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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 – Daphne Ng, CEO of JEDTrade

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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.)

Daphne Ng is the CEO of JEDTrade, a blockchain technology company focused on trade, supply chain, and financial inclusion projects in ASEAN. She is also the Scretary-General at ACCESS and Exco. of Singapore Fintech Association

What makes you do what you do?
I was introduced to blockchain technology in 2016 after I left my corporate banking career after 10 years. It was my mentor who first got me interested in this technology, which I then went on to delve further into, on its potential applications in the lending and trade finance space – domains where I came from.

How did you rise in the industry you are in?
Being in the space for 2 years and actively involved in the ecosystem, I was able to bring on the projects, network and a good degree of thought leadership in this vertical. Early on in the startup journey, our team faced many challenges. And to me, the key to rising above failures are two essential factors – resilience and support. While resilience is innate, I received a lot of help be it in terms of connections or advice. ‘Nobody succeeds without help’ rings very true for me.

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)?
From the start, I focused on my domain expertise in trade finance and the application construct of how blockchain and DLT can be applied to these use cases. Also, my strategy from the start was to build a technology company made up of 80% tech and engineers, which is also our key competitive advantage today. At the end of the day, deliverables are about strategy and execution, which includes building and leading an ‘A’ team.

Do you have a mentor that you look up to in your industries or did you look for one or how did that work?
I have many mentors, which includes our company advisors (all of whom are well-known in this industry) and mostly informal mentors I meet via my connections, and on various occasions and circumstances. Creating opportunities also means putting myself in the right place, at the right time. And in my case, these were mostly organic and genuine friendships formed from the initial connection.

How did you make a match if you and how did you end up being mentored by him?
To me, a match in values is very important. It also takes humility to ask for help and be willing to listen to advice, which is important in order for mentorships to be successful – be it formal or informal.

Now as a leader how do you spot, develop, keep, grow and support your talent?
I love this question! I am passionate about building strong teams and helping my people grow. I abide by the 3Rs when identifying talents: resourcefulness, resilience and right values. And then I invest in the ‘potential’ and this means giving them room to lead, make decisions and take risks.

Do you consciously or unconsciously support diversity and why?
My support of diverse talents, skillsets and characters can be seen in the make-up of our core team – all helming specific roles and each bringing their own value to the table. We need the sum of all parts to build a great company.

What is your take on what it takes to be a great leader in your industry and as a general rule of thumb?
Great leaders emerge in times of failures and challenges, never abandoning the team, and always putting the team’s interests before her own. And I consciously live by these mottos every day.

Advice for others?
My advice to other entrepreneurs: be resolute and dare to be different. If you are going to follow others, then you will end up on the same path as them. No right or wrong; but I would rather chart my own path. This June, we are officially launching our blockchain project, Jupiter Chain (www.jupiterchain.tech), which have garnered much interest in the industry, even before we made it public. We believe this project is the epitome of marrying innovation with practical implementation, and we want to be the first to truly operationalize blockchain for our ecosystem projects in this region.


If you’d like to get in touch with Daphne Ng, please feel free to reach out to her on LinkedIn: https://www.linkedin.com/in/daphne-ng-%E9%BB%84%E7%91%9E%E7%8E%B2/

To learn more about JEDTrade, please click here.

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Callum Connects

Jace Koh, Founder of U Ventures

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Jace Koh believes cash flow is the lifeblood of your business. Understanding it will enhance your ability to run and manage your business.

What’s your story?
My name is Jace Koh and I am the Founder of U Ventures. I’ve always been inclined towards investment and entrepreneurship. I’ve played a hand in starting businesses across these industries – professional services, cloud integration, software and music. I believe that succeeding in business is tough, but that’s what makes the rewards even sweeter.

What excites you most about your industry?
Everything excites me. These are my beliefs:

  • Why is accounting important?
    The accounting department is the heart. Cash flow is like blood stream, it pumps blood to various parts of the body like cash flow is pumped to various departments and/or functions in a business. It is vital to the life and death of the business.
  • Is accounting boring?
    Accountants are artists too. They paint the numbers the way they want them to be.
  • What makes a good accountant?
    A good accountant can tell you a story about the business by looking at the numbers.
  • Why is budgeting and projection important?
    Accountants are like fortune tellers, they can predict the numbers and if you wish to understand your business and make informed decisions, feel free to speak to our friendly consultants to secure a meeting.

What’s your connection to Asia?
I was born and raised in Singapore, and here’s where I want to be.

Favourite city in Asia for business and why?
Singapore is my favourite city. We have great legal systems in place, good security and people with integrity. Most importantly, we have a government that fosters a good environment for doing business. I recently went for a cultural exchange programme in Hong Kong to learn more about their startups. I found out that the Hong Kong government generally only supports local business owners in terms of grants. They’ve recently been more lenient and changed the eligibility to include all businesses that have at least 50% local shareholding. But comparing that to Singapore, the government only requires a 30% local shareholding to obtain government support. In the early days of starting a business, all the support you can get is precious. It’s great that we have a government that understands that.

What’s the best piece of advice you ever received?
The best time ever to plant a tree was 10 years ago as the tree would have grown so big to provide you with shelter and all. When is the next best time to plant a tree? It is today. Because in 10 years time, the tree would have grown big enough to provide you shelter and all.

Who inspires you?
Jack Ma. His journey to success is one of the most inspiring as it proves that with determination and great foresight, even the poorest can turn their lives around. I personally relate to his story a lot, and this is my favourite quote from him, “If you don’t give up, you still have a chance. Giving up is the greatest failure.”

What have you just learnt recently that blew you away?
I’ve faced multiple rejections throughout my business journey, and recently came across a fact on Jack Ma about how he was once rejected for 32 different jobs. It resonated very deeply and taught me the importance of tenacity, especially during tough times.

If you had your time again, what would you do differently?
Nothing. I live a life with no regrets. Everything I do, regardless of whether it is right or wrong, happy or sad, and regardless of outcome, it’s a lesson with something to take away.

How do you unwind?
I love to pamper myself through retail therapy and going for spas. I also make a conscious effort to take time off work to have a break outside to unwind as well as to uncloud my mind. This moment of reflection from time to time helps me see more clearly on how I can improve myself.

Favourite Asian destination for relaxation? Why?
Taiwan! Good food with no language barriers and the people are great!

Everyone in business should read this book:
I don’t really read books. Mostly, I learn from my daily life and interactions with hundreds of other business owners. To me, people tell the most interesting stories.

Shameless plug for your business:
We’re not just corporate secretaries, we’re “business doctors.”
U Ventures is a Xero certified advisory firm that goes beyond traditional accounting services to provide solutions for your business. You can reach us on our website: http://uventures.com.sg/

How can people connect with you?
Converse to connect. You can reach me via email at [email protected] or alternatively, on LinkedIn here: https://www.linkedin.com/in/jacekoh/

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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