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Brinnon Garrett Mandel: How a Loyalty Card Points the Way to Healthier Populations

The global health community can learn from local innovators, who are finding local solutions to local challenges.

Is your keychain full of loyalty cards with bar codes? I have several loyalty cards on my keychain, for grocery stores and gasoline discounts. Yet until recently, it hadn’t occurred to me how this model could inspire innovation in global health.

The intellectual capital, the creativity, the tenacity and the passion with which people are approaching global health innovation is truly energizing, but one of my must humbling experiences has been meeting one particular innovator, Dr. Benson Wamalwa. He and his team from the University of Nairobi have developed a Mother and Child Wellness Loyalty Card with quick response codes to track visits for prenatal care and vaccinations for their children. For participating, mothers earn rewards in the form of discounts on essential livelihood items from local vendors.

Those working in global health often pore over data about coverage and compliance in prenatal care, searching for innovative ways to ensure that women are giving birth in a health facility, that moms and babies are receiving adequate postnatal and early childhood interventions, or that people living with HIV or other chronic conditions are showing up for their critical medical appointments. We agonize when our efforts to train more health providers or give women and their families more information don’t necessarily translate into better health outcomes.

< p>Providing a lesson on the importance of understanding the local community, Dr. Wamalwa and his colleagues recognize that, on a given day, poor women worldwide wake up and have to make tough decisions: Do I take my baby for her vaccination appointment, or go to the market to sell our coffee beans?

His team wanted to give women an incentive to make the healthy choice. So when a family member shows up for the appointment, a “credit” is added to the barcode, which can be redeemed through discounts on small purchases offered by local vendors or accumulated to allow families to begin true household savings — so they can make more rational decisions affecting their health and their livelihood.

There have been many promising and important global health innovations that have happened in the past 50 years — like vaccination and polio eradication — and the pipeline of new, exciting ideas continues to grow. But the ones that are really influencing and working within the system tend to address human behavior and motivation, think beyond clinical health, and — most importantly — see people as people and not as denominators.

There is no question that we need better drug delivery systems and diagnostics for the poorest of the poor, those emerging from top research institutions and brilliant international scientists. Yet local innovators have insights into their own communities, as well as the right resources to drive their problem solving in immediate and concrete ways. This hyperlocal understanding — paired with, supported by, or accelerated by the large organizations and donors and financing — embodies the notion that innovation is both global and local. That has inspired Jhpiego to create a seed grant program for local innovators from within our own organization and network.

While many in global health innovation are racing through a labyrinth of complex market dynamics, chasing near-impossible thresholds of evidence and perfection, and aiming to deliver truly transformational innovation, we should also reward and support community interventions and innovators like Dr. Wamalwa and his team.

One key way to support their work is through seed grants, such as the Grand Challenges Canada program that awarded $100,000 to Dr. Wamalwa and additional support from Saving Lives at Birth, to further develop the loyalty program. Jhpiego has created a seed grant program for local innovators from within our own organization and network, but there are many ways for the international community to support community-led efforts.

Grand Challenges Canada and its partners recognized the impact a local innovator could have on his own community. If more funding groups, large organizations, and policy makers shift their models to capitalize on the enthusiasm of young, local innovators who are already working in these areas to solve problems right in front of them — through leadership opportunities as well as resources to develop and test their proposals — we might have more transformational innovations with true grassroots. As the Nigerian proverb goes, “It is from the small seed that the giant Iroko tree has its beginning.

(Top image: Courtesy of Dr. Benson Wamalwa)


Brinnon Garrett Mandel is the Director of the Innovations Program at Jhpiego, an affiliate of Johns Hopkins University, managing a portfolio of global health technology innovations and a team of bright engineers and public health clinicians, researchers, and practitioners. With a background in both public health and business, Mandel has worked in various roles at Jhpiego and in the private sector, with an interest in the intersection of global health, technology and business.





All views expressed are those of the author.

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