Within CFIA's Health Domain we aim to contribute to bridge the gap between hard-to-reach populations and health care services. We believe that frugal innovations can help bridge this gap. We do this by focusing on multidisciplinary and transdisciplinary research and education regarding health applications and tools. Below we have identified 9 crucial elements of our approach to health & frugal innovation. Not all our research & projects will and can contain all the elements below, but these elements are CFIA's compass in the Health Domain.
- At CFIA we apply a process approach with a focus on avoiding over-engineering.
Innovation is key to healthcare systems that aim to be affordable, inclusive and effective. Current innovation practices and trajectories are often characterized by over-engineering, leading to overly sophisticated products and systems, that at least initially do not fit health care needs in developing countries. Most healthcare innovations originate from corporate R&D departments and large institutionalized research networks oriented towards 'rich' markets. A process approach can investigate how to start from the needs of poor and emerging middle-class consumers, with solutions that are 'fit for purpose', robust and affordable. A process approach also means we are not automatically primarily interested in the eventual gadget or service, but especially also in how the innovation process unfolds, who participates and how. Moreover, a process approach does not stop once the innovation is developed, it also looks into the business models needed to 'roll out' the innovation, be it through commercial or public or donor-driven channels
- At CFIA we use a bottom-up and co-creation approach
This starts from the health needs in developing and emerging markets such as Africa and India. Together with a variety of local actors, including users of health services, health professionals and practitioners and local researchers. In contrast to a Eurocentric view, our starting point is to investigate the dynamic field of health innovators in resource constrained countries in the Global South. We focus on local health (knowledge) systems and locally used health technologies and are interested in how these could inform and/or interact with technologies and health (knowledge) systems that come from elsewhere. This means for example that we explore in what ways current innovation trajectories in healthcare do allow for value sensitivity, or improvisation and bricolage, and to what extent they are gender, culture and context sensitive. We also investigate how this is perceived and experienced by local actors. We do this mainly through our locally embedded hubs in Kenya and India, which makes us well positioned to develop research from a more bottom-up perspective. Also because both countries have thriving indigenous medical/health care systems. Through this locally embedded perspective we also hold an open mind to explore the interactions and complementaries between 'modern' and 'traditional' health providers, which may lead us into examining local frugal service and institutional innovations as well as the field of citizen science.
- At CFIA contribute to the field of reverse innovation.
Next to our primary focus on health innovations outside Europe, we stimulate learning in Europe from practices outside Europe. We do this by focussing on how to make healthcare in the Netherlands and in Europe more affordable, accessible and inclusive. CFIA aims to complement the Leiden-Delft-Erasmus Health Agenda by bringing in innovative examples of frugal innovation that are of relevance to Europe and The Netherlands.
- At CFIA we move beyond diagnostics.
While diagnostics are obviously important, without follow up opportunities for treatment they are not very meaningful. Therefore we aim to focus our research on diagnostics, curative and preventive frugal health interventions. This approach has become even more important in the context of what is often labeled as the 'double burden' in health care in Africa, where communicable infection diseases are still widespread while also non communicable 'wealth' related diseases like obesities and cancer are increasingly prevalent. Therefore, frugal preventive life style interventions are probably as important as low cost vaccination strategies for infection diseases.
- At CFIA we focus on localized primary and community health care
This context is most suited for carrying out a bottom-up and process approach that looks at all stakeholders and the knowledges that they may bring in. Issues of access and quality are also key in understanding local primary care facilities. In some cases primary health care is not sufficiently accessible and/or too expensive. In other cases local citizens do not go there because of (a perceived) lack of quality in health services. The absence of an effective health insurance system further causes low demand for healthcare. People take refuge to either unsafe practices or they wait and postpone visits to health care units until it is actually too late to be cures, with in many cases fatal outcomes. Frugal innovation that can improve access to and effective demand for 'fit for purpose' quality in localized primary health are of crucial importance.
- At CFIA we identify health interventions with scaling potential
While this may sound somewhat contradictory to a focus on bottom-up, context-specific and localized innovation strategies, it is also of key importance to critically investigate which frugal innovation in health are scalable and how. As there are many smaller successful interventions, identifying which examples are scalable and through which transmission mechanisms in context-sensitive ways is one of the key challenges in the broader CFIA research agenda. For example, doing research on how the COVID pandemic has led to a variety of very interesting local frugal innovations with scaling potential.
- At CFIA we explore ‘fit for purpose’ digitalization in bottom-up health interventions
We do this to identify if and when these are likely to enhance effectiveness of the interventions. Such options may range from the use of platforms, AI, Big Data to the use of IoT applications.
At CFIA we support the development of frugal innovations within LDE faculties
We do this by mobilizing additional disciplinary areas of expertise to enhance their chances of success and by offering our own expertise.