Convergent innovation for sustainable economic growth and affordable universal health care: innovating the way we innovate

Evidence on Scaling in Health and Social Care: An Umbrella Review

Policy Points More rigorous methodologies and systematic approaches should be encouraged in the science of scaling. This will help researchers better determine the effectiveness of scaling, guide stakeholders in the scaling process, and ultimately increase the impacts of health innovations. The practice and the science of scaling need to expand worldwide to address complex health conditions such as noncommunicable and chronic diseases. Although most of the scaling experiences described in the literature are occurring in the Global South, most of the authors publishing on it are based in the Global North. As the science of scaling spreads across the world with the aim of reducing health inequities, it is also essential to address the power imbalance in how we do scaling research globally.

CONTEXT

Scaling of effective innovations in health and social care is essential to increase their impact. We aimed to synthesize the evidence base on scaling and identify current knowledge gaps.

METHODS

We conducted an umbrella review according to the Joanna Briggs Institute Reviewers' Manual. We included any type of review that 1) focused on scaling, 2) covered health or social care, and 3) presented a methods section. We searched MEDLINE (Ovid), Embase, PsycINFO (Ovid), CINAHL (EBSCO), Web of Science, The Cochrane Library, Sociological Abstracts (ProQuest), Academic Search Premier (EBSCO), and ProQuest Dissertations & Theses Global from their inception to August 6, 2020. We searched the gray literature using, e.g., Google and WHO-ExpandNet. We assessed methodological quality with AMSTAR2. Paired reviewers independently selected and extracted eligible reviews and assessed study quality. A narrative synthesis was performed.

FINDINGS

Of 24,269 records, 137 unique reviews were included. The quality of the 58 systematic reviews was critically low (n = 42). The most frequent review type was systematic review (n = 58). Most reported on scaling in low- and middle-income countries (n = 59), whereas most first authors were from high-income countries (n = 114). Most reviews concerned infectious diseases (n = 36) or maternal-child health (n = 28). They mainly focused on interventions (n = 37), barriers and facilitators (n = 29), frameworks (n = 24), scalability (n = 24), and costs (n = 14). The WHO/ExpandNet scaling definition was the definition most frequently used (n = 26). Domains most reported as influencing scaling success were building scaling infrastructure (e.g., creating new service sites) and human resources (e.g., training community health care providers).

CONCLUSIONS

The evidence base on scaling is evolving rapidly as reflected by publication trends, the range of focus areas, and diversity of scaling definitions. Our study highlights knowledge gaps around methodology and research infrastructures to facilitate equitable North-South research relationships. Common efforts are needed to ensure scaling expands the impacts of health and social innovations to broader populations.

Realizing the value of complex medical technology: Demonstrating cost-effectiveness is not enough

The main factors driving the value of medical treatments are proven effectiveness and cost-effectiveness. This is different for complex medical technologies that combine scientific disciplines, functions or tools in a single solution-oriented method. This short communication provides three recommendations to realize the value of complex medical technologies. It is important to engage stakeholders before technology implementation to promote its relevance from multiple perspectives, to explore opportunities for professional development and collaboration, and to demonstrate the societal effects over the entire life-cycle.

The effect innovation cloning to small business success: entrepreneurial perspective

It is challenging to run a business during the COVID-19 pandemic, because the owners and the small business leaders must be responsible for success. Leaders need to innovate and look for sources of innovation, including practical inventions, such as innovation cloning. In this study, innovation cloning consisting of creativity cloning and implementation cloning is analyzed for its relationship to business success, in the form of owner's interest and financial performance perspectives. This study aims to reveal the role of innovation cloning, creativity cloning, and implementation cloning in achieving business success based on the owner's interest and financial performance. The study uses an explanatory survey. The number of samples is 155 entrepreneurs/small business leaders in Bandung City, Indonesia.  Snowball  sampling is carried out to obtain the data. Data processing uses descriptive statistics and multiple regression with the help of SPSS and Amos 23 software. This study found that creativity cloning and implementation cloning affected the owner's interest, and implementation cloning affected financial performance. In contrast, creativity cloning does not affect financial performance. Creativity cloning and implementation cloning are correlated with each other. Creativity cloning and implementation cloning are proved to be one unit of cloning innovation. The leader's expertise in choosing the object to be cloned and adapting it to consumer needs will facilitate company goals. Utilizing innovation, cloning, and modifying it is a practical way for small businesses to succeed. This research needs to be continued to see if there is a continuous pattern in these findings so those findings can be generalized.

Technological Innovation and Agrifood Systems Resilience: The Potential and Perils of Three Different Strategies

The interest in technological innovation has burgeoned in recent years. Theory and research support the vital role of innovative technologies in enhancing agrifood systems resilience. In this theoretical contribution, focusing on different sets of technologies, we present three technological innovation strategies, discuss their potential for strengthening resilience, and expose some open issues that need to be addressed. Responsible technological innovation arose as a response to the growing concerns about the possible unintended impacts of mega-technological trends, like digital farming tools or nanotechnologies, on agrifood systems. Although responsibly innovating is far from easy, and despite the gaps between theoretical ideals and innovation praxis, responsible technological innovation is a promising development since it can prevent counterintuitive effects of technologies on resilience. On the other hand, poly-innovation emerged as a social practice in which internetworking technologies facilitate—and create bundles with—organizational, social, and business innovation. In that strategy, technology represents a mediator of resilience-enhancing social behavior. However, by promoting the uberization of agrifood systems, poly-innovation is associated with various uncertainties. Finally, micro-innovation refers to the incremental adaptations of existing technologies or the development of new ones through bricolage and tinkering. The commercialization of such innovations through open design can increase the resilience of small-scale farming, especially in low-income countries. Nonetheless, the lack of financial resources, technical assistance, and institutional support hamper the full exploitation of micro-innovation.

The application of social innovation in healthcare: a scoping review

BACKGROUND

Social innovation has been applied increasingly to achieve social goals, including improved healthcare delivery, despite a lack of conceptual clarity and consensus on its definition. Beyond its tangible artefacts to address societal and structural needs, social innovation can best be understood as innovation in social relations, in power dynamics and in governance transformations, and may include institutional and systems transformations.

METHODS

A scoping review was conducted of empirical studies published in the past 10 years, to identify how social innovation in healthcare has been applied, the enablers and barriers affecting its operation, and gaps in the current literature. A number of disciplinary databases were searched between April and June 2020, including Academic Source Complete, CIHAHL, Business Source Complete Psych INFO, PubMed and Global Health. A 10-year publication time frame was selected and articles limited to English text. Studies for final inclusion was based on a pre-defined criteria.

RESULTS

Of the 27 studies included in this review, the majority adopted a case research methodology. Half of these were from authors outside the health sector working in high-income countries (HIC). Social innovation was seen to provide creative solutions to address barriers associated with access and cost of care in both low- and middle-income countries and HIC settings in a variety of disease focus areas. Compared to studies in other disciplines, health researchers applied social innovation mainly from an instrumental and technocratic standpoint to foster greater patient and beneficiary participation in health programmes. No empirical evidence was presented on whether this process leads to empowerment, and social innovation was not presented as transformative. The studies provided practical insights on how implementing social innovation in health systems and practice can be enhanced.

CONCLUSIONS

Based on theoretical literature, social innovation has the potential to mobilise institutional and systems change, yet research in health has not yet fully explored this dimension. Thus far, social innovation has been applied to extend population and financial coverage, principles inherent in universal health coverage and central to SDG 3.8. However, limitations exist in conceptualising social innovation and applying its theoretical and multidisciplinary underpinnings in health research.

A Biological Adaptability Approach to Innovation for Small and Medium Enterprises (SMEs): Strategic Insights from and for Health-Promoting Agri-Food Innovation

Adaptability has emerged in management/entrepreneurship literature as a business strategy to innovate, perform, and respond in a flexible manner to ever-changing contexts. Contemporary culture blurs boundaries between physical, biological, and digital domains, accelerating what entrepreneurship in sectors such as agri-food contributes to societal-scale solutions to problems at the convergence of social and commercial activities. In this study, we build upon the adaptability of biological systems to propose an approach to innovation, anchored in a tight, dynamic alignment between the strategic DNA of small and medium enterprises (SMEs) and the contexts in which they evolve. Our model employs interviews and supporting archival research on the health-promoting innovation practices of 37 SMEs in the agri-food sector. A two-year, single firm analysis illustrates its relevance and operational feasibility. Evidence suggests that the strategic DNA of SMEs, seen through the entrepreneurs’ identity, informs behavior at various stages of the innovation process and the enterprise’s evolution. Shifting identity prioritization is a reality, and interaction between entrepreneurial organizations and the environment is best understood as an interaction between the DNA of the entrepreneur/enterprise and the environment. This is valuable and will help agri-food and other SMEs to improve their ability to make the internal and external strategic adjustments required in a rapidly changing landscapes to create viable health-promoting food products.

Mind the Gap: The Potential Transformative Capacity of Social Innovation

This paper aims to contribute to the understanding of the potential of Social Innovation (SI) for social transformation. Being a popular concept, SI has been discussed for decades, increasingly recognized for its complexity. A systematic review of the literature on SI was undertaken to understand the state-of-the-art, the evolution of the concept and its core underpinnings in order to meet the research aim of this paper. The literature is relatively broad in relation to general characteristics of SI and contexts where it is happening, but the use of the ‘social innovation’ term often reveals semantic problems, generating multiple, interchangeable and mixed understandings. In this paper, we identify and discuss two ways of using SI in the literature: (i) one that favours the materialization of SI, as something tangible that can be observed, measured and systematically analysed; we called this a cartesian approach; and (ii) another that uses systemic thinking focussing on successful factors of SI to enhance its transformative capacity in existing system(s) through change in routines, resources, and beliefs; we called this a disruptive approach. While still emerging in SI literature the academic discussion about SI dynamics and its transformative capacity is increasingly addressed by scholars. We conclude the paper by arguing that more transformative-driven and systemic SI may enhance its potential to lead change, while it only creates transformation when it scales-up or out, and when it has durability and transformative impact.

Agriculture, health, and wealth convergence: bridging traditional food systems and modern agribusiness solutions

The causes of many vexing challenges facing 21st-century society are at the nexus of systems involved in agriculture, health and wealth production, consumption, and distribution. Using food as a test bed, and on the basis of emerging roadmaps that set achievable objectives over a 1- to 3-year horizon, we introduce this special feature with convergence thinking and practice at its core. Specifically, we discuss academic papers structured around four themes: (1) evidence for a need for convergence and underlying mechanisms at the individual and societal levels; (2) strategy for mainstreaming convergence as a driver of business engagement and innovation; (3) convergence in policy and governance; (4) convergence in metrics and methods. Academic papers under each theme are accompanied by a roadmap paper reporting on the current status of concrete transformative convergence-building projects associated with that theme. We believe that the insights provided by these papers have the potential to enable all actors throughout society to singly and collectively work to build supply and demand for nutritious food, in both traditional and modern food systems, while placing the burdens of malnutrition and ill health on their core strategic agendas.

A nutrition/health mindset on commercial Big Data and drivers of food demand in modern and traditional systems

Building greater reciprocity between traditional and modern food systems and better convergence of human and economic development outcomes may enable the production and consumption of accessible, affordable, and appealing nutritious food for all. Information being key to such transformations, this roadmap paper offers a strategy that capitalizes on Big Data and advanced analytics, setting the foundation for an integrative intersectoral knowledge platform to better inform and monitor behavioral change and ecosystem transformation. Building upon the four P's of marketing (product, price, promotion, placement), we examine digital commercial marketing data through the lenses of the four A's of food security (availability, accessibility, affordability, appeal) using advanced consumer choice analytics for archetypal traditional (fresh fruits and vegetables) and modern (soft drinks) product categories. We demonstrate that business practices typically associated with the latter also have an important, if not more important, impact on purchases of the former category. Implications and limitations of the approach are discussed.

Convergent innovation for affordable nutrition, health, and health care: the global pulse roadmap

The paper outlines how the principles of convergent innovation (CI) can be applied to bring about a transformation in the pulse value chain. The paper presents three pioneering CI initiatives--two in conception and one in operation--by various actors in the pulse ecosystem, which are delivering economic and human development impact in particular segments of the pulse value chain. It goes on to propose the way forward to scale up these efforts and connect them into a roadmap so as to achieve transformation throughout society, calling into action a number of actors in the ecosystem.

From policy coherence to 21st century convergence: a whole-of-society paradigm of human and economic development

The 20th century saw accelerated human and economic development, with increased convergence in income, wealth, and living standards around the world. For a large part, owing to the well-entrenched Western-centric linear and siloed industrialization pattern, this positive transformation has also been associated with complex societal challenges at the nexus of agricultural, industrial, and health sectors. Efforts at cross-sectoral policy coherence have been deployed with limited success. To go beyond what has been possible thus far, the whole-of-society (WoS) paradigm for human and economic development proposes a 21st century convergence where, instead of the rest (of the world) converging with the West, sectoral and cross-sectoral efforts converge in their single and collective policy and action on a common target of human and economic development. In this paper, we first review and discuss contributions and limitations of policy coherence approaches. We then elaborate the institutional foundation of the WoS paradigm, taking as an anchor the well-established model of polycentric governance that views individuals, and state, market, and community, forming society as part of the same complex adaptive system. Actors within such systems self-organize into nested hierarchies that operate at multiple scales and move toward 21st century convergence of human and economic development.