Accenture LLP and Jhpiego are pleased to submit this final application to express our interest in exploring the extent to which digital financial services (“DFS”) in low-resource settings have contributed to increased financial protection, increased demand and use of health services, and ultimately improved health systems performance. The consortium, which combines Accenture’s global consulting experience and innovation capabilities with Jhpiego’s intimate knowledge and experience in the global health context (including digital health, health financing, digital financial services, access to essential services, and health service responsiveness) would bring a well-positioned perspective to help PATH and Digital Square build on United States Agency for International Development’s (USAID) encouraging early research which has deepened the global understanding around benefits, challenges, and impact of DFS in health. This final application highlights the global expertise that Accenture and Jhpiego would bring to this engagement, including:
- Deep global health and health system strengthening experience
Accenture has worked with INGOs, donors, foundations, corporates, multilaterals and governments on 250+ global health initiatives to deliver sustainable impact. We work extensively to strengthen our clients’ programmatic portfolios, enabled by enterprise operations and systems. We draw on the specialization of Accenture’s 20,000+ healthcare industry professionals and 1,000+ international development professionals serving over 70 developing countries. We help our clients in emerging markets by offering strategy support to identify and capitalize on market trends, design and implement digital strategies, and develop effective and scalable programs. Accenture worked on a health system strengthening project in collaboration with the Aurum Project and the CDC. The project provided technical assistance on the development of the National Health Planning framework in the planning directorate of the National Department of Health (NDoH). The planning framework aimed to strengthen District Planning and Monitoring at the NDoH in order to improve service delivery and deliver better outcomes at the district and provincial level.
Jhpiego motivates health care providers to record and use service delivery data as an integrated component of training to improve responsiveness and quality of service delivery promoting a more client-centered approach. Accurate recordkeeping is important not only to health system strengthening, but also to scaling up high-impact interventions for quality health services. Jhpiego has provided in-service training courses on the importance of recordkeeping, development of tools, and application of data for program and quality improvement. In countries such as Tanzania and Nigeria, Jhpiego has integrated Malaria in Pregnancy (MIP) control and treatment components with ANC and RH services, working with governments to provide technical assistance to strengthen M&E capacity to capture the progress and challenges of integrated health programming. In Lesotho, Malawi and Tanzania, Jhpiego developed the current data collection tools for VMMC that have been adopted by the MOH and integrated into the national HMIS system. The 2013 report, Strengthening Health Management Information Systems for Maternal and Child Health: Documenting MCHIP’s Contributions, summarizes how the Jhpiego-led MCHIP contributed to improving global and local data management, data quality assessments. Also highlighted is MCHIP’s work in seven countries to strengthen data flow and aggregation for both facility- and community-based programs and built the capacity of health care workers in these countries to use HMIS tools correctly and consistently. MCHIP facilitated the use of information products that enable quick visualization of data such as service delivery trends posters and scorecards in 12 countries, leading to routine use of data for program monitoring and planning. These tools can lead to quicker action, increased accountability, and revitalization of commitments to improve health outcomes.
- Strong digital financial inclusion experience and applications in health and beyond
Accenture works with several commercial and NGO financial service organizations to promote the economic inclusion of low-income populations, particularly those that cut across and beyond the health. We leverage our digital capabilities to help clients remain at the forefront of emerging technologies, increase their reach and scale through innovative digital and mobile solutions, and amplify their impact through data and analytics. For example, we worked with Mastercard to identify innovative applications of their digital payment solutions throughout healthcare value chains in underserved communities, while with the Grameen Foundation in India, we leveraged artificial intelligence to develop a multilingual virtual financial advisor to empower skilled field agents and drive financial inclusion in underserved regions.
Over the decades, Jhpiego has integrated cutting edge digital health tools into our work, recognizing the power and benefit of technology to improve quality of care, affect health outcomes, and empower health workers to make complex decisions. Under the USAID-funded MAISHA project, Jhpiego collaborated with D-tree International in Tanzania on the mHealth for Safer Deliveries initiative, which incorporated a mobile decision-making application with a mobile money component for CHWs. Phones were equipped with an open source decision-support application and an EzyPesa (mobile banking) account. The tools included forms for registration of pregnant women, prior permission of decision-makers for transport, screening for danger signs at all phases, referral forms, and postnatal follow-up forms. In addition, the application allowed for registration of health facility contacts, transport provider contacts, and pre-negotiated transport rates.
- Digital and health landscaping experience in LMICs
Accenture has carried out numerous technology and digital landscape assessments for development sector clients to inform information systems & digital strategies. For instance, we worked with Amref Health Africa on an mHealth innovation market landscape and developed the strategy, design and implementation of their mobile Community Health Worker training platform that has allowed for the training of over 35,000 community health workers. We also delivered an mHealth technology strategy for Living Goods (LG), where we developed a global mHealth technology landscape assessment for Sub Saharan Africa, Asia, and Latin America, and provided recommendations for partnership based on LG’s level of technology maturity and potential partner capabilities. More, Accenture helped Philips to assess the economic and social potential for a new infant resuscitation technology across Africa, first through a wide secondary research effort, followed by deep-dive assessments in two markets. And finally, we supported PATH’s Digital Square efforts in South Africa to conduct a detailed landscape assessments of national partner management and community focused information systems.
Jhpiego seeks to achieve positive health outcomes in the most effective and efficient manner possible, putting the patient at the center of each intervention. Jhpiego leads with the health objective, not the technology. We seek to first understand and identify the health problem to be solved and the assets that can be leveraged, the context and environment as well as constraints and enabling factors, and then determine the contribution digital health can make and the most appropriate digital health solution. From as early as 1987, when Jhpiego introduced computer-assisted instruction to simulate clinical situations in several of its US-based courses, to the internet boom in 1995 when Jhpiego launched ReproLine, an online source for reproductive health information, to the mobile revolution with point-of-care and decision support tools for health workers on personal digital assistants, smartphones and tablets, digital health has been an integral part of Jhpiego’s approach to development.
- Our long-standing relationships with PATH and USAID
Accenture has built a trusted relationship with PATH for nearly a decade across all parts of the organization. In 2010, Accenture first worked with PATH to develop an overall finance IT strategy and vision to show how investments in business process and information technology will support finance operations in the future –improving operational excellence, accountability, and continued growth. Accenture also helped to develop a donor engagement strategy for PATH’s Global Health Innovation Hub, enabling PATH to continue its strategic and focused approach to fundraising. Additionally, we partnered with PATH, Pfizer, Gavi and the Ministry of Health to pilot an open source 2D barcoding tool for serialized and secure supply chains in Nicaragua, with discussions on expansion in Gambia. We also partnered with PATH, the Bill & Melinda Gates Foundation, USAID and 25+ cross sector organizations to create a control tower blueprint (The Visibility & Analytics Network) to bring leading supply chain visibility and analytics to the African public sector, starting with South Africa. We are excited to continue our strong relationship with PATH to contribute to the vision of improving the health of more than 400 million people by 2030.
Jhpiego currently implements 108 awards from various donors, including USAID. In addition to the USAID-funded MAISHA project in Tanzania, Jhpiego has led USAID’s flagship MNCH/FP/RH projects, including MCSP, demonstrating the expertise and experience required to seamlessly manage small and large programs with multiple core and field investments in 32 countries. Jhpiego is a proven and trusted implementing partner with a strong record of delivering results, in addition to having strong implementation science and research capabilities and systems.
- ADP’s unique, low cost sustainable consulting model
ADP represents a unique model where Accenture employees from across the globe are seconded to work on high-impact projects that benefit the development sector, at a reduced rate from Accenture’s commercial rates. Through our ADP practice, we have delivered over 1,400 high-impact projects that are focused on strengthening and improving the effectiveness of development sector organizations, as well as how business and technology experience can be leveraged to address key international development issues, such as health, education, disaster recovery, agriculture, urban development, energy, financial inclusion, fostering private sector development, and promoting innovation.
The consortium team of Accenture and Jhpiego is well-positioned to support PATH, Digital Square and USAID on this landscape report to explore the extent to which DFS in low-resource settings have contributed to increased financial protection, increased demand and use of health services, and ultimately improved health systems performance. In addition to bring complementary capabilities across the international development, global health, and digital financial services landscape, Accenture and Jhpiego would bring a seamless approach to co-managing the project and all its activities and deliverables, highlighting the strongest assets of each organization where most applicable.
Accenture
Accenture is a leading global professional services company, providing an extensive range of services and solutions in strategy, consulting, digital, technology and operations, with more than 490,000 employees working in 120 countries. As a business unit within Accenture, Accenture Development Partnerships (“ADP”) collaborates with international development organizations to deliver innovative solutions that truly change the way people work and live around the world. Accenture leverages a unique award-winning cost-sharing model which allows us to apply the full breadth of our global assets, capabilities, and resources to the international development sector and provide our clients with leading insights and winning strategies.
Accenture is well-positioned to support the proposed landscape report based on our experience in the DFS space, our digital health expertise, and partnerships we’ve made in global health. Across the international development sector, Accenture has delivered more than 1,500 projects that have helped donors, foundations, corporates, and INGOs assess and expand initiatives in developing countries around the world. In consideration of the current scope, Accenture has carried out numerous technology and digital landscape assessments for development sector clients to inform and implement digital strategies. In the financial inclusion arena, we worked with FSD Africa on a refresh of their digital finance strategy to position the organization to deepen their impact across Africa’s changing financial sector. We have also been engaging closely with the Better than Cash Alliance to provide landscape research and define action-oriented recommendations on scaling payment digitization and adoption of digital financial services for small merchants in the supply chain of fast-moving consumer goods companies in Mexico. In health, we worked with Amref Health Africa on an mHealth innovation market landscape and developed the strategy, design and implementation of their mHealth training platform that has allowed for the training of over 35,000 Community Health Workers. We delivered an mHealth technology strategy for Living Goods, where we developed a global mHealth technology landscape assessment for Sub Saharan Africa, Asia, and Latin America, and provided recommendations for partnership based on their level of technology maturity and potential partner capabilities. Lastly, we have helped Philips to assess the economic and social potential for a new infant resuscitation technology across Africa, first through a wide secondary research effort, followed by deep-dive assessments in two priority markets.
To deliver on the scope of work, Accenture would leverage relationships with subject matter advisors from across Accenture, bringing a wealth of experience across financial services, global health, international development, communications, and technology. Our financial services practice engages with 90 percent of the insurance companies in the Fortune Global 500, while our digital health practice engages with 21 of the top 25 firms in life sciences, the top 10 in med tech, and the top 5 in medical diagnostics. As Accenture is ranked the No. 1 largest healthcare management consulting firm, our ADP practice has drawn heavily upon this relationship to deliver 300+ global health initiatives with leading INGOs, donors, foundations, corporates, multilaterals and governments to create sustainable impact.
Jhpiego
Jhpiego is an international NGO affiliated with Johns Hopkins University (JHU), putting evidence-based health innovations into everyday practice to overcome barriers to high-quality health care since 1973. Jhpiego currently implements 108 awards from various donors including USAID, CDC, bi-lateral institutions, national governments, multi-lateral institutions, corporations and foundations, among others, and had an FY2019 budget of $350 million. Jhpiego empowers health workers and beneficiaries by designing and implementing effective, low-cost, hands-on solutions that strengthen the delivery of health care services, following the household-to-hospital continuum of care. We partner with organizations from the community to the national levels, building sustainable, local capacity through advocacy, policy development, human resources for health and quality and performance improvement approaches. Jhpiego has worked with more than 150 countries throughout Africa, Asia, the Caribbean, Europe, Latin America and the Middle East. The majority of Jhpiego’s projects relate to maternal, newborn and child health, family planning, reproductive health, HIV/AIDS and infection prevention and control. Jhpiego’s Digital Health unit seeks to implement innovative and evidence-based technology tools into everyday practice to break down barriers to high-quality health care for the world’s most vulnerable populations.
Jhpiego has a physical presence in 36 countries and has led USAID’s flagship MNCH/FP/RH projects, including MCSP, demonstrating the expertise and experience required to seamlessly manage small and large programs with multiple core and field investments in 32 countries. Jhpiego is a proven and trusted implementing partner with a strong record of delivering results, in addition to having strong implementation science and research capabilities and systems. At any one time, Jhpiego is implementing 70+ rigorous human subjects research studies globally. In 2017 alone, Jhpiego had 82 IRB approved studies in process. These studies address questions around integration, quality improvement, scale-up (acceptability and sustainability), and intervention effectiveness. Jhpiego frequently collaborates with Johns Hopkins University expert faculty and researchers and taps into their extensive network of educational and research institutions. By building strong M&E systems and conducting targeted implementation research (IR) and effectiveness evaluations, Jhpiego ensures that programs continuously implement proven interventions. The organization seeks to improve project quality and impact through collection and use of targeted data and ongoing program learning. Jhpiego also assures integration of best practices in research methods, ethics and institutional review board compliance into its research so that client safety and confidentiality are ensured and key findings essential to building program knowledge in the field can be published and widely disseminated. Jhpiego also recognizes that an essential part of strategic learning is the dissemination of results and lessons learned to the wider public health community. Thus, through the establishment of the Publications Initiative, Jhpiego is sharing findings and results through peer-reviewed publications at increasing rates.
Comments
Request for Application #2019
Request for Application #2019-020
Digital Financial Services on Health Outcomes and Health Systems
General comments and observations submitted by Walter Brown: walter@sakan.org.za. This comment applies to all applications.
The Digital Financial Services on Health Outcomes and Health Systems funded by USAID in this Request for Application #2019-20 is most welcome, timely, and urgent: implementation of the research results will most definitely ease the plight of many low-income individuals and groups to better manage their health service needs.
But, based on analyses of all Sustainable Development Challenges focused on South Africa, a leading African continental economic giant, and the global leader in income inequalities, unemployment, and inadequate national educational outcomes, there remains a vast population of global citizens that remain excluded from the benefits of this and numerous other global initiatives aimed at resolving all SDG challenges through ICT by year 2030. These are the global citizens who cannot afford ANY digital services, financial or otherwise, to help them to overcome ANY of the SDG challenges, especially SDG3 – Health and Wellbeing, which this DFS programme seeks to address.
This phenomenon is skewed heavily against sub-Sahara Africa:
Does this mean that 57.1% of South Africa’s citizens are excluded from the full benefits of the DFS initiative?
What of the remaining sub-Sahara African (SSA) countries, especially those in the SADC region, which is the epicenter of poverty as reflected by the proportion of Least Developed Countries (LDC)? Are 85% of this population group excluded from the DSF initiative? The few SSA countries included in the current phase of the DSF initiative are welcome inclusions, but the comments above are very relevant to their unique situations.
Note: Data sources: https://www.worldbank.org/en/topic/poverty/overview - Last Updated: Oct 02, 2019; AND World Bank Poverty Data (updated 28 October 2019): https://data.worldbank.org/topic/poverty.
The “pleas and/or requests” emanating from this comment are three-fold:
In the context of South Africa, several “conversations” are at an early stage, including with the financial services sector, see e.g. the “Financial Services and SDG Talking Points”, and the more detailed submission to the “Competition Commission’s Data Services Market Inquiry”, both are available for download via the hyperlinks provided, and the latter will launch its final report this coming first week of December 2019.
Country Case Studies
It would be good to see examples of countries you will consider to include in the case studies. Adding specificity to the country context to give reviewers an idea of your focus would improve the application. Good luck!
Hi Amanda,
Hi Amanda,
Thanks so much for this feedback. That is exactly the conversation that ADP and Jhpiego are having as a team now, so we are certainly aligned! Any other similar points of feedback would certainly be welcome.
Thanks,
Mark
Feedback on Application
Great! One more piece of feedback from my side. Can you address what additional value do you see out of a collaboration, both for the work in general and the partnership on your consortium?
Technical feedback
While the deliverables (key implementation considerations) are appropriate, we suggest that the process may be too high level. How can this process make clear connections to country-level work? We recommend elaboration on the proposed country surveys.
Technical feedback
While the deliverables (key implementation considerations) are appropriate, we suggest that the process may be too high level. How can this process make clear connections to country-level work? We recommend elaboration on the proposed country surveys.