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Innovation in Healthcare in Asia

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The countries comprising the South Asian Association for Regional Cooperation (SAARC) region (India, Pakistan, Bangladesh, Nepal, Bhutan, Afghanistan, Sri Lanka, and the Maldives) commonly known as South Asia face serious healthcare affordability and accessibility challenges. According to World Bank national estimates, South Asian countries houses more than 390 million poor people and a very significant percentage of total population lies below national poverty line (Figure 1). This large number of population is quite unlikely to afford private healthcare services and heavily dependent on the public healthcare facilities.

Figure 1: % of population below nationally determined poverty line

Figure 1: % of population below nationally determined poverty line

Source: World Bank

Apart from just high poverty levels, the availability of doctors is another critical challenge. As per World Bank data except Maldives, every SAARC country has less than 1:1000 doctor to population ratio which is an area of concern (Figure 2). The availability of qualified doctors in the rural areas is dismal and people often tend to self-medicate or take treatment from self-proclaimed doctors who often have no formal education in practicing medicine. It is also important to note that more than 50% South Asian population amounts to approximately 1.17 billion lives in rural areas that often has to travel to cities to access secondary and tertiary care raising tough accessibility barriers.

The high cost of travel to urban health centers coupled with a lack of awareness make the situation worse. Hence, it can be argued that the basic health care demography for these South Asian countries is reasonably identical, and the problem of health care can also therefore be looked at from a regional level rather than in the context of an individual country.

Figure 2: Number of doctors (physicians) per 1000 people

Figure 2: Number of doctors (physicians) per 1000 people

Source: World Health Organization

These severe affordability and accessibility barriers to universal quality healthcare demands for innovation in the way care in being delivered both to the poor and people living in rural areas. To understand innovation in South Asia, things need to be put into right perspective. Innovation in health care is not only about technological innovation or new systems of health care financing or upcoming health care delivery models targeting a vulnerable population. Health care innovation is a mix of all the abovementioned elements, which covers all aspects from diagnosis to delivery of service to the end customer, which is the patient in this case.

Often, the misconception is that technological innovation is confined to the sophisticated labs of developed nations. The increasing adoption of frugal innovation by many technological firms has changed this notion dramatically in the past few years especially in the area of health care diagnosis. Intel in India launched a device in 2015 called Lifephoneplus, which enable people to take an ECG and monitor glucose levels by themselves. This device uses the existing bluetooth and wireless network to transfer the health information record by phone, from which it can then be sent to the doctor directly.

Since 2007, GE Healthcare, one of the biggest providers of health care systems, has been developing portable and battery-operated ECG systems out of India’s labs, and these are already being used in rural areas in the developing world. The company has recently claimed to launch the first CT scanner made out of its India facility in 2015 for the developing market, keeping in mind the twin big challenges of affordability and accessibility. The challenges of the developing world are very unique and therefore the technological innovation needs to be tinkered in a way that it takes care of local needs and challenges.

South Asian countries have witnessed nearly a wind of various telemedicine initiatives and, of late, mobile apps operating at different levels and scale. Some examples include Apollo Telemedicine and iClinics in India, mPower in Bangladesh, and Aman Telehealth in Pakistan, among many others. The telemedicine-based business models leverage the information and communication technologies to act as a bridge connecting rural patients with qualified doctors in the urban areas and could be effective in improving the outcomes especially in primary care. What is more interesting is the acceptance that telemedicine seems to have generated among the governments of the South Asian countries. India has recently announced that an e-Health authority will be set up in 2015, while the Maldives and Nepal and have national telemedicine helplines in place since 2011. But Telemedicine alone has limited capacity to address the vast healthcare needs in South Asia. There is certainly a need for fostering effective partnerships to increase the geographical reach, impact and service offerings.

So what are the prospects for health care innovation in South Asia? One possibility is that the next wave of innovation in health care will be defined by increasing partnerships, such as those being implemented on a PPP model, where PPP stands for public, private, and people. For instance, the coupling of telemedicine and other innovative health care delivery models with public insurance schemes could be very effective in addressing the huge unmet need of quality rural health care in developing nations. The pairing of the low-cost surgery center, Narayana Health, with state government–supported micro insurance schemes in which poor people pay a premium of only $4–$6 annually in India is one such great success story.

The immediate need is not only for stand-alone frugal innovations or new delivery mechanisms, but devising a way to better integrate the various actors across the health care delivery value chain. The governments in South Asian countries need to upgrade their role from being merely a support provider to that of being a key enabler to bring all stakeholders on a single platform. If low-cost medical devices and technology-based frugal innovation are not being implemented in public health care systems then the potential impact of these advancements will be very limited.

The health care delivery services could also be contracted to the innovative and effective private health care providers by the different governments so that the much-needed quality primary care services are provided in the rural areas. The public insurance schemes supported by the government can be used as payment for these services. The health care innovation driven by the private sector brings in expertise and ideas but the scalability can only be achieved from active government participation in it, and not merely support. Therefore, this may be the right time for both the government and the private sector to reconsider the current innovation ecosystem in the health care sector in South Asia from the lens of active collaboration and setting the clear standards for service delivery.

Given that both of the challenges and solutions to healthcare look similar for South Asian countries, it may also be a good idea to form a regional cooperation model to foster innovation in healthcare. Different countries can both share and learn from each other experiences in adopting innovative healthcare delivery practices. The lessons learned from the establishment of SAARC as a regional multilateral institution could also be leveraged in this regard.

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About the Author

This article was written by Anshul Pachouri of Asia Pathways. Asia Pathways is the blog of the Asian Development Bank Institute which was established in 1997 in Tokyo, Japan, to help build capacity, skills, and knowledge related to poverty reduction and other areas that support long-term growth and competitiveness in developing economies in the Asia-Pacific region. Anshul is currently working on strategy practice at a global consulting firm based in India.

Entrepreneurship

Women on Top in Tech – Espree Devora, Creator, Podcast Producer, and Host at WeAreLATech.com

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(Women on Top in Tech is a series about Women Founders, CEOs, and Leaders in technology. It aims to amplify and bring to the fore diversity in leadership in technology.)

Espree Devora is known as “the Girl who Gets it Done”. She created WeAreLATech.com, a hub for entrepreneurs to connect to resources in the Silicon Beach community, which hosts the 1st podcast focused on LA Startups. She is also a podcast Producer and Host of the show, Women in Tech Podcast. The purpose of the show is for every listener to walk away feeling ‘If She Can Do It So Can I’. She calls it “actionable empowerment”. In 2017, Espree was listed by Inc Magazine as top 30 Women in Tech to follow.

What makes you do what you do?
Being an entrepreneur is in my blood. Some days are epic highs. Others are incredibly uncomfortably low. It’s not an easy day to day life, but living with a sense of purpose is an extraordinary gift.

How did you rise in the industry you are in?
Being myself. Pushing through my fears to be positively vulnerable. To live as though I am always mentoring even though I may not know who’s paying attention.

Why did you take on this role/start this startup especially since this is perhaps a stretch or challenge for you (or viewed as one since you are not the usual leadership demographics)?
I’ve always loved media production. It’s a creative art form that can have long lasting positive effects on the audience who absorbs the content I create.

Do you have a mentor that you look up to in your industries or did you look for one or how did that work? How did you make a match if you and how did you end up being mentored by him/her?
I do now have a mentor I look up to to be my most powerful self. We met at a conference and we speak regularly to work past my self-limiting beliefs and to build an abundant life, both spiritually and professionally. My mentor’s name is Debra Hockemeyer.

Now as a leader how do you spot, develop, keep, grow and support your talent?
I seek out integrity and a moral compass code. I want empowering solution mind teammates who value our company culture.

Do you consciously or unconsciously support diversity and why?
Yes, because we’re human.

What is your take on what it takes to be a great leader in your industry and as a general rule of thumb?
Lead with vulnerability, let your audience share in the progression of your journey.

Advice for others?
Your “intuition is your oracle”. Walk your own path, don’t try to be someone else. They had their journey so it’s time for you to create your own journey now.

People crave connectivity, not celebrity. So rather than trying to look big, instead focus on creating immense positive impact in each person’s life (be it customer or partner or friend)

My Mom always says every “No” is one step closer to a “Yes”.

We want to continue to build connective technology, produce meaningful media and create unique offline experiences in the startup space to move people from online digital relationships to high quality offline relationships.


If you’d like to get in touch with Espree Devora, please feel free to reach out to her on LinkedIn: https://www.linkedin.com/in/espree/

To learn more about WeAreLATech.com , please click here.

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Callum Connects

Darvin Kurniawan, Founder & CEO of REIDAO

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Darvin Kurniawan is impressed by blockchain technology. He believes it will change the way we live in the not so distant future. His business, Crowdvilla.io is using blockchain technology to change how society owns assets.

What’s your story?
I was trained in computer science and I went on to appreciate the many facets of business. I delved into multiple industries, which equipped me with the many skills to become a ‘jack of all trades.’ This allowed me to see things from various points of view and to identify opportunities and potential risks.
I heard about bitcoin for the first time in 2011. It was very difficult for me to understand back then. I revived my interest in blockchain technology near the launch of the second most popular blockchain, ethereum and I have been involved ever since.

What excites you most about your industry?
Blockchain has a real chance to change how we live as a society. This is not just as a business or start-up, but a way of life.

What’s your connection to Asia?
My grandfather came from China to Indonesia. I was born in Jakarta, Indonesia. I moved to Singapore for university and have stayed here since then.

Favourite city in Asia for business and why?
Singapore, for its efficiency, and very clear rules and regulations. Not to mention the relatively competitive tax rate.

What’s the best piece of advice you ever received?
“Just try it out.” So simple, yet many fail to appreciate the fact that surveys and questionnaires sometimes just don’t work.

Who inspires you?
Nassim Nicholas Taleb, a writer. He inspires me because of his ability to see things the way they are. He articulates points that I knew existed, but I couldn’t explain. That’s what makes me drawn to his writing.
Basuki Tjahaja Purnama (Ahok), a politician. He is able to say what’s right, no matter what!

What have you just learnt recently that blew you away?
A blockchain AI project by SingularityNET. It’s going to change how we live if it goes mainstream.

If you had your time again, what would you do differently?
I would have been more persistent in my endeavours. I learnt the hard way. In many cases, what was needed was time.

How do you unwind?
I frequently take a long stroll.

Favourite Asian destination for relaxation? Why?
Lombok, Indonesia. It’s not as crowded as Bali, with similar, if not better beaches. It’s perfect for a quiet time and a short getaway.

Everyone in business should read this book:
Antifragile: Things That Gain from Disorder by Nassim Nicholas Taleb

Shameless plug for your business:
It’s more than just a business. It’s a movement. Crowdvilla.io is changing how society owns assets. Through blockchain technology and the ability to create digital assets, we can create digital assets that mimic and govern a real estate utilization model.
Imagine if there was a hotel chain where the buildings or assets were owned indirectly by the community, and the hotel’s mandate was to make itself available for the community to use. Removing all the middlemen, we can immediately give better value to the community.

How can people connect with you?
[email protected]

Twitter handle?
@darvink

This interview is part of the ‘Callum Connect’ series of more than 500 interviews

Callum Laing is an entrepreneur and investor based in Singapore. He has previously started, built and sold half a dozen businesses and is now a Partner at Unity-Group Private Equity and Co-Founder of The Marketing Group PLC. He is the author two best selling books ‘Progressive Partnerships’ and ‘Agglomerate’.

Connect with Callum here:
twitter.com/laingcallum
linkedin.com/in/callumlaing
Download free copies of his books here: www.callumlaing.com

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