As a software engineer, there's a lot to think about if asked what to expect in any software or application. However, when it comes to the health sector, a worker would expect at most two features from a software:

• Ease of use: Perform tasks using less time and energy.
• Efficiency: Perform many tasks better with the use of the computerized system.

My internship project entailed working on a health management information system currently being used by Afya Research Africa (ARA) in their Ubuntu Afya clinics which are located in several counties in Kenya. The development of the system started almost ten years ago, by Dr. Moses Ndiritu, whom I have been honored to work with throughout my stay at ARA. I was part of the software development team that was working on improving and adding new functionalities to the system.

I spent my project working specifically with the StoneHMIS system, which was developed using the Zend framework. Developing a health system requires some basic knowledge on the processes carried out in clinics. Considering that I have little background knowledge in medicine, working together with a medical doctor was a big asset to me.

The fact that the design and development of StoneHMIS was started by a medical doctor has made a big difference to other health management information systems since it is customized to:

• Reduce wait times experienced by patients and make necessary information easily accessible to doctors.
• Reduce workload for all clinic staff, including doctors, nurses, pharmacists, etc.
• Support easy access of patient data/ information to the allowed staff.
• Preserve patient's privacy.
• Fit in the context of health system institutions in countries such as Kenya.

Throughout my work at ARA I wondered how many lives could be saved, or disabilities avoided if patient wait times in hospitals were reduced, and if doctors had easy access to needed information in a timely manner. These questions greatly motivated me and guided my work. Consider a scenario where the patient information wasn't conveyed accurately to the care providers.  This would be a disadvantage to the patient, and impact the quality of the healthcare received.

Apart from developing the system, I learned a lot in terms of medical procedures, as well as improving my programming skills. Software development usually involves many programming languages while working on different projects, especially when one is new to the field. However, during my study at Carnegie Mellon University in Rwanda (CMUR), I learned that the most important aspect in programming is the algorithm used and its adaptability to any language that can solve an intended problem. I managed to apply this knowledge in the development of the health system I was working on to ensure that more lives are saved.

“So basically your job is to compare apples to oranges?”
 
This was one professor’s amused (and insightful) remark when I showed her the scope of work for my internship just before I left for my summer at USAID. Within a few days on the job, I quickly realized my professor was right. Fortunately, this made for both a challenging and exceptionally valuable learning experience.
 
I was lucky enough to have the opportunity last summer to intern with the Global Partnerships Team within USAID’s Global Development Lab. One of the Partnership Team’s main focus areas is entrepreneurship, including finding ways to bridge what is known as the ‘pioneer gap.’ The pioneer gap in this context describes the disconnect that persists between investors and early-stage entrepreneurs in the developing world. Entrepreneurs have great ideas for businesses that will create jobs and provide much-needed goods and services. Investors want to invest capital in great ideas, often to generate a financial return and/or create a social impact.
 
One way that USAID is working to bridge the pioneer gap is through the Partnering to Accelerate Entrepreneurship (PACE) Initiative, which includes around a dozen public-private partnerships across Asia, Africa, and Latin America. Each PACE partnership model is unique, but all share the goal of helping early-stage entrepreneurs refine their business models to attract more private investment.
 
While more time and data are needed to fully analyze all the individual PACE models, one summer was enough to convince me that PACE-like partnerships have significant potential to bridge the pioneer gap. Two of my most significant learnings were the following (the first involves a common misperception corrected and the second involves a firmly held personal belief further confirmed):
 

• Foreign aid can be smart, targeted, and data-driven. People may imagine foreign aid as the government simply giving money away. While this can be true, it is not the full story. PACE provides an excellent example of how government can target its resources to promote sustainable, bottom-up solutions. By empowering other committed stakeholders and encouraging them to develop financially self-sustaining models, PACE creates a multiplier effect – increasing the impact of each dollar and ensuring this impact continues long after USAID’s grant funding is spent.

 

• What matters is the people. I learned this in my previous jobs in the private and nonprofit sectors, but I realized it is equally or more important in the public sector. The job of managing PACE partnerships cannot be filled by just anyone. The core PACE team members, Rob Schneider and Matt Guttentag, have an exceptional skillset. They could speak the language and understand the motivations of every stakeholder in a partnership. They adapted their style seamlessly to facilitate collaboration between groups from every imaginable sector and geography. They approached grantee relationships as true thought partnerships. Rob and Matt embody the concept of tri-sector leadership, and anything less than this caliber would undervalue the potential impact of these partnerships.

 
Overall, my internship left me feeling inspired, hopeful, and filled with a renewed sense of urgency. But it also confirmed a hard truth - there is not going to be a single breakthrough moment or concept that will suddenly empower entrepreneurs to eliminate poverty overnight. A robust ecosystem is needed to nurture and sustain entrepreneurship. Building ecosystems takes time. And of course, entrepreneurship is only one piece of the puzzle. But the absence of entrepreneurship is both a cause and consequence of poverty, which makes it a profoundly powerful piece of the puzzle.
 
I am excited to see how the PACE partnerships unfold and help solve this puzzle, as well as how they improve countless people’s lives along the way. 

​SEAD and Innovations in Healthcare convenes dozens of dynamic meetings each year with diverse stakeholders around the world. And while these workshops, conferences and meetings are exciting when they are happening, what we are really proud of is what happens after everyone goes home.  Last year’s SEAD Health Hackathon is no exception.
 
Our Health Hackathon, which took place one year ago -- September 18-19, 2015 -- at Strathmore University in Nairobi, was one of the most ambitious gatherings we have ever attempted outside of our SEAD Summits and Annual Forums.  The vision was this: bring together talented people from a variety of backgrounds and disciplines in East Africa and ask them to work in teams to design solutions for some of the most pressing health challenges in the region.  Specifically, we were looking for solutions in three main areas:

• Increasing Access to Healthcare
• Managing Non-Communicable Diseases
• Improving Maternal and Child Health.  

We selected 102 participants in late August 2015 from a pool of 280 applicants.  Participants – from fields as varied as health, technology and entrepreneurship – formed 20 teams.  At a pre-event on September 15th, participants gained a deeper understanding of our three focus areas through presentations made by representatives from corporate sponsor organizations. These insights allowed them to innovate based on real world market and customer challenges. Corporate sponsors included: BD, Merck, AHTI, and Philips, and Google Developers Launchpad.
 
During the hackathon event, the 20 teams worked together and with mentors to refine their ideas, develop a business case and write code for their various applications. Following several rounds of practicing their pitches, teams presented their innovative ideas on the last day of the Hackathon to a panel of five judges.  Cash prizes were awarded to four teams which were also eligible to receive structured mentorship support from October through February. The mentorship support was provided in collaboration with iBiz Africa that is based out of Strathmore University.

This post originally appeared on the SOCAP blog. You can read the original post here. We are happy to announce the CASE Smart Impact Capital™ site has officially launched this week! You can view the website here.

The Challenges of Raising “Smart” Capital  
Social entrepreneurs are busy people with many competing claims on their time. Raising capital can demand an overwhelming amount of this time, and yet many entrepreneurs end up with capital that is not a great fit for their business’s growth and/or impact.

We at the Center for the Advancement of Social Entrepreneurship (CASE) have heard from hundreds of social entrepreneurs that they crave the opportunity to learn how to be more targeted and successful in raising capital and scaling their impact. The challenges of identifying the right investors, communicating the right balance of information, and analyzing investment offers are ones that all social entrepreneurs need to address to raise capital that is “smart” for their ventures.

Traditional accelerator programs for social ventures strive to address many of these challenges, but are often constrained themselves. Accelerators are typically short-term and have a more general focus, but entrepreneurs’ needs and opportunities are constantly changing. We hear from accelerators that their ability to respond to just-in-time entrepreneur needs, and to provide the right expertise at the right time, is often limited.

To address these challenges, and to complement the important work of accelerator programs, CASE began development of CASE Smart Impact Capital™, a series of online training modules that take the lessons learned from 15 years of work with investors and social entrepreneurs around the world to address the needs and pitfalls social ventures face when seeking investment capital. The modules are designed to be entrepreneur-friendly – straightforward, flexible, and with frameworks and tools that lead to actionable decision making.

Smart Impact Capital™ modules
The modules are designed to allow users to access exactly the information they need in the moment, rather than following a linear curriculum. Not sure whether equity or debt is right for your company? The Calculating Your Funding Gap module walks you through the process of building your cash model and calculating your funding gap, and the Scenario Planning module lets you see the effects of different types of capital on your bottom line. How do you balance business growth and impact evidence when speaking to investors? OurArticulating Strategy to Investors and Motivations of Capital Providers modules give you tools to speak about both dimensions and insight into the right balance you should strike for different audiences.

In total, nine modules walk entrepreneurs through the core tactics needed to be successful when raising “smart” capital. Over the past few months we have invited a number of social entrepreneurs, impact investors, and other intermediaries to beta test the first two modules; the overwhelmingly positive response we received validates the need for these tools.
“I usually am a bit jittery about getting involved in online or remote kinds of training because of the lack of interpersonal communication. This was amazing. I could do it at my own pace,” said Sam Gwer, cofounder of Kenyan social venture Afya Research, of his recent experience beta testing the modules with his management team.

“You could think about growth and your financials from the unit perspective and from the whole organizational perspective,” explains Sam. “I keep on getting feedback that some of our unit managers who are still using [the financials spreadsheet]. And they say that this thing works so well because they can just change a figure here and see what that impacts on the whole growth experience.”
We invite you to visit www.CASEsmartimpact.com to explore elements of the modules and see how they could benefit your accelerator program or social venture.

For the second year in a row, our East Africa team is helping organizations in our network to scale up through targeted support from expert consultants.


Thanks to funding from USAID East Africa, we invited select East African innovators in the SEAD Program to submit proposals outlining strategic projects that would benefit from outside expertise. Innovators applied for funds to hire consulting firms to assist them with high impact capacity building projects. SEAD team members reviewed the proposals and selected five projects for funding. Five firms – Think Place, Vera Solutions, Intellecap Advisors, Open Capital Advisors, and BTL Consulting – were matched with innovators. Some $81K in SEAD funds will be provided directly to the firms to complete the project activities with innovators.


The Innovators selected included: Safe Water and AIDS Project (SWAP), LifeNet International, MicroClinic Technologies, Afya Research Africa, and ZanaAfrica.


The types of projects funds will go toward include:

• Developing a business and funding plan to include setting growth goals, identifying overall funding needs, type of funding and key funder mapping.
• Developing a sales and marketing process that addresses customer preferences.
• Identifying and implementing the right platforms for data collection

These funds are just one example of how innovators in the SEAD and Innovations in Healthcare networks are matched with the resources they need. Innovations in Healthcare is currently accepting nominations for new innovators through September 16th Through a competitive selection process, innovators are chosen to join our network based on the strength of their innovation, their readiness to scale, and the financial sustainability of their approach. Once selected into the network, innovators receive a variety of support including great showcasing opportunities, access to our student internship program, peer learning opportunities and more.


If you are interested in nominating your organization or an organization you think would be a great fit for the Innovations in Healthcare network, please click here.

Nearly every few days this summer some horrific event rocked a community, country, and the world. Orlando, Bangladesh, Nice, Germany… the list goes on. Headlines refer to this summer as the “Summer of Hate” or the “Summer of Terror.”  As a result of all these events, many were left reeling in the aftermath, afraid to travel and perhaps feeling declining faith in humanity. My summer travels took me to India and Bangladesh, staying in a hotel just minutes away from the location of the café attack in Dhaka. Luckily, I had returned to the US days before. Despite all the violence and uncertainty, my summer offered me something very different -- a glimmer of hope.

This summer, I was the Innovation Scale-Up Intern for the Center for Accelerating Innovation and Impact, a cross-cutting team at USAID in the Global Health Bureau. The Center utilizes business-minded approaches to develop, introduce, and scale health innovations. One of the major objectives of the center is to help interventions accelerate impact through market access and scaling efforts.

This summer, I led a market assessment in India and Bangladesh for a medical device called bubble CPAP (bCPAP), which is a type of CPAP (continuous positive airway pressure) machine. Over 15 million babies are born prematurely each year and one of the most common complications is Respiratory Distress Syndrome (RDS)1. RDS is often fatal if not treated and the preferred treatment for RDS is CPAP therapy, as this device helps the baby to breathe by keeping the lungs open and preventing the lungs from collapsing. Nearly every hospital in the developed world has these devices but they are strikingly absent from facilities in developing countries. The bCPAP device is one of the preferred options for low resource settings as it is more cost effective but just as clinically effective as other CPAP devices.

​Courtney Cobb is a second-year MBA candidate at the Fuqua School of Business concentrating in Social Entrepreneurship and serving as Co-President of the Association of Women in Business. She also participated in FCCP working on a consulting project for North Star Alliance in Kenya. Prior to Fuqua, Courtney was awarded a Fulbright Scholarship to earn a Masters of Economic Science in European Public Affairs and Law from the University College Dublin in Dublin, Ireland. She also spent over three years with Deloitte Consulting in the Strategy and Operations practice focusing on the healthcare provider space. 

International entrepreneurial hubs like Kenya have become attractive targets for impact investors looking for financially viable and impact-generating investment opportunities. The Global Impact Investing Network (GIIN)’s “The Landscape for Impact Investing in East Africa” reports that at least $240MM USD has been deployed as impact investments in Kenya specifically, with more than half of an additional $2.5B USD committed to East Africa likely headed there as well (“The Landscape for Impact Investing in East Africa,” 6). With a focus on global health, the USAID-supported Social Entrepreneurship Accelerator at Duke (SEAD) convenes interdisciplinary partners to identify, develop, and scale the innovative impact solutions vying for this capital. As the partnership’s capital connection provider, Investors’ Circle organized Investor Days: Nairobi 2016 to bring six US-based investors to Kenya – four in Africa for the first time – to explore and assess early-stage global health and broader impact investment opportunities there.


In addition to site visits with local social enterprises, Investor Days: Nairobi 2016 attendees engaged with local investors representing a new and growing class of asset holders in Kenya. The fifth-largest economy in Sub-Saharan Africa, Kenya is expected to watch its millionaire (USD) demographic increase 74% in the next decade, at more than double the global rate (Ombok). As more Kenyans build wealth, some are moving from community-focused pooled giving and informal investment groups into early-stage venture investment strategies.


Despite a shared vision of early-stage investments that fuel social change and economic development in Kenya, it became apparent that US and local investors have different perspectives on impact interests and return expectations. What does this mean for catalyzing early-stage capital into Kenya? Is there an opportunity to collaborate or are these two groups fundamentally misaligned?
​

A closer look into US impact investor and local angel investor perspectives reveals that differing skills and needs could create a complimentary approach to early-stage investing in Kenya if intentionally engaged. At the end of this paper, we suggest actions that investors can take to understand potential cross-cultural investment collaborators, build investment skills and co-investment relationships, and move capital into promising Kenyan impact enterprises.

On July 7th, Duke University through the Social Entrepreneurship Accelerator at Duke (SEAD) program, held a “Doblin’s 10 Types of Innovation” workshop at Makerere University in Kampala.

The SEAD program works with nonprofit and for profit global health solutions addressing cost, quality and access issues for low and medium income populations in East Africa and India as part of the Higher Education Solutions Network.

The 4-hour workshop was co-hosted by Makerere’s College of Engineering Design Art and Technology (CEDAT), the Innovation Village and SEAD. The event drew 112 participants including undergraduate students from at least six of the ten major colleges at the oldest learning institution in Eastern and Central Africa as well as students from the neighboring International Health Sciences University Kampala.

The Chief Guest, CEDAT Deputy Principal Dr. Venny Nalubwama in her opening remarks, commended Duke University and the Innovation Village for “providing a learning avenue to the students.” She reiterated that Uganda was one of the most enterprising countries in the world, according to the World Bank, but new enterprises collapse within the first three months of existence. 

Facilitation and moderation of the workshop was done by three Duke University masters’ students Emmy Komada (Business Administration) James Ruggiero (Business Administration) and Caesar Lubangakene (Global Health). The students worked with the SEAD/Innovations in Healthcare team to develop, research and organize the content to facilitate the students at the workshop.

The graduate students presented the 10 Types of Innovation Framework and used their own summer internship attachment organization as models. All three graduate students are placed with East African based health innovators that are part of the SEAD program cohort and the Innovations in Healthcare network. The USAID-funded initiative aims at collaborating academic rigor and inter-disciplinary approaches to development for maximum impact. The organizations where the students are placed are: Kenya’s Jacaranda Health (Emmy), Afya Research Africa (James) and LifeNet Uganda (Caesar).

All through the workshop, the facilitators maintained an interactive session designed to encourage active engagement among the participants. There were many exciting discussions and debates around various innovation topics and ideas. The most outstanding was a long debate between divided participants whether “Rwenzori Water”- Uganda’s leading water bottling company was innovative after learning about Doblin’s 10 Types of Innovation.

The most exciting component of the event according to most participants we spoke to, was the team break-out session where groups of students selected a brand from either a shared list of local East African and global brands, picked an unlisted brand of their choice or crafted a new innovative company of their choice. The students broke out into 12 groups of student teams. The twelve brands that the student teams chose to analyze were:

• Nemo Rolex (catering services)
• Coca Cola (beverage) 
• Fresh Dairy Milk (dairy products)
• Harris International (beverage)
• Air BnB (hotel and travel)
• EcoFuel (biomass fuel)
• Total (petroleum company)
• Save for the Future (credit and savings)
• Tesla Motors (renewable energy and technology)
• Online Construction Tendering Company (construction)
• Lipa Mobile (electronic money transfer)

The student teams then applied “Doblin’s 10 Types of Innovation” to cooperatively analyze and understand the types of innovation in the selected companies within assigned teams. After which, all the groups presented their key ideas in relation to the framework to the audience in three minutes and answered questions from the audience about their chosen innovative brands. The top three brands deemed to be most innovative were then selected by the participants through a popular vote to win prizes.

The winners by the popular vote from the audience were Nemo Rolex (catering services), Coca Cola  (beverage), Air BnB (hotel and travel). The three teams each received a brand new copy of Larry Kealy’s Ten Types of Innovation: The Discipline of Building Breakthroughs book. While handing the three prizes to the winning teams, SEAD East Africa’s Regional Director, Dr. Patricia Odero implored the students to use the materials to learn more about innovation and apply them while assessing innovations in companies around the world.

In his closing observations, the University Guild President thanked the students for attending the workshop and acknowledged the organizers for availing the opportunity for the students to learn something new about innovation. He added that innovation and entrepreneurship are the most vital aspects in improving prospects of self-reliance and employment in the job market today for the young people. He also requested for more workshops of such nature for students in future through university partnerships.

This week, Investor Days: Nairobi attendees share their perspectives on what is important when reviewing global health investment opportunities. We were surprised to find that their priorities actually were not surprising – their focus on finding the right companies and the right entrepreneurs to solve huge global health challenges in East Africa echo the conversations the IC network has when reviewing companies across sectors and across geographies in the US. However, trip attendees were able to identify innovative business and investment models that they think make the right companies for these challenges and characteristics to look for to find the right entrepreneurs to build successful businesses and good investments.


Innovative global health models…
​

… Often combine healthcare delivery and technology. Healthcare delivery is complex, and our trip attendees found that technology-based business models can be effective tools for simplifying systems, streamlining delivery, and scaling health interventions. Michelle Schwartz was impressed by TotoHealth, which uses text messages to deliver critical healthcare information to new and soon-to-be parents across Kenya.

explains Schwartz. Look for technology that makes it easier, faster, or safer to provide and access healthcare.
​

… Might not look like health at first glance. Jim Davidson, IC Board chair, reminds us to look beyond the health sector to find industries and companies that have a significant impact on the health of global communities.

Davidson shares. Jibu, which uses a franchise model to make clean drinking water affordable in East African slums, excites Jim in terms of impact and investing. He adds, “They’re operating well and hitting their targets, so at scale they could positively affect health across Africa and that would make a great investment.” Look into water, agriculture, and energy as additional sectors where impact investing can improve health around the world.


… Innovate on investment models as well. Healthcare delivery via health clinics was a core focus for Investor Days: Nairobi, and we found many exciting examples of clinics that bring quality healthcare to Kenyan communities. However, concerns emerged about the exit potential for clinic models: What is scale? How big do clinic networks need to grow? Are there prospective acquirers? A visit with Jacaranda Health, a network of maternal and child hospitals in peri-urban areas, inspired Stephanie Wilson to bring her US medical real estate background into her global health impact investing strategy. “Good investments are not all about equity. Jacaranda has a strong model, superior care, and the potential to grow. Obtaining and outfitting their facilities is a huge challenge, so structuring this investment around real estate could help them where they need it most and create an interesting risk/return profile for an investor as well,” says Wilson. Look beyond traditional notions of equity and debt to real estate and revenue-based financing as appropriate capital solutions for compelling global health enterprises.


Compelling global health entrepreneurs…


… Are internationally savvy. Global health entrepreneurship is a tall order: companies need to understand healthcare delivery, how to grow a sustainable business, and the emerging markets in which they operate. Our trip attendees discovered that Kenya has a growing population that has developed medical and business skills around the world and returned home to build global healthcare companies in the communities they know best. Stephanie Wilson was impressed by Jacaranda Health as a business and by its Chief Medical Officer Faith Muigai, highlighting that “she’s a Kenyan-born, US-trained doctor and business woman who is bringing 20+ years working in the US health system back to Kenya and building a management team that balances the business side of Jacaranda’s hospital system.” Look for entrepreneurs and management teams that understand both their models and their markets.
​

… Have relationship potential.

explains Luni Libes, maintaining that “trips like ours to Nairobi are much more impactful to investors than virtual meetings and standard pitch events.” Libes has the benefit of spending hundreds of hours with social enterprises through his Fledge accelerator program, including a relationship that came to life when we visited cohort company, GreenChar. GreenChar produces and sells clean charcoal briquettes, and Investor Days: Nairobi gave attendees a chance to observe Founder Tom Osborn engage with his team, customers, investors, and stakeholders. International investments are challenging because interaction is rarely face-to-face, so take advantage of limited time on the ground to get a feel for entrepreneurs as people. Look for those with the potential to build trusting relationships that can grow over time and distance.
​

IC members have found and invested in global health companies in East Africa and are calling for more impact investors to get involved. Bill Harrington shares,

Forus Health, a Bangalore-based SEAD innovator since 2014, develops and sells affordable technology to diagnose eye diseases that can be easily used by minimally trained technicians, making eye care in lower- income settings more accessible. Since 2013, Forus has installed its devices in over 1,100 locations in 25 countries. This year, Forus has set its sights on entering the U.S. market.

Forus’ flagship product, the 3nethra classic imaging device, is an affordable, robust, and portable eye-screening device that allows a health worker to screen a patient in less than 5 minutes for five major eye conditions. To date, over 2 million patients have been screened by the device, which received 510K-exempt clearance from the U.S. Federal Drug Administration (FDA) earlier this year, paving the way for Forus to market the device in the U.S. FDA clearance is important from a manufacturing and quality standpoint globally because it signifies that Forus adheres to the highest international medical device manufacturing standards. The ability to enter the US market is also important from a sales and strategic partnerships perspective.

According to Connor Larkin, who leads U.S. business development for Forus, a large underserved patient base in the U.S. still lacks affordable ophthalmic screening. For example, diabetes-induced blindness (diabetic retinopathy) afflicts over 30% of the 25 million people with diabetes in the U.S. and currently is the leading cause of working age blindness between the ages of 20 and 65. An estimated 50% or more people with diabetes in the U.S. do not receive a medically-required annual retinal screening exam due to lack of accessibility and cost. “In India, we already have around 400 devices linked to a telemedicine-enabled diabetic retinopathy screening network, and plan to replicate a similar system in the U.S. with the goal of ending this type of blindness,” Larkin said.

Since launching in the U.S. in February, Forus has already sold and installed  more than 10 devices across multiple states and Puerto Rico. “We plan to pursue multiple market segments, including optometry, opticians, general ophthalmologists, retinal specialists, and teaching hospital institutions – all of which are represented in our current client base – as well as screening at the general physician/primary care level. The goal is to eventually make this type of screening accessible at all income brackets,” Larkin said.
​
Forus is planning to launch another device, 3nethra Neo, in early 2017. This lightweight device enables clinicians to capture high quality images of neonatal infants’ eyes, and is 1/3 the cost of previous options on the market. Forus Health hopes to be able to launch several more devices in the US by 2018, and to screen  20 million patients within the next three years.