie with private/global organisations, NGOs, and entrepreneurs. The concluding hypothesis would be the improved and rapid deployment of such initiatives, which would not only address of the toughest healthcare challenges on the continent with rapid, innovative and self-sustainable solutions, but also contribute towards economic growth, job creation and investment attractiveness of the region.

It is therefore necessary for a design-thinking principles to be implemented in creating newer, future-fit healthcare service models that are suited for the African continent and improve health spending efficiency, along with health access and outcomes for the general population.

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