Community-led Health Innovation
Community-led innovation is closely linked to collective action where local stakeholders identify a health priority and pioneer interventions to address a common goal which will benefit others in their community. Community led innovation also signals a break from the traditional groups that engage in health system strengthening – it is about recognizing that health innovation is inter-sectoral encompassing a range of stakeholders, social economy actors and social innovation intermediaries. Community in this case is defined as diverse stakeholders who are all linked to country health systems -as health workers, administrators, program implementers, goods and service providers and end-users.
Role of Technology and the Private Sector
Countries from around the world have developed different models for delivering healthcare. Some are fully public, some are mostly private, and others an intricate mix of both. As governments continue to embrace Universal Health Coverage (UHC), they will need to invite the private sector to join key conversations to build trust and ensure innovations and initiatives are supporting long-term health system goals. There is increasing interest among countries of the global south to see how regional partners are combining private and public providers; but what that system should look like, how it should be regulated and what the balance should be often remains unclear. It is important to see if this sector can go beyond vertical health projects/services to championing government-led systems focusing on UHC. Companies, technology actors and non-state private providers can bring a unique set of skills and resources that can complement the public sector to improve access and outcomes particularly for vulnerable poor and rural communities.
National or Social Health Insurance schemes are attracting considerable attention in low- and middle-income countries in Asia and Africa as a means for improving health care utilization and protecting households against impoverishment from out-of-pocket expenditures. Although health insurance coverage incentivises expenditure on innovation, it does not seem to heighten technology adoption, a challenge to the idea that innovation increases healthcare costs. Cognizant of coverage gaps in SHI models and the need to invest in primary heath and outpatient care, many Asian and African countries are investing in low-cost technology based innovations. The lack of institutional/government capacity has also led to the rise of intermediary organizations that are now bridging gaps between sectors. The challenge remains however on how these new actors are embedded in UHC agendas and if / how various successful but discrete health innovations could potentially be bundled and scaled.
Learnings from the Global South
In line with UHC2030 mission to further collaborate at the global and country level, Asia-Africa consultations are examining the various actors and components that make up complex heath eco-systems in the global south, serving as a platform that builds trust across sectors, and can reap significant dividends in accelerating UHC. The event in Hanoi, Vietnam will be held in partnership with the Public Health Foundation of India, Amref Health Africa and Takeda, jAPAN.
This event is the fourth of a series. The first one, Innovations for UHC- India-Africa Conclave, was organised in June 2018 by Government of India’s NITI Aayog and Government of Karnataka in collaboration with Public Health Foundation of India (PHFI), Amref Health Africa and the Institute of Development Studies (IDS). It brought together various actors – innovators, government officials, public and private sector service providers – to consider strategies for transforming health care delivery in Asia and Africa. The deliberations were captured as a series of opportunities, challenges, and next steps . Secondly, in September 2018 Amref Health Africa and UHC2030 hosted ‘Equitable Access to Healthcare in Asia and Africa,’ a high level consultation along the sidelines of the UN General Assembly. This was followed by a multi-stakeholder consultation on Leveraging Community-led Innovations for UHC, held at the Africa Health Agenda International Conference in March 2019, in Kigali. This meeting led to an examination of the various factors in complex heath eco-systems in the global south and how locally-developed health innovations are helping accelerating Universal Health Coverage (UHC).
In Hanoi, deeper consultations will be held to explore how countries in the global south are adapting health systems to achieve UHC. The emerging deliberations will be presented at the World Health Assembly (WHA) in May 2019.