Innovate4Health Design Elements

Let’s begin with this application process to vision how your proposed innovation might spur transformative change. We provide below useful guidance on how to address each of the four criteria that will be assessed in each team’s application: 1) theory of change, 2) target population, 3) innovation, and 4) potential for scale-up or replication. Teams need not address every point that has been suggested, but we hope these will provide a useful start in considering how they shape their innovations. These design elements correspond very closely to the elements of the proposal application which can be found below and here.

Theory of Change

A ‘theory of change’ can be described as a hypothesis regarding what change will come about with a certain intervention and the steps that are necessary to bring that change to life. It may be described in an “if… then…” statement. What is your hypothesis of what will happen and how? A theory of change makes explicit the intermediate steps, outputs, and outcomes that will ultimately lead to achieving the change one seeks to make.

For example, in addressing the lack of access to antiretroviral therapies to treat HIV/AIDS in low- and middle-income countries (LMICs), the theory of change that civil society considered was: If antiretroviral therapy prices can be lowered from $10-15,000 per year to $350 per patient per year, international development agencies would be more willing to fund the treatment of HIV/AIDS in low- and middle-income countries, which would lead to more affordable and universal access, which, in turn, would reduce deaths and other illnesses related to HIV/AIDS in these settings. In fact, this occurred with the entry of Cipla, an Indian generic firm, onto the world market with a generic, triple-therapy HIV/AIDS combination at $350 per patient per year, or less than a dollar a day. This made possible the creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which likely would not have been conceivable at $10,000-$15,000 per patient per year for the 25 million afflicted with HIV/AIDS in LMICs at the time.

Some tips on developing your theory of change:

  • Consider how your proposed intervention causes change. How does it help us get from Point A to Point B? What assumptions must hold for this to work? If your team were to backward map this from the outcomes, what would be the intermediate outputs from your intervention to what success looks like?

  • Make it understandable to a wide audience. The reviewers may not be familiar with your field, innovation, or the problem that you seek to address. Provide enough context for someone to quickly understand why your problem is a noteworthy one, and why your innovation might be particularly effective in the situation and the context that you are laying out.

More information on theory of change can be found here.

Target Population

Your innovation should target a specific population in a way that demonstrates an understanding of and addresses this unique population’s needs. Innovations should ideally target those in low-resource settings, however, teams may also apply with innovations which target marginalized and/or disadvantaged populations within higher-resource settings. When detailing your target population, you might consider:

  • The characteristics that might contribute to your target population’s unique needs. This might relate to the source of health inequity, challenges that come from social disadvantage or stigma, or the geographical locale or level of education of those in the target community.

  • How your innovation might particularly benefit this population. How is your innovation specifically targeted at this population in a way that works within these constraints? Does it advance health equity by narrowing the distance between those who might benefit, perhaps disproportionately lifting up the least advantaged the most?

  • How your innovation may have a disparate impact on your target population compared to other populations. Disparate impact refers to a situation where the same illness, intervention or or regulation applies equally to all, but results in disproportionate impact on some more than others. For example, if one’s intervention relies on access to smart phones, then it may have a disparate impact: those who cannot afford smart phones or who do not have even access to a phone may not benefit from the intervention. How does your innovation work your target population to maximize the desired impact?

Innovation

The Innovate4Health cohort will be made up of teams which have thought of novel ways to approach issues related to emerging infectious diseases while understanding the constraints that their target populations face. Innovation can take multiple forms, including, but not limited to:

  • Reimagining how existing systems and stakeholders might meet unmet needs. For example, COVID-19 changed how many sourced their food, made their doctors’ appointments, or connected with their fellow workers. Can the value chain—from source to delivery of a product—be reengineered to bypass bottlenecks in the system?

  • Increasing access to care. For example, clinical algorithms can help healthcare workers triage patients who need more expensive diagnostic work-ups, empiric treatment with an antibiotic, or referral to better equipped facilities.

  • Creation of new systems and partnerships to meet unmet needs. For example, striking new partnerships to create services that go to rural patients in contrast to the services coming to the city, or digital telehealth applications to connect specialists with patients in countries with limited local expertise.

  • Creative approaches to behavior change. For example, a team might place a tool into the hands of a community to monitor and hold governments or industry accountable; enlist the community in a participatory research project that empowers those in need to co-produce the solution; or make transparent an injustice that triggers follow-on advocacy.

Potential for scale-up or replication

To maximize impact, teams might consider how their innovations could be scaled up or replicated by others in different contexts. Depending on the scope of your innovation, you might consider whether you would begin with a pilot study, to establish proof-of-concept, before advancing your innovation to reach more people.

You might also consider:

  • Could your innovation have broader applicability beyond your target population? Could an innovation that is targeting healthcare workers within a city be adaptable to other cities similarly situated in the country? What about cities in other countries? Rural settings?

  • Who could help to achieve this scale-up or replication? Could your intervention be picked up by the local IFMSA chapter? Once piloted, be picked up by a healthcare delivery system, a group of healthcare workers like midwives, or a vertical program treating a disease like TB or HIV/AIDS?

  • How easily can this scale-up/replication occur? Would this be an innovation that others could easily reproduce, or is your innovation limited to unique circumstances such as a specific target population or available partnerships and resources? How might the intervention be propagated? Via mHealth app, train-the-trainers program, or piggyback as part of an existing service?

We hope these questions will help enrich your start to the Ideation phase of developing a transformative innovation and a promising proposal for Innovate4Health. We look forward to hearing what your team develops!