Tammy’s Highlights from Week #3 –
- Meeting with our technology team and seeing the first steps towards an inventory prototype
- Hearing Ciiru’s report on her two additional days in the Transmara – a private facility in Llogorian and a full day shadowing a chemist in Kilogoros
- Meeting with Sunny, and our advisors Josh Cohen and Eran, in Kenya for meetings related to their project
- Putting together my first wireframe mockups for the inventory and financial systems
- Informal meetings with friends and friends of friends, learning about different health projects around Kenya such as Changamka. It’s great to learn what others in this space are thinking, what their challenges are, and where they’re heading
Advisors and people we talk to often express the most excitement over the potential for impact through clinical decision support. Unfortunately, this sentiment is not as strongly expressed by the healthcare providers or pharmacists we talk to, who – much like providers in the United States – are often either confident in their own abilities, the “art” of medicine, or are pressed for time and reluctant to include new systems. As we build our technology, we need to be able to build it with an eye towards both improving health impact but also making it usable, with enough of a “hook” to ensure adoption.
In contrast to clinical decision support, we have a reverse problem with chemists. Here, we see more active interest by chemists for the technology we are building – but wariness by advisors in ensuring this improves health outcomes. We believe chemists play an important role in supplying drugs stocked out at other facilities, and have been impressed by the patched-together network of suppliers, couriers, and informal mobile payments to get drugs out to remote areas. However, we take seriously the advice from others to think carefully about how we engage with chemists. One example of this is our decision to not provide diagnosis / clinical support to chemists, who are not legally permitted to do so (the reality, however, is chemists are often the first stop and diagnosing often). Still, there is a clear conflict of interest that occurs with a chemist’s desire to make a sale – this could potentially lead a chemist to prescribe something inappropriate because their income generation comes from whether they sell a medicine, not if it is appropriate or not.
How we balance market needs (and therefore the ability to scale) with creating health impact is a big question for us. Ben is interning with Living Goods this summer, and focused entirely on impact; he is developing a score card with a single metric combining both health and economic impacts to help evaluate the impact of different operational models across Uganda and Kenya. In an interesting evening conversation, we each mentioned ways we have thought about “impact” before. Jessica, at Dispensers for Safe Water, spent significant time on health impact analysis, quantifying the program’s impact through randomized surveys, and used demographic and health survey data to guide decisions on expansion to new geographies. While I was at BCG and consulting with non-profits, I spent time thinking about how to build a portfolio of programs or activities so that you have the right suite (rather than any single optimal program) of both sustainability / profit contribution as well as fit with mission. Last school year, I sat in on judging rounds for the Global Social Venture Competition, where our judges – leaders in different organizations of different sectors – would ask the student leadership team the same thing. How do you want us to think about impact? Does the direct, immediate saving of a life matter more than broad systemic change? There is no right or “best” answer, but having an explicit discussion helps clarify the approach for an organization.
