Driving innovation at scale

Back in the 1950s in the East Asia and Pacific Region, a UNICEF midwife working in a Philippine village was getting frustrated. Why was it that whenever supplies ran out for the training sessions she was running, she had to order replacement stock one by one – all the way from Manila? Surely it would be easier if all the materials needed for one midwife could be provided in a single pre-packaged kit!

The midwife passed on her idea to her supervisor, and soon afterwards the UNICEF midwifery kit was created. Over the last 70 years, UNICEF has been behind the development of many other durable, well-designed products that meet the essential needs of children and their families all over the world, including such iconic items as the school-in-a-box kit and the classic UNICEF cyan-blue school backpack.

Increasingly, however, people are realizing that the big obstacle in innovation for development is driving products to scale. Too often, innovation has remained a shiny object and contributes to the concern around ‘pilotitis’. What really counts is to translate new ideas into scaled-up solutions that match the needs of millions of children in all manner of settings. This daunting challenge is what drives the staff at UNICEF Supply Division, and one where Regular Resources makes a telling contribution.

“Because of our global footprint, our close links with governments, and our strong convening power, UNICEF is in a unique position to take good innovations to scale,” says Kristoffer Gandrup-Marino, Chief of Product Innovation at UNICEF Supply Division. “But there’s a complex process involved, and there are no silver bullets.”

The redesign of the classic multipurpose emergency field tent is one example. Over the decades, the tent has provided sturdy service whether as a temporary classroom, as a distribution point, or as a child-friendly space. But UNICEF recognized it was time for something better. Consequently, staff and partners around the world proposed over 1,000 technical improvements, including better resistance to wind, rain, dust, and snow, as well as hard flooring, electricity, increased space, and easier installation and transportation.

Working with a group of private-sector partners chosen through a transparent competitive process, UNICEF facilitated a research and development phase that featured a high level of collaboration and co-creation. Eleven companies developed prototypes that were tested in Copenhagen and in a wind tunnel facility in France. From this, tents from three companies were selected to be tested in the field in different climates and regions: Uganda for hot and dry, the Philippines for wet, and Afghanistan for cold. Three tent designs were ultimately selected, and UNICEF is now working to make the modified tents ready to meet humanitarian response needs worldwide.

“It took time, but the outcome was a product that is truly fit for purpose,” says Gandrup-Marino. “The process that got us there wouldn’t have been possible without the support of our Institutional Budget, of which Regular Resources is a critical part.”

Sometimes scaling even proven technologies can be extremely difficult, especially when local governments are the intended buyers and implementers. This was the origin of SPRINT (Scaling Pneumonia Response Innovations), an initiative launched by UNICEF in 2018. Pneumonia is the most lethal infectious disease affecting young children worldwide, yet it is preventable and treatable with two key products: antibiotics to treat pneumonia, and oxygen to support a child’s recovery.

The challenge, however, is that bottlenecks at different levels of national health systems can complicate matters. Some countries might have antibiotics on the market, but no access to oxygen. Others may have oxygen supplies, but no or suboptimal antibiotics not suitable for children. Such problems contribute to the approximately 800,000 children who die from pneumonia every year.

Taking solutions to the global scale is all the more critical as the world works towards the ambitious targets set by the Sustainable Development Goals. But scaling up lifesaving products for children and families is complex and costly. Many products take decades to progress from the prototype through to worldwide availability and use.

To overcome these problems, UNICEF created a partnership with Senegal and Ghana – two countries in West Africa with a high burden of child pneumonia deaths. Together, they developed a systematic approach to identifying and overcoming the barriers to scaling oxygen and amoxicillin DT, an antibiotic suitable for treating pneumonia in children 

“Having flexible Regular Resources for this initiative enabled us to iterate a complex process and to move much more quickly than otherwise.” explains Gandrup-Marino. “Building on the initial success, we are now working towards supporting many other countries, including to ensure that oxygen is available to address the COVID-19 crisis.”

Taking solutions to the global scale is all the more critical as the world works towards the ambitious targets set by the Sustainable Development Goals. But scaling up lifesaving products for children and families is complex and costly. Many products take decades to progress from the prototype through to worldwide availability and use. During this time, market environments and trends evolve, as do global and national policies. Shifting supply chains can also affect how a product will be taken to scale.

Through the timely allocation of Regular Resources, UNICEF is able to guide every step of the scaling journey, rather than efforts being limited by the often relatively short horizon of dedicated grants. From advocating for children’s unique requirements during product design, to working with industry leaders to develop prototypes, to strengthening supply chains to distribute products, UNICEF has the presence and influence to contribute and lead on a global scale.

“What we’re aiming for is a systematic process whereby UNICEF takes a proactive role and makes conscious decisions about where to take risks, enabling more efficiency in driving scale,” notes Gandrup-Marino. “This is how we can have the greatest possible impact on children for the resources used.”

Bottom line, Regular Resources is an essential part of the equation as it allows for longer and more strategic thinking and keeps the focus on results. Whether hiring skilled project managers to oversee the innovation and scaling process or providing small capital investments to trial new prototypes, these flexible core resources lend UNICEF the agility to respond to ever-changing requirements. And to save children’s lives.

The UNICEF 2019 Regular Resources report can be downloaded here