National Health Innovation Guide

Launching and High-Level Advocacy

Program

25 April 2024
Elily Hotel, Addis Ababa
 The guide has the following contents

1. Introduction and Background 4. Health Care Innovation Processes and Framework (6 steps)
1.1. Background 5. Implementation arrangement
1.2. Introduction to Health Innovation Landscape in Ethiopia
5.1. Innovation Governance
2. Definitions and Types of Health Innovations
5.2. Innovation Planning and Management
2.1. Definition of Health Innovation in the Ethiopian Context
5.3. Financing Health Innovation
2.2. Types of Health Innovation

3. Goal and Objectives of the Guide 5.4. Stakeholder Engagement

3.1. Rationale 5.5. Program Communication

3.2. Scope of the Guide
5.6. Monitoring and Evaluation
3.3. Goal
5.7. Knowledge Management
3.4. Objectives
5.8. Roles and Responsibilities of Stakeholders
3.5. Guiding principles
6.Instutionalizatioon

7.Anexes
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Development Processes
The guide has undergone the following Development Processes

The guide developed within the framework of :

WHO regional strategy for scaling up health innovations in the who African region, 2019.
 National Science, Technology and Innovation (STI) Policy

The HSTP II and HSDIP

National strategic documents

Desk review of national and global exigencies

Development Processes……
The development processes have also undergone :
 Consecutive Consultative meetings with experts from MOH, Innovators and relevant partners
Under TWGs and stakeholders
 Consultative meeting with LEOs, RHB and other stakeholders
 Reviewed by global experts: WHO/R4D ,Health innovation exchange

 Consultative meeting at wing level with LEOs

 High level review at the Ministerial level
 Strategically reviewed by MOH MC
1. Introduction and Background
1. 1 Background
• WHO REGIONAL COMMITTEE FOR AFRICA developed and introduced the ‘’STRATEGY FOR SCALING

UP HEALTH INNOVATIONS IN THE WHO AFRICAN REGION’’ in 2019.

• This strategy presents an opportunity for Member States to strengthen their innovation systems to make

them responsive to the innovation needs of the African Region.

• Success in developing a functional innovation system that harnesses and scales up new and improved

innovations will be a key determinant in achieving UHC and the health-related SDGs.

• A progress report on the implementation of the regional strategy is being presented to the WHO Regional

Committee for Africa every two years since in 2023.

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•
1. 1 Background…
• By 2023 • By 2025

(a) 80% of Member States have performed needs assessments to (a) 80% of Member States have developed national patent
identify critical gaps in their health systems. systems to fully reflect the flexibilities provided in the Agreement

(b) 75% of Member States have developed policies and incentive on Trade-Related Aspects of Intellectual Property Rights

frameworks to stimulate development of high impact health (TRIPS),19 including those recognized in the Doha Declaration on

innovations. the TRIPS Agreement and Public Health.

(c) 50% of Member States have developed analytical tools to assess (b) 75% of Member States have established national regulatory

the economic and social impact of innovations to support decision- mechanisms that fast-track the review of the science and maturity

making. of innovations.

(d) 80% of Member States have established high-level coordination (c) 60% of Member States have a clear approach to engaging

mechanisms to facilitate the scaling up of innovations that meet the other key stakeholders, including the private sector, to support the

needs of the most vulnerable populations. scaling up of locally developed health innovations.
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1. 1 Background…
By 2030

(a) 80% of Member States have well-functioning country-level forums and innovation hubs to support the generation
of innovations and knowledge management.

(b) 80% of Member States have adopted educational and training approaches and other investments needed to
support the development and effective diffusion of new health innovations.

(c) 90% of Member States have established and operationalized mechanisms that foster joint learning and sharing of
best innovation practices.

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1. 1 Background…

MOH’s Innovation experience in the past 20 years are:

• Health Extension Program
• Hospital Reforms
• Auditable Pharmaceutical Transactions and Services (APTS)
• Digital Health Solutions
• SBFRs

Challenges:
• Rapidly Growing Population
• Climate Changes
• Tripple Burden
• Resource-Related Gaps
.
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 1.2. Health Innovation Landscape in Ethiopia
-Ethiopia is working towards institutionalizing health innovation and ensuring its integration
into the broader health system, focusing on long-term sustainability and impact.
-Some of the enabling environments for health innovation in Ethiopia include:
• Innovation Policy : National STI Policy, Priority in HSDIP (among the 8 SOs)
• Structures and Governance for Innovation and Research :
-(HSIQI-LEO, DH-LEO, PSR-LEO, AHRI, EPHI, Universities and Artificial Intelligence Institute and MiNT)
• Incubators and innovation Hubs: innovation hubs and labs to bolster innovation ecosystem
• Investment and funding: gov’t budgetary support and resources mobilization ,partners and donors
• Regulatory support: Existing research review boards and relevant proclamations provide regulatory
support
• Collaboration and Partnership: national health innovation and quality steering committee ,TWGs,
Innovation networking and community of practice platforms

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2. Definition & Types of Innovation
Health innovation has been defined and classified differently from various institutional perspectives but
emphasized on solutions that can improve the health of individuals and populations.

2.1. Definition
• World Health Organization (WHO):

The development and application of new concepts, products, processes, and systems that increase
efficiency, and enhance service delivery ,ultimately to improve health outcomes.

• National Institutes of Health (NIH):

The transformation of ideas and discoveries into novel products, services, and approaches that
prevent, diagnose, or treat disease and improve healthcare delivery.

• Healthcare Information and Management Systems Society (HIMSS):

The implementation of new or altered products, services, processes, and organizational structures that
create value and improve healthcare quality, safety, and efficiency. 10
2. Definition & Types of Innovation
2.1. Definition

In Ethiopian Context:

A multifaceted concept involving developing and applying new ideas, technologies, products,

processes, and systems to enhance efficiency and effectiveness in service delivery, optimize quality

and safety, ultimately to improve health outcomes and impacts

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2. Definition & Types of Innovation
2.2. Types of Health Innovation
classified into 3 various types based on their nature, mission, and scope in Ethiopia…
1. Product Innovation:

The development of new or improved products, designs, or materials that have high value in improving healthcare
and administration. It may include developing new drugs, vaccines, medical devices, or diagnostics that improve health outcomes or reduce costs.

2. Technology Innovation:

Creating new or modifying existing technology to cutting-edge digital information and communications
technologies to promote equitable, affordable, and universal access to health benefits. This may include digital health solutions,
telemedicine services, electronic health records (EHRs), and artificial intelligence (AI) in healthcare.

3. System Innovation:

Hanging health services' structure, organization, management, governance, processes, and delivery to improve
access, quality, equity, efficiency, and effectiveness. Includes : Process Innovation, Service Delivery Innovation, Organizational and
Management Innovation, Social and Behavioral Innovation, and Policy and Regulatory Innovation.

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3. Goal and Objectives of the Guide

3.1. Rationale

-The world is facing unprecedented health challenges and opportunities in the 21st century.

-The COVID-19 pandemic has exposed the fragility and inequity of many health systems
and the need for timely, resilient, and effective responses to emerging threats.

-At the same time, the global burden of non-communicable diseases is rising, especially in
LMICs.

-Moreover, people's health needs and expectations are changing as they demand more
personalized, convenient, and affordable care.

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3. Goal and Objectives of the Guide

3.1. Rationale…..
Promoting and prioritizing health innovation in the health system can lead to:
• Improved Health Outcomes

• Increased Access and Equity

• Enhanced efficiency and Cost-Effectiveness

• Sustainable Healthcare Systems

• Economic growth and Competitiveness

• Response to emerging Health Challenges

• Collaborative partnerships and Knowledge Exchange

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3. Goal and Objectives of the Guide

3.2. Scope
• This guide applies to process, system, product, social, management,
leadership, and technology innovations in and for the health sector of
Ethiopia.

• It also provides a framework and principles to be followed by the MOH,

regional health bureaus, health facilities, and key stakeholders

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3. Goal and Objectives of the Guide

3.3. Goal

In general, provides a framework and guidance for fostering innovation within the

Ethiopian health system to lower financial burden , and build a more resilient and

sustainable health system, improve client and health workforce experience and

improve health outcomes.

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3. Goal and Objectives of the Guide

3.4. Objectives(3)

• Provide a framework and guiding principles to build a culture of and foster health
system innovation in Ethiopia.
• Support and guide the management of health system innovation from idea creation
to implementation and scale-up in Ethiopia.
• Outline the duties and responsibilities of stakeholders in health system innovation in
Ethiopia.

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3. Goal and Objectives of the Guide

3.5. Guiding Principles(12)

The fundamental principle of health innovation is that innovation efforts should lead to meaningful and impactful

• Mission-driven • Sustainable and Scalable Solutions

• Demand-driven • Ethical Considerations
• Patient-Centeredness • Continuous Learning and Improvement
• Equity and Access • Regulatory and Policy Support
• Collaboration and Partnership • Flexibility and Adaptability
• Evidence-Based Practice • Stakeholder Engagement and Empowerment

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4. Health Care Innovation Processes and Framework
Innovation Framework is a structured approach that
- provides a systematic way to understand, develop, and implement innovative solutions within the
health sector.
-used for identifying unmet needs or challenges, generating and selecting novel ideas or
interventions, testing and refining, and scaling successful solutions for broader impact.
- guide the process of fostering and implementing healthcare innovation.

Ethiopia’s Health Innovation Model (HIM)

-developed by adapting and integrating two models:
- Model for Improvement :
-a model for continuous improvement in our NHQSS/ Manuals
-Mountain Model:
- Model for Enhancing Public Sector Demand for innovation and Scaling Innovations by WHO

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4. Health Care Innovation Processes and Framework…..
Model for Improvement

• is a framework widely used in healthcare industries for :

-identifying opportunities for improvement,

-testing changes, and
-continuously learning and refining processes to achieve better
outcomes to drive improvement initiatives.

• It consists of three fundamental questions anchored by PDSA) cycle.

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4. Health Care Innovation Processes and Framework…..
Model for Improvement….
1st Qn: is to establish a clear and measurable
goal(SMART) for the improvement initiative.

2nd Qn :focuses on establishing metrics (objectives)

to measure progress towards the goal.

3rd Qn :involves identifying potential

solutions(inervention) and testing them on a small
scale using the PDSA cycle. before implementing
them more broadly.

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4. Health Care Innovation Processes and Framework…..
Mountain Model for scaling health innovation
• outlines the stages and processes involved in scaling up innovative
healthcare solutions.
• provides a structured approach to understanding and navigating the
complexities of scaling health innovations, ultimately aiming to
improve healthcare delivery and outcomes.
• uses the metaphor of climbing a mountain to represent the journey
of taking an innovation from initial development to widespread
implementation stages.
• exploration and idea generation (base camp),
• pilot testing and validation (ascent),
• scaling up and integration into healthcare systems (summit),
• sustaining and spreading the innovation (plateau). 22
4. Health Care Innovation Processes and Framework…..
Mountain Model for scaling health innovation…
Base camp stage - identifying healthcare challenges and generating ideas for potential solutions.

-conducting needs assessments, research and engaging with stakeholders.

Ascent stage -pilot testing and validation of the innovation in real-world settings.

-small-scale trials, gathering feedback from users, and refining the innovation based on feedback.

Summit stage -securing funding, building partnerships with healthcare providers, and navigating regulatory and

policy barriers.

-scaling up and integrating the innovation into healthcare systems.

Pateau stage -sustaining and spreading the innovation to ensure long-term impact.

-developing strategies for sustainability, building capacity among healthcare providers, and

disseminating knowledge and best practices.

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4. Health Care Innovation Processes and Framework…..

Mountain Model
6. Institutionalize

5. Implement,
Learn and Iterate
Steps

1-2 Sourcing innovations matching priority

needs / Base camp stage
4. Attract/Allocate
3-5 Scaling specific innovations/ Ascent Scaling Resources
3. Identify
6 Sustaining the innovation at scale &
Scaling Pathway
embedding scaling policies and
practices/ Summit & Pateau

2. Scan, Assess & Select Innovations

1. Articulate Demand
4. Health Care Innovation Processes and Framework…..

Ethiopia’s Health Innovation Model (HIM)

- as it is or with further modification, it can be used by Ethiopia's public

and private health sectors.

-will be used as a framework for fostering a culture of innovation and

promoting its scale-up in Ethiopia's public and private sectors

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4. Health Care Innovation Processes and Framework…..

Ethiopia’s Health Innovation Model (HIM)

Figure 1 Health System Innovation Model for Ethiopia 26

4. Health Care Innovation Processes and Framework…..

4.1. The Model for Improvement, anchored by the Plan-Do-Study-Act (PDSA) cycle

• The Model for Improvement, anchored by the Plan-Do-Study-Act

(PDSA) cycle, is a robust framework for developing, testing, and
validating innovation as desired changes (improvement) in health
systems.

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4. Health Care Innovation Processes and Framework…..

4.2. Repository of innovations

-A repository of successful, prioritized, ready-to-scale (groomed)

innovations, with room for integrating innovations sourced from other

sectors.

-The health system must develop the capacity to store and spread

groomed innovations from all sources.

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4. Health Care Innovation Processes and Framework…..

Steps in enhancing the demand for innovation and scaling :

Step 1: Demand Articulation
• Clearly defining and expressing the specific healthcare
challenges or needs that require innovative solutions.

Step 2: Scan, Assess, and Select Innovations

• To explore a range of existing innovations, both within and
outside of healthcare (the repository)

Step 3: Identify Scaling Pathway

• Identifying the resources, partnerships, and actions required
to implement and sustain the selected innovations on a larger
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scale.
4. Health Care Innovation Processes and Framework…..

Steps in enhancing the demand for innovation and scaling :

Step 4: Identify and Allocate Scaling Resources

• Financial and Human Resources, Technology and
Infrastructure, Training and Capacity Building, Monitoring
and Evaluation

Step 5: Implement, Learn, and Iterate

• Support, Continious Learning, Optimization,Collaboration
and Feedback, Scaling and Sustainability

Step 6: Institutionalize Health Innovation

• Integration into Policies and Processes, Training and
Capacity Building, Governance and Leadership Support,
Continuous Improvement, Communication and Change
Management, Knowledge Sharing and Collaboration
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5. Implementation arrangement
5.1. Program Governance

• Establishing a governance structure that oversees the program's implementation,

coordination, and decision-making.
• Program governance for health innovation involves several key stakeholders.
• Ministry of Innovation and Technology

• Ministry of Health ( HSQI-LEO, DH-LEO)

• Armauer Hansen Research Institute (AHRI)

• Ethiopian Public Health Institute (EPHI)

• And others

• Roles and Responsibilities of Stakeholders (Annexed)

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5. Implementation arrangement
5.2. Program planning and Management
• Develop a comprehensive health innovation plan tailored to their
specific mandate
• Allocate adequate resources effectively and efficiently
• Engage various stakeholders
Ethiopian Intellectual
Property
Authority(EIPA)
• Identify potential risks and develop strategies to mitigate them
• Establish robust monitoring and evaluation mechanisms.
• Establish partnerships with national and international
organizations, academic institutions, research bodies, and private
sector entities.
• Take initiatives to build the capacity of stakeholders involved in
the health innovation program
Figure 2 Health system innovation and quality Organizational
structure
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5. Implementation arrangement
5.3. Funding

• Identifying and securing financial help from various sources, such as government budgets,
public-private partnerships, grants, or investments.

• A few dedicated staff with time assigned for innovation

• Healthcare Innovation Labs

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5. Implementation arrangement
5.4. Stakeholder Involvement

• Identifying and involving stakeholders such as government agencies, health ministries,

healthcare providers, academia, industry partners, patient advocacy groups, and regulatory
bodies.

• Effective stakeholder engagement helps to get buy-in, gather diverse perspectives, and ensure
collaboration and cooperation.

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5. Implementation arrangement
5.5. Program Communication

• Helps create awareness, build support, and disseminate information about the program

• Involves developing a communication plan, establishing communication channels, and

conducting regular updates and outreach activities to inform stakeholders, gain public
support, and leverage media opportunities to create visibility for the program.

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5. Implementation arrangement
5.6. Monitoring and Evaluation

• Involves setting up evaluation frameworks, defining key performance indicators (KPIs),

collecting and analyzing data, and conducting regular program assessments.

• Evaluation findings provide insights into the program's progress, identify areas for
improvement, and help inform policy decisions and future program planning.

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5. Implementation arrangement
5.7. Knowledge Management

• Establishing mechanisms to disseminate and exchange best practices, lessons learned, and
research findings.

• Effective knowledge management promotes continuous learning, supports evidence-informed

decision-making, and encourages innovation within the program.

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6. Institutionalizing Innovation

• An organizational innovation system requires a structure that may base an organization’s

mission and vision, internal and external demands, and available capacity.

• Key factors for ensuring innovation to be institutionalized:

• Leadership

• Learning and Experience sharing

• Innovation Challenge

• Grant funding for innovation

• Resource Allocation

• Coordination

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7. Annex

Annex 1: National focus Areas for Health System Innovation

Annex 2. Innovation Lab Protocol

Annex 3: Terms of Reference (TOR) for Innovation Think Tank Team

Annex 4: Change concepts for innovation

Annex 5: Roles and Responsibilities of Stakeholders

Annex 6: Health System Innovation Appraisal Process

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Thank you

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 National Health Innovation Guide

Launching and High-Level Advocacy

Program

25 April 2024
Elily Hotel, Addis Ababa