SWITCHPOINT highlights: innovation, new technologies & scale up

Switchpoint was held on the 18th & 19th April, in Saxapahaw North Carolina. It was a conference of ideas, innovation, art and action around global health – organized by IntraHealth International. I have captured some of the coolest ideas below…IMG_0590



One of the great messages from day one was how resource constrained environments are fruitful environments for innovation. Erik Hersman, the keynote speaker, highlighted that when you don’t have prepackaged solutions that are available over the counter, you need to find solutions from readily available materials (such as a nebulizer from a bike pump!). This concept is captured by the Hindi phrase jugaad – (make do), described in a book of the same name (actually not mentioned at the conference).


One pitiable component of this, highlighted by Jose Gomez-Marquez, is that the creators of these solutions are often embarrassed by them – they don’t look pretty and they seem to indicate an unprofessional environment. Of course, there are also safety and efficiency implications from such off-the-grid solutions. But they are indications of creativity that can be harnessed to create durable and systematic solutions.


And, if a solution works in a difficult environment such as the Sudan, it is likely to be robust enough to work anywhere.



Another message re-emphasized over and over was the need to design for and in collaboration with the end-user – the health worker or patient. Designing locally, at the site of use was highlighted as an important strategy. Stembile Mugore from Malawi emplored us to bring the technology to her, an individual health worker – not to a generic low resource setting.


However, Chris Elias from BMGF, pushed a bit further. He suggested acceptability and utility of the end user is insufficient – new innovations or products also need to fit into the systems context. He gave the example of a new vaccine that was developed for low resource settings and yet the packaging made it three times the size – and made it impossible to ship in bulk along the cold chain. Unpackaging and repackaging also had implications for time and efficiency. Regard needs to be paid to those who use, those who choose, and those who pay the dues – usually all different people. If these three things are not aligned markets are broken.


Enabling EnvironmentsHaw River

Karl Brown from the Rockefeller Foundation described their efforts to create enabling environments for innovations to scale up. He cited the example of the Rockefeller- supported agricultural research institutions that helped foster the Green Revolution. He differentiated between faucets – which a lot of innovations are – shiny and visible at the user interface; and the plumbing, which is less sexy but an important delivery system for the innovation.


Getting the delivery system right means that governments can respond to different problems as they arise. Josh Nesbit mentioned that if we get the delivery system right for ANC and vaccinations – eventually the same system can support the delivery of more sophisticated interventions such as 3D printed organs.



Chris Elias from BMGF recounted a story that I have already retold multiple times in the last few days. BMGF facilitated a site visit from Pakistan to India a few years ago to learn from India’s success in combatting polio. The Pakistan delegation asked the Indian officials what was the one thing that turned the situation around, towards achieving polio free status. The Indian officials did not even hesitate; “we started paying for it ourselves”. Once the government started paying for the program, they paid more attention to implementation, solving systems problems as they arose. This story provides a strong case for country participation to create accountability mechanisms.


microlabsign-webRoutine Data Collection & Use

Promoting data use is tricky when we know the quality of routine data is often poor. One quote I really liked was roughly “the quality of data collected by health workers is directly related to the value placed on the data for the health workers’ own use”.


An engineer from Instedd, Eduardo Jezierski, pointed out a solution to the reporting burden; gathering data from medical devices directly to a server. This will tell us how often and when they are used, when they are broken – but it will also indicate patient flow, absenteeism, working hours etc.

(See another post about data use here.)


Cool people I met

At every conference or event, you pay the registration fee for the professional-related content and the big-name key-note speakers (hyperlinked above), but it’s the people you meet in the lunch queue that make it a rich experience, and a delight.


You can read more about Switchpoint at: http://www.switchpointideas.com/, or at the IntraHealth blog


DJ Spooky performed on the first night of the conference, friends from town came in to join me.

DJ Spooky performed on the first night of the conference, friends from town came in to join me.


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