5 Steps for Engaging Communities in Global Health Technology Innovation

What happens when government leaders establish policies or health leaders change operational procedures “because they said so”?

This is the result of the style of leadership that does not listen to the people and those who are impacted by it. It is a top-down, decision-making approach. Unfortunately, we see this often in our workplaces, health facilities, and government departments. It is not the most effective and equitable approach to innovate, collaborate, and solve problems.

What can community, government, and health leaders can do to improve their decision-making process to ensure it supports an equitable and efficient environment for innovative collaboration that benefits the area of health technology in their communities?

#1 — Inclusive Listening

Effective leaders of change should break down barriers of division (e.g., ethnic, religious) and promote a unified and inclusive front to solve problems. For example, Claudia Brind-Woody serves as vice president and managing director of intellectual property at IBM. As a leader within a multinational technology powerhouse, “Inclusivity means not ‘just we’re allowed to be there,’ but we are valued,” she said. “Smart teams will do amazing things, but truly diverse teams will do impossible things.”

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Consider the traditionally marginalized groups within your community.

  • What can we do to include them in the process of improving access to care in your community?
  • Are they considered an at-risk group based on health standards?
  • What are their ideas and suggestions to improve access to care?
  • Is the intervention or program we are considering an equitable one?

Community and government leaders should take inventory of the strengths and opportunities to create a more inclusive and innovative environment. It will require leaders to collaborate with community members and identify areas of improvement. If not, communities receive the health interventions and programs leaders think they should need, rather than what they actually need. Leaders cannot know what their communities need unless they listen.

Dr. Vincent Turbat, a highly respected health economist and professor at Georgetown University, held many positions in the World Bank. His experience as a country manager in charge of working with government officials offered many lessons. In his reflection:

“First step: listen… At the beginning [of my journey], I was not hearing [beneficiaries] properly because I had my own ideas, but then when you learn to listen to them, then you are able to design the proper response to meet their needs,” said Dr. Turbat. “If you want to work in this business [of global health], [you should] not to push your own agenda, but push the agenda of the people [or population] you are going to work for. In order for you to be able to do so, you need to be able to listen to them,” he said. The most cost-effective intervention is often found by listening and understanding the needs of the people.

Once we listen and understand the needs of the population, we can begin to stimulate research. Research will lead us to identify evidence-based solutions in health technology and develop public policies that protect new businesses working to find solutions.

Consider opening dialogue with different religious, ethnic, and socioeconomic groups, and ensure that they have a seat at the table.

#2 — Diversity and Equity, not Tokenism

Having a seat at the table is important, but it should not be for the wrong reason: Tokenism. According to the Cambridge Dictionary, Tokenism includes “actions that are the result of pretending to give advantage to those groups in society who are often treated unfairly, in order to give the appearance of fairness.”

One of the lessons we learned from the history of health technology innovation is the importance of taking an inclusive, equitable, and diverse approach to collaboration — it is more than an appearance. Research published by the BMJ Global Health journal and the World Health Organization has shown that there is a lack of equity and diversity in key decision-makers in global health when looking at the global health workforce. That has to change.

But why is it beneficial to take an equitable approach?

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Shana Abraham is a global health advocate for women empowerment who supports an equitable approach to collaboration.

“Collaborating with other people really helps you understand not just your own perspective better, and how that may have formed, but maybe some of the things you’re missing, that you wouldn’t have been able to note if you hadn’t collaborated,” she said. Collaboration requires you to take a step back and ask a few questions to identify what areas you need to include a diverse set of perspectives.

“So, what kind of barriers do different people face when it comes to adopting innovation? What are their concerns? What are they seeking? What do they want, right? It will only serve to better support innovation and whatever program you’re doing, or whatever endeavor you’re seeking, support collaboration, make sure you cover your bases to the best of your ability, and also consider things you may not have previously been exposed to.”

Collaborators need to include people from different ethnicities, genders, and backgrounds in their team to ensure they have a multifaceted and comprehensive innovative solution to a problem. In addition, they need to overcome systemic inequity within their organizations. Remember, your company, health system and organization should seek equity and diversity, but not with the intention of Tokenism.

#3 — Be Flexible and Open-minded

Community leaders have an opportunity to build bridges between people in the community and between companies in different sectors.

One powerful technique to enable cross-discipline and multisector cooperation is to bring companies together to formulate a partnership. While it is difficult for an entire country to shift this paradigm, community leaders can work with community-led partnerships as a bottom-up approach. Identify the strongest industries and companies in your community and find ways to create a partnership with small businesses.

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“If you can go find grassroots innovators and figure out individually the challenges they’re bumping into, and then collectively, the most common challenges are they’re all facing,” said Elizabeth Hoffecker from the MIT D-Lab Local Innovation Group, “it will tell you where you need to work at the system level. It’ll tell you what the problems are in your innovation ecosystem that needs to be addressed from the level of policy and funding.”

Leaders also need to be flexible and open-minded to acknowledge that certain processes need to change. For example, how can you use technology to improve access to health services within your community? Are there any outdated policies or procedures hindering increasing access to services?

I was conducting a health system research analysis recently and I came across a policy in a municipal system of a country in Latin America that did not allow patients to cancel their immunization appointments. That meant that patients who could not make their appointments had to leave that time blocked off, and that did not allow those who wanted an appointment without the ability to take their slot. In other words, there was high demand for immunization, but not enough slots due to an outdated policy.

Community leaders should be willing to modernize and optimize processes within their community, and partnerships will help with that. Do not merely reach across the aisle; shake hands across the aisle, work together across the aisle, and solve problems together across the aisle. Collaboration is not easy, but it is a prerequisite to solving complex world problems.

#4 — Cultivating Local Talent

Fourth, health leaders need to facilitate public health policies and adapt the health system to accommodate innovative technological solutions while prompting local entrepreneurs to find local solutions. How can we expect community-based health technology innovation to appear out of nowhere without propagating and cultivating the brightest minds in our communities? Unfortunately, one of the problems we see in many low-income countries is that government, public health, and economic policies are not always attractive enough to keep local talent in-country.

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Various research and reports have investigated the difficulties of the migration of talent to high-income countries seeking a better quality of life for their families. This concept is famously known as the “brain drain.” I believe the brain drain is much more than the diaspora of doctors and other health workers into developing countries. I argue that we are also experiencing the “brain drain” of the technology industry. Many brilliant entrepreneurs either leave rural areas and move to urban areas or even move to other technology-driven metropolitan areas within their region or other continents. Therefore, attractive policies need to be designed to convince local talent to stay local and solve local problems.

#5 — Multidisciplinary and Cross-sector Collaboration

Leaders cannot do it by themselves. That is why any policy decision will require the inclusion of experts and leaders from different sectors and disciplines. Without collaboration, leaders are forging an irrelevant legacy — merely temporarily holding a position in government. Renowned author and leadership expert John Maxwell believes “a leader is one who knows the way, goes the way, and shows the way.” You now know the way of collaboration, and it is up to you to prepare the way for others and show the way to your community.

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Leadership in the twenty-first century has been transformed by the speed and accessibility to communication tools; information is at the press of a button or the click of a mouse. With that in mind, leaders must adapt to the new realities of technology, but also leverage the technological tools you have to better understand the needs of the people. While we addressed many strategies to enhance the innovative collaboration that actually leads to equitable solutions, it all starts with listening. As leaders, we were honorably given the responsibility to think and act in service of our community, and not our own agendas. Therefore, listen and think, then act.

While I acknowledge there are still many other areas health leaders need to address, these five critical points of action will provide a foundation in which cross-sector and multidisciplinary partnerships could spark and cultivate innovation in new health technology in low-income countries.

About the Author

Alcir Santos Neto is the author of the book “Rebooting Global Health: Changing How We Approach Health Technology” and the Founder of the organization, Rebooting Global Health. A former U.S. Army Medic, he holds a master’s degree in International Relations and has multisector experience working as a consultant and researcher. His ultimate goal? Impact global health and international relations by empowering people worldwide to be a positive force of change.

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