Last month I traveled to Nepal and India to meet with Skoll Awardees and partners and learn about their progress in deploying mobile health solutions, fighting gender bias, and expanding girls’ access to education. I was impressed and humbled by the impact that social entrepreneurs are having on these complex problems.
In Nepal, I visited Medic Mobile to learn more about their scale-up of mobile solutions for community health workers—also called mHealth. Due to Nepal’s mountainous terrain and challenges in delivering critical health services for the mostly rural population that lives in these hard-to-reach places, healthcare delivery is initiated and enabled by a cadre of village community health volunteers. Nepal’s government-initiated Female Community Health Volunteer (FCHV) program has over 50,000 FCHVs. The dropout rate is impressively low—less than five percent.
Medic Mobile hopes to achieve full coverage in five of Nepal’s 75 districts by the end of 2016, equipping all community health workers there with mobile and web solutions. To see their work in action, I took a short flight west from Kathmandu, followed by a four-hour drive to Baglung District. Baglung, population 270,000, is the first district where Medic Mobile’s solutions have been fully scaled up.
There I met with 15 FCHVs and a village Health Post Officer in a village that sees 90 pregnancies a year. It’s a two-hour walk from the village to the closest health facility. Since the FCHVs started using Medic Mobile’s solutions to deliver prenatal and postnatal care, they can now better track pregnancies and each patient’s needs.
The technology has had a big impact. Ninety percent of prenatal consultations are now done on time, up from 40 percent, and almost 100 percent of births now take place in a health facility, as opposed to unsafe in-home delivery.
This improved care has led to increased respect for the FCHVs by their patients and the community. I felt a deep sense of commitment come through when the volunteers shared that they feel a moral obligation and pride in selflessly serving their community. The FCHVs and village Health Post Officer view mobile tools as a critical part of their workflow and ability to best perform their duties. They look forward to continue investing in this program with the district government’s support.
I also met with Baglung District Health Officer Maheshwor Shrestha, who drove the district-wide adoption of Medic Mobile’s solutions. He feels confident in his ability to continue the program after Medic Mobile’s two-year transitional commitment ends next year.
Back in Kathmandu I met with senior officials from the Ministry of Health & Population and representatives of GIZ, a German agency that is deeply involved in Nepal’s eHealth efforts, to learn more about the country’s plans for scaling up mHealth. The Nepal government recently approved an eHealth strategy that includes investments in mobile health technology, and Medic Mobile has an opportunity to play a crucial role in it.
From Nepal, I traveled to Delhi, India, where I met with senior members of the Breakthrough team. This 2016 Skoll Awardee prevents violence and discrimination by changing social norms. Breakthrough is currently working in five Indian states with initial efforts in a sixth—Haryana.
The state of Haryana has the lowest ratio of girls to boys in the country: 879 to 1000. Breakthrough has an agreement with the state government to address the underlying gender bias, via trainings in 150 government schools. A randomized control trial is underway to assess long-term results and the Ministry of Education has already indicated a desire for full statewide scale-up of Breakthrough’s programs.
After the Eid al-Fitr holiday, I met with Educate Girls Executive Director Safeena Husain and Development Director Maharshi Vaishnav to learn about early results from their impact bond for education. They explained that though the bond is small in dollar terms, it reaches a large beneficiary pool—the target is 15,000 girls.
I learned that after year one of the impact bond’s three-year period, Educate Girls achieved 44 percent of their enrollment targets and 23 percent of their learning improvement goals. The bond has forced the organization to move their impact monitoring approach from a focus on activities to a more outcomes-oriented culture. We look forward to sharing more about Educate Girls’ learnings with the rest of our community of Skoll Awardees.
After Delhi I journeyed on to Mumbai. There I enjoyed a great meeting with Neera Nundy of Dasra, a foundation that acts as an intermediary between philanthropic capital and nonprofits in India. Dasra has powerful insights into the Indian social entrepreneurial ecosystem. I learned that over 60 percent of the nonprofit social enterprises in India are female-led, while this number drops to under 30 percent for for-profit social enterprises.
Later I visited the Aadhaar offices, where I saw first-hand how more than one billion Indians have been registered for a unique 12-digit identification code that enables greater access to government subsidies, banking and other services.
The story of the Aadhaar project and its founder Nandan Nilekani is one we point to often here at the Skoll Foundation as an example of the power of social entrepreneurship to transform a status quo. You can learn more in Getting Beyond Better, a recent book about social entrepreneurship written by strategy guru Roger Martin and Skoll Foundation President and CEO Sally Osberg.
There’s no substitute for getting on the ground and seeing first-hand the work of social entrepreneurs to better understand and appreciate their impact, challenges, and day-to-day realities. I remain humbled by each of these organizations and optimistic about our collective future with such committed leaders working tirelessly to change the systems underlying some of our most pressing problems. Onward!