After a day of discussions on how to scale social enterprise innovations to improve health outcomes during an event hosted by the World Bank Group’s (WBG) Innovation Labs and Health Global Practice on June 8th, one clear message emerged – public-private dialogue and collaboration, as well as collaboration between the public sector, the private sector and multilateral organizations such as the WBG is required to reach those living at the last mile.
A prime example of this need can be seen in a mobile phone health clinic program developed by VillageReach, a social enterprise working to provide access to quality health care to underserved communities through an integrated approach.
Developed in partnership with Concern Worldwide, Chiptala Cha Pa Foni (CCPF or Health Center by Phone) is VillageReach’s mhealth innovation designed to increase access to timely and appropriate maternal, neonatal and child health information, advice and care in Malawi. Their model is composed of two parts: 1) a toll-free hotline for people to call, and 2) an individualized mobile messaging service that provides tips and reminders. Given its simplicity, but its ability to reach those living at the last mile, this solution is making rapid headway. At current scale, CCPF reaches 300,000 women by delivering 1,000 calls and 3,000 SMS messages per month.
Given the scale and clear opportunity for national impact, the Malawi Ministry of Health endorsed CCPF, however, like many developing countries, did not have enough funds to implement the program at the national level. VillageReach saw an opportunity for a private provider – Airtel – to step in and supply the necessary technology and funding to deliver the social enterprise’s solution through a zero-rated service. By collaborating between the social enterprise, a private telecom provider, and the Ministry of Health, costs, knowledge and innovation were able to be shared, and those living in extreme poverty were able to receive lifesaving information on health services.
However, the reality is that not all social enterprises are fortunate enough to have everything align this way. In addition to high standards of proof on efficacy and cost effectiveness, adaption of new innovations and technologies require considerable buy-in from governments who must also dedicate time and resources to training and capacity building of government workers. Changing public service delivery systems requires strong leadership commitment from the government and the willingness of the public workers to adapt and adopt.
This said, the WBG is in a unique position to enable collaborative relationships between governments and social enterprises. Given the institution’s experience working with governments, the WBG can ensure solutions are working constructively with pre-existing models and clarify the distinction between financing, provision and regulation. It will be important to identify which WBG operations and tools can be designed, delivered and used to support the linkage between policy makers and private providers.
VillageReach’s story in bridging the gap between the Ministry of Health’s needs and the collaboration with Airtel serves as a prime example for other social enterprises who may be struggling with engaging policy makers to help scale their solutions. The pathway to scale is not one without challenge and does not have a one-size-fits-all solution, but through the collective effort of governments, social enterprises, and enablers we can create an environment that facilitates the type of solutions that are most effective in improving health outcomes for those at the last mile.
Village Reach is a social enterprise whose mission is to save lives and improve well-being in developing countries by increasing last-mile access to healthcare and filling gaps in essential supporting infrastructure, especially for remote, underserved rural communities. VillageReach received the Development Marketplace award in 2003 and also participated in the Development Marketplace Investment Platform program with its vaccination program in Mozambique.
Elaine Tinsley is an Operations Officer for Social Enterprise Innovations, leading the work on the Social Enterprise Knoweldge Base. The Knowledge Base provides users with an array of innovative models in service delivery to be applied to WBG operations and research. Additionally, the program offers an ecosystem diagnosis to better understand the constraints in the sector and the policies that might need to be undertaken to improve the sector’s potential and improve service delivery.