“Collaboration is the new Innovation” - Creating a Community of ‘Champions’ to Advance the Government scale-up of healthcare innovations in Kenya
This blog is part of a series developed by Results for Development sharing learning from the design and implementation of a locally-led and demand-driven Public Sector Scaling Action Lab for East Africa. We welcome comments and insights from others working to scale up innovations within government health systems.
If “collaboration is the new innovation”, a quote by Dr Amit Thakker, Executive Chairman at Africa Health Business (AHB), and one of the Public Sector Scaling (PSS) Action Lab “Champions”, then the Action Lab is poised to be a springboard to what is possible when different actors come together with a common objective. The PSS Action Lab is designed to provide a flexible platform through which these country-based “Champions”, working to integrate health innovations within public health systems, can come together to exchange learning and collaboratively advance the Government scale-up of impactful solutions in East Africa.
To set-up the Action Lab, an elaborate consultative process, with a wide range of stakeholders, established that those who are driving the Public Sector Scaling agenda in different ways would value an action-oriented forum through which they can collaboratively join forces and amplify the impact of their (currently fragmented) efforts. The local champions are also conduits for targeted Government engagement, leveraging their current relationships and collaborations to accelerate PSS uptake. Focusing on Kenya and Ethiopia in the first instance, the PSS Action Lab Champions have been researching, designing and/or testing new partnership models, tools and practices that are helping to fill knowledge gaps and address collaboration barriers hindering Government sourcing and scale-up to meet their health system needs.
The first in-person convening of the PSS Action Lab was held in Nairobi on 30th September 2022, bringing together Champions, with other stakeholder groups represented including private sector, innovation incubators as well as development partners.
In the first session, Dr Nelson Gitonga, PSS Lab Champion and CEO at Insight Health Advisors (IHA) shared insights on government demand for innovations in the public sector, drawing on lessons learned from implementing the ‘Mountain Model’ in two Kenyan Counties; Makueni and Kajiado. Nelson shared the following key reflections regarding PSS-related challenges and opportunities:
Articulating demand: We need to provide space for (and facilitate where necessary) governments to state what they are looking for with regard to innovation, rather than the current dominant model which is very supply-driven. Articulating / translating this demand from policy targets or political priorities is not always a straightforward process, but is critical for both government ownership and sustainability.
Incentives: Are stakeholders driven and interested in scouting innovations out there? Public officials are often not aware or interested in innovations and the potential they present to shift things around in the health system.
Financial and political barriers: Undoubtedly, governments work with a very tight fiscal space. Also, public procurement rules and processes are often complex and misaligned with the flexibility that innovations need in order to adapt to different contexts and find the right pathway to scale within each government system. IHA is working on co-designing potential solutions to these challenges with government teams from Makueni and Kajiado counties in Kenya, who have demonstrated commitment and a readiness to address these problems.
Open Phences, a “Think and Do Hub” that works to democratize public private collaborations in healthcare, proceeded to share insights from their ‘Engage to Action’ model led by another PSS Lab Champion, Prof Frank Wafula. The Hub's “Engage to Action'' model proposes a unique approach to ecosystem building, joint priority-setting and planning, and investing based on shared goals. The aim is to create a shift from the push-model (where innovators compete to sell innovations to a usually disinterested ecosystem) to the “pull-model” (where a cohesive and informed ecosystem defines priorities and demands the right innovations). This amplifies the role of collaboration, which Dr Amit emphasised in the follow on session on brokering pathways to scale, while also reminding participants that the Covid-19 pandemic had been a wake up call for the continent. However, every crisis leads to opportunity, and this is the time to scale up innovations in the interests of creating more self-sufficient and adaptive health systems.
Participants then took time to listen to experiences and insights from supporting scale-up of innovations within the Public Sector; Dr Rowena Wairimu of PharmAccess shared insights from supporting public sector scaling of digital health innovations in Kenya, specifically the experience of PharmAccess in supporting governments to scale up health innovations, including through their ‘MomCare’ program in Kenya and Tanzania; and Edward Owino of Results for Development (R4D) shared insights from research into an analysis of success factors contributing to a sample of health innovations that have reached scale through East African government health systems. Some of the key messages from these case examples include;
Supportive legislation is crucial to support the uptake and sustainability of innovation, as well as true collaboration between public and private actors.
An inclusive approach from frontline healthcare workers and community health volunteers to senior technical and strategic leadership is critical to ensure ownership when articulating innovation priorities and solution assessment.
Governments and ecosystem actors can leverage investment cases for health innovations that make use of data to tell compelling stories to attract investors.
The innovation space is overrun by digital innovations. There is a need to think and champion innovation more broadly especially around process innovation; this is critical but often disregarded because it is not deemed commercially attractive by investors and funders.
The second part of the day kicked off with a panel discussion on priorities and opportunities for increasing public sector demand for innovation. A wide array of challenges and opportunities emerged from a rich discussion, ushering in two break-out planning sessions to discuss priority intervention areas in Kenya and Ethiopia. These sessions fed into draft “Country Action Plans” with priority activities through which the PSS Action Lab might support greater demand for and scale-up of health innovations in Kenya and Ethiopia. The Action Plans align these activities around a shared commitment to enable a targeted and efficient collaboration across the Champions, their network of government and ecosystem actors, and the Lab facilitation team at R4D.
PSS Action Lab Champions at the inaugural in-person workshop in Nairobi on 30th September, 2022
Written by: Thomas Feeny, Michael Nzungi, Paulina Adjei and Anna Giulia Ponchia
