Open innovation as a new paradigm for global collaborations in health

September 6, 2013 · 0 comments

Open innovation as a new paradigm for global collaborations in health. Globalization and Health 2013, 9:41.

Patricia Dandonoli

Open innovation, which refers to combining internal and external ideas and internal and external paths to market in order to achieve advances in processes or technologies, is an attractive paradigm for structuring collaborations between developed and developing country entities and people. Such open innovation collaborations can be designed to foster true cocreation among partners in rich and poor settings, thereby breaking down hierarchies and creating greater impact and value for each partner.

Using an example from Concern Worldwide’s Innovations for Maternal, Newborn & Child Health initiative, this commentary describes an early-stage pilot project built around open innovation in a low resource setting, which puts communities at the center of a process involving a wide range of partners and expertise, and considers how it could be adapted and make more impactful and sustainable by extending the collaboration to include developed country partners.

India – Mobile health clinics: Meeting health needs of the urban underserved

September 5, 2013 · 0 comments

Mobile health clinics: Meeting health needs of the urban underserved. Indian J Community Med cited 2013 Sep 5];38:132-4.

Limalemla Jamir, et al.

In general, the services delivered by the mobile health team are immunization, promotion of community health, including diarrhea management, antenatal care, child nutrition, family planning services, information education and communication services (disease awareness, sexually-transmitted diseases), referral and basic laboratory tests, primary medical care, mental health, and addiction counseling.

Studies have reported on the benefits of mobile health clinics. Immunization coverage increased to 80% in Gwalior, Madhya Pradesh, infant mortality declined, and the marriage age rose from 15.9 to 16.5 years. [10] In Bhopal, family planning increased by 14%, use of oral contraceptive pills increased by 63%, and condom use increased by 20%. [10]

Patro et al., studied client satisfaction with mobile health clinics in an urban resettlement colony of the National Capital Territory of Delhi. [11] Curative services were provided 5 days a week wherein treatment of minor ailments was provided, and specialized clinics provided antenatal and immunization services twice a week. They reported that two-thirds to three-fourths of the clients were satisfied with the mobile health care services.

Challenging urban environments: mapping health risks using spatial video in Haiti

August 23, 2013 · 0 comments

A ubiquitous method for street scale spatial data collection and analysis in challenging urban environments: mapping health risks using spatial video in Haiti. International Journal of Health Geographics 2013, 12:21.

Andrew Curtis, et al.

Background – Fine-scale and longitudinal geospatial analysis of health risks in challenging urban areas is often limited by the lack of other spatial layers even if case data are available. Underlying population counts, residential context, and associated causative factors such as standing water or trash locations are often missing unless collected through logistically difficult, and often expensive, surveys. The lack of spatial context also hinders the interpretation of results and designing intervention strategies structured around analytical insights. This paper offers a ubiquitous spatial data collection approach using a spatial video that can be used to improve analysis and involve participatory collaborations. A case study will be used to illustrate this approach with three health risks mapped at the street scale for a coastal community in Haiti.

Methods – Spatial video was used to collect street and building scale information, including standing water, trash accumulation, presence of dogs, cohort specific population characteristics, and other cultural phenomena. These data were digitized into Google Earth and then coded and analyzed in a GIS using kernel density and spatial filtering approaches. The concentrations of these risks around area schools which are sometimes sources of diarrheal disease infection because of the high concentration of children and variable sanitary practices will show the utility of the method. In addition schools offer potential locations for cholera education interventions.

Results – Previously unavailable fine scale health risk data vary in concentration across the town, with some schools being proximate to greater concentrations of the mapped risks. The spatial video is also used to validate coded data and location specific risks within these “hotspots”.

Conclusions – Spatial video is a tool that can be used in any environment to improve local area health analysis and intervention. The process is rapid and can be repeated in study sites through time to track spatio-temporal dynamics of the communities. Its simplicity should also be used to encourage local participatory collaborations.

Pathways of Economic Inequalities in Maternal and Child Health in Urban India

August 23, 2013 · 0 comments

Pathways of Economic Inequalities in Maternal and Child Health in Urban India: A Decomposition Analysis. PLoS ONE, March 2013.

Srinivas Goli, et al.

Background/Objective – Children and women comprise vulnerable populations in terms of health and are gravely affected by the impact of economic inequalities through multi-dimensional channels. Urban areas are believed to have better socioeconomic and maternal and child health indicators than rural areas. This perception leads to the implementation of health policies ignorant of intra-urban health inequalities. Therefore, the objective of this study is to explain the pathways of economic inequalities in maternal and child health indicators among the urban population of India.

Methods – Using data from the third wave of the National Family Health Survey (NFHS, 2005–06), this study calculated relative contribution of socioeconomic factors to inequalities in key maternal and child health indicators such as antenatal check-ups (ANCs), institutional deliveries, proportion of children with complete immunization, proportion of underweight children, and Infant Mortality Rate (IMR). Along with regular CI estimates, this study applied widely used regression-based Inequality Decomposition model proposed by Wagstaff and colleagues.

Results – The CI estimates show considerable economic inequalities in women with less than 3 ANCs (CI = −0.3501), institutional delivery (CI = −0.3214), children without fully immunization (CI = −0.18340), underweight children (CI = −0.19420), and infant deaths (CI = −0.15596). Results of the decomposition model reveal that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical factors contributing to economic inequalities in maternal and child health indicators. The residuals in all the decomposition models are very less; this implies that the above mentioned factors explained maximum inequalities in maternal and child health of urban population in India.

Conclusion – Findings suggest that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical pathways through which economic factors operate on inequalities in maternal and child health outcomes in urban India.

Five Creative (and Successful) Initiatives to Bring Clean Water to the Urban Poor

August 7, 2013 · 0 comments

Five Creative (and Successful) Initiatives to Bring Clean Water to the Urban Poor | Source: Josephine d’Allant, Managing Editor, URB.im in Huffington Post, July 30, 2013 |

Access to clean, potable water is a central issue for slum dwellers around the world and is often a time-consuming endeavor that involves walking great distances and waiting in long lines. Water is often expensive, demanding a large portion of families’ budgets. And it is often contaminated — dirty water is responsible for 80 percent of all sickness and disease worldwide, and for 15 million child deaths every year. But initiatives in Jakarta, Mexico City, Lagos, Rio de Janeiro and Ahmedabad are closing infrastructure gaps and providing slum residents with clean water solutions.  

In India, women are forced to orient their entire day around collecting expensive and unsafe water. An Ahmedabad-based social enterprise recently introduced an innovative way to distribute treated water through solar-powered ATMs. They allow 24-hour access by swiping pre-paid cards, which are easily recharged, or by paying with coins. Around-the-clock access provides the convenience rarely experienced by the urban poor. Using reverse-osmosis technology, the purification centers supply water to a network of decentralized, “off-grid” solar-powered ATMs, thus keeping fees low. This initiative also provides a long-term sustainability solution to an important problem: ATM ownership lies in the hands of the community, as the company recruits and trains local entrepreneurs to run the water service centers through a franchise model.

Environmental degradation and poor water management have lead the Indonesian Institute of Sciences and UNESCO to launch an eco-hydrology initiative (eco-hydrology is an interdisciplinary field that examines the interactions between hydrology and ecosystems). In Jakarta, it is being used to revitalize the Citarum, one of Jakarta’s main rivers, by creating artificial wetlands to provide clean water to the residents of Jakarta and the surrounding areas.

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Ventilated Improved Latrine construction in the slum areas of Kampala, Uganda

July 31, 2013 · 0 comments

Ventilated Improved Latrine construction in the slum areas of Kampala, Uganda, 2013.

Swiss Federal Institute of Aquatic Science and Technology (Eawag); Department of Water and Sanitation in Developing Countries (Sandec), Dübendorf, Switzerland

U-ACT toilets feature one- or double-stance toilets with a lined pit and a brick superstructure. Pit lining prevents groundwater contamination and ensures that a facility can be emptied when it is full (ideally by a vacuum truck). To guarantee ease of access for the hose from the vacuum truck, the pit is equipped with a removable brick. The solid brick and cement structure makes the latrine very durable. All latrines are equipped with wooden doors and a sturdy lock. To reduce flies and odours, the U-ACT latrine is provided with a ventilation pipe. Furthermore, it is equipped with a handwashing facility that can be filled with rainwater or piped water. In locations where there is a risk of flooding and/or a high water table, the latrine is raised.

Innovation for Health: How Text Messages and Micro-Insurance Help the Urban Poor

July 31, 2013 · 0 comments

Innovation for Health: How Text Messages and Micro-Insurance Help the Urban Poor Stay Healthy | Source: Huffington Post, July 17, 2013 |

Slum residents across the Global South lack access to affordable health care services. Despite a pervasive lack of funding, often mediocre infrastructure, and too few trained personnel, slum dwellers have come up with innovative solutions. Using forums, text messages, micro-insurance, and community engagement, they help residents in Mumbai, Nairobi, Jakarta, Rio de Janeiro, and Mexico City lead healthier lives.

In Mumbai, Innovation Alchemy recently hosted an open forum on urban issues that featured innovators, investors, creative minds, engaged citizens, and entrepreneurs. The discussion featured two main social enterprises: Swasth India, which provides low-cost and discounted health care services to slum dwellers, and WaterWalla, which sources and introduces clean water technologies into Mumbai’s informal settlements. The session put an emphasis on the need and opportunity for breakthrough innovation designed for, and implemented with, the urban poor — a rapidly growing challenge in cities such as Mumbai, where 54 percent of the population lives in slums.

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USAID/Ethiopia Urban Health Extension Program End-of-Program Report

July 26, 2013 · 1 comment

USAID/Ethiopia Urban Health Extension Program End-of-Program Report, 2013.

USAID’s Urban Health Extension Program (USAID/UHEP), implemented by John Snow, Inc. (JSI), was a three-year project (2009-2013) launched to support the Government of Ethiopia’s Urban Health Extension Program (UHEP). The goal of USAID/UHEP was to support, at scale, the implementation and monitoring of the UHEP as a means of improving access to and demand for health services. 

Specifically, the program aimed to strengthen the capacity of UHE professionals to identify and reach most-at-risk populations (MARPs)/vulnerable individuals or groups in their catchment areas and provide these individuals with public health services. This report summarizes USAID/UHEP’s experience supporting and implementing a new government program, illustrating the meaningful partnerships which JSI maintained throughout the Program. JSI, 2013.

US second lady, Joe Biden’s wife visits USAID urban health program

July 23, 2013 · 0 comments

US second lady, Joe Biden’s wife visits Agra slum | Source: Hindustan Times, July 23, 2013

It was a memorable day for the slum-dwellers of Kachchpura near the Taj Mahal here as they had a VIP visitor — US second lady Jill Biden who spent nearly an hour with them.

Known for her interest in education and healthcare issues, Jill braved the sultry weather and walked the half-a- kilometre unpaved mud road to reach the place. She was accompanied by her daughter Ashley Biden and son-in-law Howard David Crein.

Her visit to Kachhpura was to take stock about the Health for the Urban Poor programme, funded by USAID which is aimed at providing basic healthcare to urban poor focusing on maternal health and community participation.

She was greeted by Machla Devi, president of Adarsh Mahila Arogra Samity, its secretary Manju and other members. Adarsh Mahila Arogra Samity is a group of local women who are working to raise awareness among the women and children about basic health related issues.

After interacting with the members she visited the pre-school cum anganwadi centre and met children there.

Jill, a Ph.D. in education who has been an educator for over two decades, had her special gift for the children there — a basket full of books ranging from colour books to story books and book on the White House.

She interacted with the workers there about the work on community centre and various maternal and healthcare programmes run by the centre. She also gave two drops of polio to a small girl child of one-and-a-half months.

Her son-in-law Howard asked about vaccination program run in India.

Jill also inquired about the nearest delivery centre for pregnant women in the area.

Kachhpura is one of the 46 slums of Agra where the Health for Urban Poor programme is running. A settlement from Mughal empire days, it was notified as a slum in 1998.

Half of over 3200 people are involved in the shoe making while rest are engaged in other occupation such as farming and dairy.

USAID/Angola supports municipal health planning

July 23, 2013 · 0 comments

USAID/Angola supports municipal health planning | Source: Gidungo Newsletter, May/June 2013

From May 24 to June 4, the USAID strengthening Angola system health funded project (SASH) supported a planning process workshop at Longonjo municipality in Huambo province. The technical support is focused on building the capacity of municipal health teams to develop, implement and monitor their health plans and budgets, as per the new guidance provided by the Ministry of Health (MOH).This process is part of the main activity of decentralization in the Angola Health Sector aiming to more efficiently man-age resources received at the local level through the Revitalization of Municipal Health Services strategy as released by the National Strategic Health Plan 2012-2025.

Community Health Leaders join together to plan for community health needs

Based on the reports of deaths the past three years, these teams of health municipal department identified weaknesses linked to maternal diseases in the municipalities of Chinjenje, Longonjo and Ukuma, diseases such as diarrheal and acute respiratory infections, as those that cause the most queries and/or preventable deaths. Then, through a process of participatory analysis they chose the services related to these problems that performed poorly and could benefit from greater attention and resources to improve in the next 1-3 years. At the end of the process, the three municipalities produced municipal health plans that will guide health priorities interventions leading to the city from 2013 to 2015.

As requested by the Provincial Health Director in Huambo Province, SASH is in the process to support all of 11 municipalities to produce their priority health plans and budgets, as well as support the Provincial Health Team to plan how they would provide technical support to the municipal teams and monitor the implementation of their plans. This process brought together 20 members of the municipal health teams, including the Municipal Health Directors, to analyze the health information data that had been organized by each health municipality department team with SASH’s support in a previous phase.

Managed by JHPIEGO to help support a sustainable basic services governance system, USAID’s “SASH” project works with municipalities in Luanda and Huambo provinces (the two most populated) to strengthen local planning, implementation and moni-toring of decentralized health services. The goal of the SASH program is to increase the availability and use of high quality services in key areas including family planning, malaria and HIV/AIDS. SASH applies an integrated health systems approach in which higher quality health care services (and, thus, better health status outcomes) are achieved through more affective management processes and institutional-ized quality improvement programs.

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