I’m taking a class where we have to write weekly “reflections”. Last week I reflected on why nobody buys pears (the reasons are many, believe me), but apparently we were actually supposed to write about something to do with what we learned in the class. Being too lazy to come up with blog topics, I have decided to post this week’s reflection here.
Read it and weep, losers.
Last week’s presentation got me thinking about innovation in the health sector. Dr. Bowie mentioned that while technical bio-medical advancements do have an impact in the global health arena, particularly in the area of vaccination, they can also be high-cost and inefficient. As the both the financial and time investments needed for bio-medical research are high, resulting products or innovations are often very expensive. Are there low-cost, high-impact initiatives that some resources might be better spent on?
The Centre for Strategic and International Studies recently held a “Smart Global Health” essay contest in which entrants wrote about an innovative idea that they believed would contribute to improving global health. The essay I found most persuasive, however, argued against innovation.
The author stated that a great deal of funding is available for bio-medical research while “non-technical” projects receive little attention, even when they have proven results. One example is the Integrated Management of Childhood Illness (IMCI) program put forth by the WHO and UNICEF. IMCI is intended to improve child health by focusing on prevention of disease. The program educates families on children’s nutritional needs as well as issues surrounding breast-feeding, vaccinations, and so on. It provides support to health care professionals in both preventative and curative care. The project has been evaluated and found to prevent growth stunting, improve the performance and quality of care of health workers, and improve nutritional status of children. It is also low cost. The program has been implemented, however, in less than ten countries as it has not received adequate funding.
After looking around on the internet, I was surprised to see the amount of funding that is devoted to high-cost research in comparison with proven, but less technical, projects. Esther Duflo, a professor of economic development at MIT, wrote a paper demonstrating the correlation between girls’ levels of education and pregnancy rates. In much of Africa, girls who drop out of school earlier tend to have children earlier and are more likely to live in poverty, meaning that both themselves and their children will be highly susceptible to disease and illness. She ran a pilot program in Kenya where 12-year-old girls were given a free school uniform (costing $6 each) and would receive another after 18 months if they stayed in school. The dropout rates in schools where the program was implemented fell by a third over a time span of three years. The pregnancy rate for the schools fell from 12% to 8%. The experiment was then repeated in a secondary school and the impact was even greater. Purchasing and distributing school uniforms is simple, low-cost and could create partnerships between the public and private sectors if uniforms are purchased from local businesses. Yet although Duflo has tested her project in other countries and has seen similar results, she struggles to find funding.
I believe that innovation and experimentation are essential for growth. We would not enjoy the quality of health we do in Canada were it not for bio-medical experimentation. Innovation does not need to be restricted to technical solutions, however. There are many empirically tested, non-technical, and low-cost projects whose benefits could be widespread if they were given the same attention bio-medical research.