A vacuum of information: why is there still a lack of understanding?

It is a familiar problem. A well-meaning donor gives a shiny new piece of equipment to a poor country only for it to gather dust. Parts that are expensive and difficult to replace, the need for a constant electricity supply, a lack of trained operators, unsuitability to rough terrain are all factors preventing the use of these devices in the developing world.

The scale of the problem is considerable. The World Health Organisation (WHO) estimates that as much as three-quarters of all medical devices in the developing world do not function.

“Factors contributing to this are: lack of needs assessment, appropriate design, robust infrastructure, spare parts when devices break down, consumables and a lack of information for procurement and maintenance, as well as trained healthcare staff,” says the WHO.

The Guardian’s recent article highlights the lack of understanding of the local operating environment and challenges among those who select and install medical equipment in the developing world. Perhaps in this regard there are other, more political and social factors that influence the choice of product and its destination. But nonetheless the question remains, why after so many years of the design industry’s talk of  ‘design for the 90%’ and ‘frugal innovation’ from emerging markets, is there still such a vacuum of information and subsequent failures?

Here’s another snippet talking about a service rather than a product, saying more or less the same thing:

“To do this, companies have to realise that insurance policies cannot simply be a low-value replica of what they provide for the higher-income market. They need to be able to address the needs of the low-income market in a unique way. A good understanding is needed of the economic circumstances of the low-income market, the way finances are managed and their overall financial needs. Serious consideration should also be given to the best way to communicate with the targeted market. Marketing and education should go hand in hand,” Smith said.

For companies to extend their reach in the micro-insurance market, they require the development of alternative distribution channels that reach beyond the broker, agent and employment networks, the development of products that fit the profiles and needs of the low-income clients, successful navigation of increasingly complex and uncertain regulatory environments and a fundamental reinvention of the delivery of insurance.

As I increasingly see these stories and statements about the ‘need to develop appropriate solutions from scratch’, I think back to the pondering I’ve done on whether these opportunities are better suited for a startup / social enterprise or a multinational? One would have the ability to focus entirely on solving the challenges of serving this demanding customer demographic in the context of their environment but the other would have the financial wherewithal to scale rapidly and extend their reach. On the other hand, that ability implies the barriers against too much customization.

Can there be an optimum solution or middle ground between these competing factors? And is that a role that local or regional companies or those of a medium size can play? Call it a Goldilocks Solution.

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