innovations-investment, processes, and outcomes_kureshy_5.11.11

Child Survival and Health Grants Program:

INGO led Innovation and Operations Research

(2008 – 2011)

Nazo Kureshy, Team Leader, CSHGPOffice of Health, Infectious Diseases and Nutrition

Bureau for Global HealthUSAID

CSHGP’s CURRENT PORTFOLIO OF INONVATION & OPERATIONS RESEARCH

• Summarized in brief: “Testing innovations to improve and scale up high impact MNCH interventions in vulnerable communities: USAID’s partnership with 14 INGOs through the CSHGP in 16 countries

• Reported in 3 Congressional Reports focusing on updates to USAID’s Research Strategy – 4th currently in progress

INNOVATION & EVIDENCE: NUTS & BOLTS

– Deliberate Flexibility in Design of Innovation• PVO/local and national stakeholder driven designs responsive to local

challenges• Relevance beyond project area (national policy/program; global)• Illustrative areas for innovation and OR – no themes

– Developed in collaboration with BGH technical teams to link CSHGP innovations to research and incorporate GCD challenge areas, as feasible

– Integrated into an effective community oriented project platform (single or multi-district)

– Focus on Evidence & Use• Credible evidence (global/national/local), new partnerships for

research, relevance/use through stakeholder engagement

DEFINITION

Innovation is defined as an approach or practice that introduces novel ways of addressing critical operational barriers to delivering (for improving the delivery and use of) high impact MNCH interventions to (in) vulnerable populations and strengthening health systems, ultimately leading to increased scale of these interventions and improved health outcomes.

Innovations require challenging existing paradigms in order to address an identified need (by key stakeholders) at national and global levels.

DEFINITION (CONTD.)

• The proposed innovation should be an appropriate solution to a relevant public health challenge. It may include the following:

• Introduction of a new approach or practice;• Substantial transformation of an existing approach or

practice; and/or• Deleted: Adaptation of a successful approach or

practice for a different context.

DEFINITION (CONTD)

FY 2011 RFA ADDITIONAL NOTES ADDED TO DEFINITION

•Clearly differentiated from existing alternatives•Incremental solutions – not innovative proposed as project strategy rather than innovative solution•May integrate innovative approaches with low-cost products and technologies, as relevant and feasible (integrated innovations)

ANATOMY OF CSHGP’s EVALUATION CRITERIA FOR INNOVATION (2008-2011)

2008 2009 2010 2011

28 points 30 points 36 points 35 points

*Rationale and capacity to address key barriers

*Focused description /rationale for innovation* Contribution to evidence base/furthering policy/scale up

*Problem/relationship to national context*Prior research* Appropriate solution

*Problem/relevance/prior research*Unconventional* Potential for Impact, sustainability, scalability

*Methodology to evaluate innovation

*Mechanisms to share evidence

*Proposed OR design, including research questions

*OR partner/demonstrated capacity

* OR objectives, questions, and other design components

* OR questions only

* Stakeholder engagement in research and use of information (USAID Mission)

Innovation/Evidence Building Niche?

• Can frame with technical interventions and/or cross-cutting approaches lenses

• Proof of concept (4) + refinement/evidence building for scale up (13); of 13, 6 have some new components within innovation model

• Not a specific grand challenge but sets of relevant challenges for operationalizing a range of components in a community health system (delivery to utilization/participation) relevant to national/local policy and program context

• Clustering in challenge areas, particularly relevant to community level inputs and packaging

Innovation Clustering/Contributions

• Technology and mHealth• Developing new or improving community platforms

for delivery and use (CHWs; community mobilization; behavior change; governance)

• New practices in integration (within and outside of health)/Smart integration

• New or low coverage interventions (CCM, community newborn care)

• Equity

IDEAS ACROSS USAID INNOVATION MECHANISMS

CSHGPDevelopment

Innovation Ventures (DIV)

Grand Challenge: Saving Lives at Birth

New teaming at community level for CCM

Range of Task Shifting/Performance/Motiv

ation

Maternity Waiting Homes

MHealth (Dimagi comm care app)

Care Group model

People’s Institute Model

Simplified HFP-ENA model

EONC network

Inventory credit (bankers and farmers)

E-bike

Test for pre-eclampsia

Mobile phones (Dimagi comm care app for maternal

health; election fraud; mobile diagnosis)

TBD

Tensions/Reflection Areas

CONTENT•Flexibility vs. Themes

– Thematic Challenges for strengthening a cross-country learning potential (global vs. national)

•Range: strengthening coordination and collaboration across community of innovators:

– Integration of technology/other new comonents with cross-cutting approaches and community systems models

– Energize range of ideas? Cross-learning?

•Focus on credible evidence (national/global): sufficient process learning? Creativity with new methodologies? Culture of success and failure?

Tensions/Reflection Areas

CONTEXT•Integration of innovation within NGO project ($1.75, 4-5 years) – constraining? Cleaner division between smaller proof of concepts (with greater risk) and scale up?•Ideation vs. Sale: Novelty in Innovation/Risk vs. Evidence for scaling up promising/”safer” approaches and models •Priority countries or broader? Generalizeable vs. context specific solutions? Global vs. national?