Frugal innovation in healthcare

Providing ‘Good health at low Cost’, an imperative for UHC, is increasingly becoming a challenge due to rising cost of health care globally, especially in LMICs like Bangladesh where out-of=pocket expenditure for healthcare stands around 67% of the total health expenditure. This is mainly due to rise in life expectancy and associated rise in demand for care especially for chronic conditions over prolonged period of time, and expectations among population for the best available health care based on latest health technologies. In resource constraints LMICs like Bangladesh, ‘scarcity’ of HRH and non-HRH resources lead to search for alternatives and providing ‘inexpensive solutions for more people with fewer resources’. This idea that ‘more can be done for less for many more people,’ nicknamed ‘frugal innovations’, stands to benefit most the healthcare sector of the LMICs, and also, unsustainable growth in healthcare expenditure is forcing global healthcare systems to learn from these affordable technologies and models (‘reverse innovation’).

Some examples of such frugal innovations are: i) Reproductive Health Vouchers

Programme, Bangladesh (Maternal health programme which provides vouchers to pregnant women to cover transport to antenatal care, delivery and postnatal care and for purchasing medicines.); ii) GeriCare@North, Singapore (Telemedicine solution that involves a hospital-based specialist physician examining patients in

nursing homes with the assistance of a specially trained geriatric nurse on site); iii) ReMeDi: Medical Data Acquisition Unit, India (Provides Electronic Medical Records including; images, various health parameters as well as audio-video conferencing at very low bandwidth for remote healthcare delivery); iv) GlicOnLine, Brazil (Service to support the treatment of all types of diabetes by empowering patients to correctly follow treatment plans through digital alarm reminders and improved data collection through any Android mobile phone device or via the Internet); v) ReMeDi: Medical Data Acquisition Unit, India (Provides Electronic Medical Records including; images, various health parameters as well as audio-video conferencing at very low bandwidth for remote healthcare delivery); vi) i-calQ/Smartphone Thyroid Disease Management, multicountry (Turns an ordinary smartphone into a portable diagnostic laboratory combined with medical decision support algorithms to provide a comprehensive disease management solution) etc.

BRAC, an indigenous NGO in Bangladesh with global outreach in Africa and south/south-east Asia, has been experimenting with social innovations for quite some time. Its Social Innovation Lab, is a cross-disciplinary platform for promoting and testing innovative ideas to solve problems in the development field. However, few works have been done in the health sector. This has created a space for testing out frugal, innovative solutions to problems of delivering equitable and quality health services to those who are in need including the poor, marginalized and vulnerable populations. Addressing emerging problems of delivering NCD services at the PHC level, and innovations for reducing maternal and neonatal mortality further which is currently stagnating, are two important areas which need such ‘frugal innovations’ to expand outreach within short time.

Source: excerpts from an on-going proposal for establishing a  “Frugal Innovation for Universal Healthcare Hub”