 Earlier this week, the Financial Times published an interesting op-ed by an Acumen Fund intern on the state of healthcare in Africa. One prominent theme was the paucity of useful information:
We have no market research reports and there are no systems to capture consumer data. Reading scholarly journals will only get me so far. To understand the health marketplace for poor consumers, I must see it with my own eyes, hear it with my own ears and speak to as many patients and doctors in low-income areas as I can.
The author's noble efforts to press on to establish an innovative "market-based" "social venture capital approach" to delivering medical services to the poor is undeniably inspiring, and I certainly agree with the need for informed collaborative partnerships to promote effective change.
Yet I wonder what someone with more experience with healthcare in Africa would make of the piece. The notion that there are relatively few useful resources for healthcare strategy strikes me as overstated at best. The African hospital sector in particular has been in the midst of fascinating changes in recent years, from major investment by South African and Indian firms to more local projects. Missionary and university-based healthcare initiatives have decades worth of experience, and despite what the well-meaning Acumen Funder says, there's a robust body of directly applicable or roughly analogous research that anyone developing new healthcare systems would benefit from engaging.
Which brings me to my larger point. Healthcare reform has once again become a major issue in the U.S., and here as elsewhere we tend to treat it as a realm of ancient dragons and young knights. However, the dirty secret of healthcare is that it's a field long defined by the very practices that we promote as hallmarks of social enterprise. Charitable business; hybrid for-profit/nonprofit ventures; commercial entities blending the pursuit of profit with social responsibility; massive investment in innovation; metrics, metrics and more metrics--it's entirely possible that by focusing on the day-to-day problems that ordinary people experience with the current system, we are overlooking systemic and historic weaknesses within our own vision for reform.
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