Fighting Corruption in Health Care? There’s an App for That

Curated on Posted on by Stefaan Verhulst

Akjibek Beishebaeva at Voices (OSF): “As an industry that relies heavily on approvals from government officials, the pharmaceutical field in places like Ukraine and Kyrgyzstan—which lack strong mechanisms for public oversight—is particularly susceptible to corruption.

The problem in those countries is exacerbated by the absence of any reliable system to monitor market prices for drugs. For example, a hospital manager bribed by a pharmaceutical representative could agree to procure a drug at a price 10 times higher than at a neighboring hospital. In addition, those medicines procured by the state and meant to be dispensed freely to patients often appear for sale at hospital-based pharmacies instead.

These aren’t victimless crimes. The most needy patients are often the first to suffer when funds are diverted away from lifesaving treatments and medicines.

To tackle this issue, last year the Soros Foundation–Kyrgyzstan and the International Renaissance Foundation jointly conducted the Health Data Hackathon in the Yssyk-Kul region of Kyrgyzstan. Two teams from Ukraine and three teams from Kyrgyzstan—consisting of coders, journalists, and activists—took part. Their goal was to find innovative solutions to address corruption in public procurements and access to health services for vulnerable populations.

Over the two-and-a-half-day effort, one of the Ukrainian teams developed a prototype for a software application to improve the e-tendering platform for all public procurement in Ukraine—ProZorro.

ProZorro itself revolutionized the tender process when it first launched in 2015. It combined a centralized database of online markets and was made accessible to the public. Journalists, activists, and patients today can log in to the system and scrutinize tenders approved by the government. The transparency provided by the system has already shown savings of more than a billion UAH (US$37 million). However, the database is huge and can be tricky to navigate without training.

The application developed at the hackathon makes it even easier to monitor the purchase prices of medicines in Ukraine. Specfically, it will allow users to automatically and instantly compare prices for the same products—a process which previously took many days of manual effort.

The application also offers a more intuitive interface and improved search functionality that will help further reduce corruption and save money—savings that can be redirected towards treatments for people living with HIV, cancer, and hepatitis C. The team is now testing the software and working with the government to introduce it early this year.

Another team came up with the idea to let patients monitor supplies of medicine at facilities in real time. If a hospital representative says that a patient needs to buy drugs that should be readily available, for example, the patient can check online and hold the hospital accountable if the medicines are meant to be provided for free. The tool, called WikiLiky, has already been implemented in the Sumy region of Ukraine.

Likewise, one of the Kyrgyz teams looked at price monitoring in their own country, focusing on the inefficient and mistake-prone acquisition process. For instance, the name of one drug might be misspelled in several different ways, making it difficult to track prices accurately. The team redesigned the functionality of the government e-procurement portal called Codifier, creating uniformity across the system of names, dosages, and other medical specifications….(More)”

How disaster relief efforts could be improved with game theory

Curated on Posted on by Stefaan Verhulst

 in The Conversation: “The number of disasters has doubled globally since the 1980s, with the damage and losses estimated at an average US$100 billion a year since the new millennium, and the number of people affected also growing.

Hurricane Katrina in 2005 was the costliest natural disaster in the U.S., with estimates between $100 billion and $125 billion. The death toll of Katrina is still being debated, but we know that at least 2,000 were killed, and thousands were left homeless.

Worldwide, the toll is staggering. The triple disaster of an earthquake, tsunami and nuclear meltdown that started March 11, 2011 in Fukushima, Japan killed thousands, as did the 2010 Haiti earthquake.

The challenges to disaster relief organizations, including nongovernmental organizations (NGOs), are immense. The majority operate under a single, common, humanitarian principle of protecting the vulnerable, reducing suffering and supporting the quality of life. At the same time, they need to compete for financial funds from donors to ensure their own sustainability.

This competition is intense. The number of registered U.S. nonprofit organizations increased from 12,000 in 1940 to more than 1.5 million in 2012. Approximately $300 billion are donated to charities in the United States each year.

At the same time, many stakeholders believe that humanitarian aid has not been as successful in delivering on its goals due to a lack of coordination among NGOs, which results in duplication of services.

My team and I have been looking at a novel way to improve how we respond to natural disasters. One solution might be game theory.

Getting the right supplies to those in need is daunting

The need for improvement is strong.

Within three weeks following the 2010 earthquake in Haiti, 1,000 NGOs were operating in Haiti. News media attention of insufficient water supplies resulted in immense donations to the Dominican Red Cross to assist its island neighbor. As a result, Port-au-Prince was saturated with cargo and gifts-in-kind, so that shipments from the Dominican Republic had to be halted for multiple days. After the Fukushima disaster, there were too many blankets and items of clothing shipped and even broken bicycles.

In fact, about 60 percent of the items that arrive at a disaster site are nonpriority items. Rescue workers then waste precious time dealing with these nonpriority supplies, whereas victims suffer because they do not receive the critical needs supplies in a timely manner.

The delivery and processing of wrong supplies also adds to the congestion at transportation and distribution nodes, overwhelms storage capabilities and results in further delays of necessary items. The flood of donated inappropriate materiel in response to a disaster is often referred to as the second disaster.

The economics of disaster relief, on the supply side, is challenged as people need to secure donations and ensure the financial sustainability of their organizations. On the demand side, the victims’ needs must be fulfilled in a timely manner while avoiding wasteful duplication and congestion in terms of logistics.

Game theory in disasters

Game theory is a powerful tool for the modeling and analysis of complex behaviors of competing decision-makers. It received a tremendous boost from the contributions of the Nobel laureate John Nash.

Game theory has been used in numerous disciplines, from economics, operations research and management science, to even political science.

In the context of disaster relief, however, there has been little work done in harnessing the scope of game theory. It is, nevertheless, clear that disaster relief organizations compete for financial funds and donors respond to the visibility of the organizations in the delivery of relief supplies to victims through media coverage of disasters….(More)”

Migration tracking is a mess

Curated on Posted on by Stefaan Verhulst

Huub Dijstelbloem in Nature: “As debates over migration, refugees and freedom of movement intensify, technologies are increasingly monitoring the movements of people. Biometric passports and databases containing iris scans or fingerprints are being used to check a person’s right to travel through or stay within a territory. India, for example, is establishing biometric identification for its 1.3 billion citizens.

But technologies are spreading beyond borders. Security policies and humanitarian considerations have broadened the landscape. Drones and satellite images inform policies and direct aid to refugees. For instance, the United Nations Institute for Training and Research (UNITAR), maps refugee camps in Jordan and elsewhere with its Operational Satellite Applications Programme (UNOSAT; see www.unitar.org/unosat/map/1928).

Three areas are in need of research, in my view: the difficulties of joining up disparate monitoring systems; privacy issues and concerns over the inviolability of the human body; and ‘counter-surveillance’ deployed by non-state actors to highlight emergencies or contest claims that governments make.

Ideally, state monitoring of human mobility would be bound by ethical principles, solid legislation, periodical evaluations and the checks and balances of experts and political and public debates. In reality, it is ad hoc. Responses are arbitrary, fuelled by the crisis management of governments that have failed to anticipate global and regional migration patterns. Too often, this results in what the late sociologist Ulrich Beck called organized irresponsibility: situations of inadequacy in which it is hard to blame a single actor.

Non-governmental organizations, activists and migrant groups are using technologies to register incidents and to blame and shame states. For example, the Forensic Architecture research agency at Goldsmiths, University of London, has used satellite imagery and other evidence to reconstruct the journey of a boat that left Tripoli on 27 March 2011 with 72 passengers. A fortnight later, it returned to the Libyan coast with just 9 survivors. Although the boat had been spotted by several aircraft and vessels, no rescue operation had been mounted (go.nature.com/2mbwvxi). Whether the states involved can be held accountable is still being considered.

In the end, technologies to monitor mobility are political tools. Their aims, design, use, costs and consequences should be developed and evaluated accordingly….(More)”.

The Whatsapp-inspired, Facebook-investor funded app tackling India’s doctor shortage

Curated on Posted on by Stefaan Verhulst

 at TechInAsia: “A problem beyond India’s low doctor-to-patient ratio is the distribution of those doctors. Most, particularly specialists, congregate in bigger cities and get seen by patients in the surrounding areas. Only 19 percent of specialists are available in community health centers across India, and most fall well below the country’s requirement for specialists. Community health centers are located in smaller towns and help patients in the area decide if they need to visit a larger, better-equipped city facility….

The IIT-Madras grad’s company, DocsApp, co-founded with fellow IIT-Madras alum Enbasekar D (CTO), joins startups like Practo, DocDoc, and Medinfi in helping patients find physicians. However, the app’s main focus is specialists, and it lets patients chat with doctors and get consultations.

DocsApp’s name is directly inspired by WhatsApp. As long as you have a chat screen on your phone, you can input your problems and location, find a doctor, and ask questions. A user can pay for his or her own appointment over mobile. If treatment requires a physical visit, the user’s money is refunded….

Doctor profiles include the physician’s experience, medical counsel ID, patient reviews, specialty, and languages – DocsApp covers 17 different languages. DocsApp has 1,200 doctors in 15 specialties. All doctors on the platform are verified by looking up certification, an interview, and a facilities review.

If a consultation reveals that a patient needs a prescription, the doctor can provide a digitally-signed e-prescription. DocsApp can deliver medicines within two days to any location in India, says Satish.

Once a user has access to one of the doctors, he or she can message the doctor 24/7 and get a response in 30 minutes – Satish says that the company’s average is now 18 minutes. The team of 55 is aiming for a minute or less….

Telemedicine is one of the ways tech is combatting India’s doctor shortage. Other startups in the industry in the country include Visit, which focuses on both physical and mental health, and SeeDoc, a physician video consultation app.

A chat is a little less personal than a physical visit, which can open the door for patients who want to discuss more taboo topics in India, like mental health and fertility questions. Satish adds that women who live in locations where it’s best to be accompanied by a man when going out also find convenience, as they don’t necessarily need to wait for a husband to come back from work before addressing a medical question she has about her child…(More)”.

Denmark is appointing an ambassador to big tech

Curated on Posted on by Stefaan Verhulst

Matthew Hughes in The Next Web: “Question: Is Facebook a country? It sounds silly, but when you think about it, it does have many attributes in common with nation states. For starters, it’s got a population that’s bigger than that of India, and its 2016 revenue wasn’t too far from Estonia’s GDP. It also has a ‘national ethos’. If America’s philosophy is capitalism, Cuba’s is communism, and Sweden’s is social democracy, Facebook’s is ‘togetherness’, as corny as that may sound.

 Given all of the above, is it really any surprise that Denmark is considering appointing a ‘big tech ambassador’ whose job is to establish and manage the country’s relationship with the world’s most powerful tech companies?

Denmark’s “digital ambassador” is a first. No country has ever created such a role. Their job will be to liase with the likes of Google, Twitter, Facebook.

Given the fraught relationship many European countries have with American big-tech – especially on issues of taxation, privacy, and national security – Denmark’s decision to extend an olive branch seems sensible.

Speaking with the Washington Post, Danish Foreign Minister Anders Samuelsen said, “just as we engage in a diplomatic dialogue with countries, we also need to establish and prioritize comprehensive relations with tech actors, such as Google, Facebook, Apple and so on. The idea is, we see a lot of companies and new technologies that will in many ways involve and be part of everyday life of citizens in Denmark.”….(More)”

Connecting the dots: Building the case for open data to fight corruption

Curated on Posted on by Stefaan Verhulst

Web Foundation: “This research, published with Transparency International, measures the progress made by 5 key countries in implementing the G20 Anti-Corruption Open Data Principles.

These principles, adopted by G20 countries in 2015, committed countries to increasing and improving the publication of public information, driving forward open data as a tool in anti-corruption efforts.

However, this research – looking at Brazil, France, Germany, Indonesia and South Africa – finds a disappointing lack of progress. No country studied has released all the datasets identified as being key to anti-corruption and much of the information is hard to find and hard use.

Key findings:

  • No country released all anti-corruption datasets
  • Quality issues means data is often not useful or useable
  • Much of the data is not published in line with open data standards, making comparability difficult
  • In many countries there is a lack of open data skills among officials in charge of anti-corruption initiatives

Download the overview report here (PDF), and access the individual country case studies Brazil; France; Germany; Indonesia and South Africa… (More)”

How a Political Scientist Knows What Our Enemies Will Do (Often Before They Do)

Curated on Posted on by Stefaan Verhulst

Political scientists have now added rigorous mathematical techniques to their social-science toolbox, creating methods to explain—and even predict—the actions of adversaries, thus making society safer as well as smarter. Such techniques allowed the U.S. government to predict the fall of President Ferdinand Marcos of the Philippines in 1986, helping hatch a strategy to ease him out of office and avoid political chaos in that nation. And at Los Angeles International Airport a computer system predicts the tactical calculations of criminals and terrorists, making sure that patrols and checkpoints are placed in ways that adversaries can’t exploit.

The advances in solving the puzzle of human behavior represent a dramatic turnaround for the field of political science, notes Bruce Bueno de Mesquita, a professor of politics at New York University. “In the mid-1960s, I took a statistics course,” he recalls, “and my undergraduate advisor was appalled. He told me that I was wasting my time.” It took researchers many years of patient work, putting piece after piece of the puzzle of human behavior together, to arrive at today’s new knowledge. The result has been dramatic progress in the nation’s ability to protect its interests at home and abroad.

Social scientists have not abandoned the proven tools that Bueno de Mesquita and generations of other scholars acquired as they mastered their discipline. Rather, adding the rigor of mathematical analysis has allowed them to solve more of the puzzle. Mathematical models of human behavior let social scientists assemble a picture of the previously unnoticed forces that drive behavior—forces common to all situations, operating below the emotions, drama, and history that make each conflict unique….(More)”

Recovering from disasters: Social networks matter more than bottled water and batteries

Curated on Posted on by Stefaan Verhulst

 at The Conversation: “Almost six years ago, Japan faced a paralyzing triple disaster: a massive earthquake, tsunami, and nuclear meltdowns that forced 470,000 people to evacuate from more than 80 towns, villages and cities. My colleagues and I investigated how communities in the hardest-hit areas reacted to these shocks, and found that social networks – the horizontal and vertical ties that connect us to others – are our most important defense against disasters….

We studied more than 130 cities, towns and villages in Tohoku, looking at factors such as exposure to the ocean, seawall height, tsunami height, voting patterns, demographics, and social capital. We found that municipalities which had higher levels of trust and interaction had lower mortality levels after we controlled for all of those confounding factors.

The kind of social tie that mattered here was horizontal, between town residents. It was a surprising finding given that Japan has spent a tremendous amount of money on physical infrastructure such as seawalls, but invested very little in building social ties and cohesion.

Based on interviews with survivors and a review of the data, we believe that communities with more ties, interaction and shared norms worked effectively to provide help to kin, family and neighbors. In many cases only 40 minutes separated the earthquake and the arrival of the tsunami. During that time, residents literally picked up and carried many elderly people out of vulnerable, low-lying areas. In high-trust neighborhoods, people knocked on doors of those who needed help and escorted them out of harm’s way….

In another study I worked to understand why some 40 cities, towns and villages across the Tohoku region had rebuilt, put children back into schools and restarted businesses at very different rates over a two-year period. Two years after the disasters some communities seemed trapped in amber, struggling to restore even half of their utility service, operating businesses and clean streets. Other cities had managed to rebound completely, placing evacuees in temporary homes, restoring gas and water lines, and clearing debris.

To understand why some cities were struggling, I looked into explanations including the impact of the disaster, the size of the city, financial independence, horizontal ties between cities, and vertical ties from the community to power brokers in Tokyo. In this phase of the recovery, vertical ties were the best predictor of strong recoveries.

Communities that had sent more powerful senior representatives to Tokyo in the years before the disaster did the best. These politicians and local ambassadors helped to push the bureaucracy to send aid, reach out to foreign governments for assistance, and smooth the complex zoning and bureaucratic impediments to recovery…

As communities around the world face disasters more and more frequently, I hope that my research on Japan after 3.11 can provide guidance to residents facing challenges. While physical infrastructure is important for mitigating disaster, communities should also invest time and effort in building social ties….(More)”

Embracing Innovation in Government Global Trends

Curated on Posted on by Stefaan Verhulst

Report by the OECD: “Innovation in government is about finding new ways to impact the lives of citizens, and new approaches to activating them as partners to shape the future together. It involves overcoming old structures and modes of thinking and embracing new technologies and ideas. The potential of innovation in government is immense; however, the challenges governments face are significant. Despite this, governments are transforming the way they work to ensure this potential is met….

Since 2014, the OECD Observatory of Public Sector Innovation (OPSI), an OECD Directorate for Public Governance and Territorial Development (GOV) initiative, has been working to identify the key issues for innovation in government and what can be done to achieve greater impact. To learn from governments on the leading edge of this field, OPSI has partnered with the Government of the United Arab Emirates (UAE) and its Mohammed Bin Rashid Centre for Government Innovation (MBRCGI) , as part of the Middle East and North Africa (MENA)-OECD Governance Programme, to conduct a global review of new ways in which governments are transforming their operations and improving the lives of their people, culminating in this report.

Through research and an open Call for Innovations, the review surfaces key trends, challenges, and success factors in innovation today, as well as examples and case studies to illustrate them and recommendations to help support innovation. This report is published in conjunction with the 2017 World Government Summit, which brings together over 100 countries to discuss innovative ways to solve the challenges facing humanity….(More)”

Toward a User-Centered Social Sector

Curated on Posted on by Stefaan Verhulst

Tris Lumley at Stanford Social Innovation Review: “Over the last three years, a number of trends have crystallized that I believe herald the promise of a new phase—perhaps even a new paradigm—for the social sector. I want to explore three of the most exciting, and sketch out where I believe they might take us and why we’d all do well to get involved.

  • The rise of feedback
  • New forms of collaboration
  • Disruption through technology

Taken individually, these three themes are hugely significant in their potential impact on the work of nonprofits and those that invest in them. But viewed together, as interwoven threads, I believe they have the potential to transform both how we work and the underlying fundamental incentives and structure of the social sector.

The rise of feedback

The nonprofit sector is built on a deep and rich history of community engagement. Yet, in a funding market that incentivizes accountability to funders, this strong tradition of listening, engagement, and ownership by primary constituents—the people and communities nonprofits exist to serve—has sometimes faded. Opportunities for funding can drive strategies. Practitioner experience and research evidence can shape program designs. Engagement with service users can become tokenistic, or shallow….

In recognition of this growing momentum, Keystone Accountability and New Philanthropy Capital (NPC) published a paper in 2016 to explore the relationship between impact measurement and user voice. It is our shared belief that many of the recent criticisms of the impact movement—such as impact reporting being used primarily for fundraising rather than improving programs—would be addressed if impact evidence and user voice were seen as two sides of the same coin, and we more routinely sought to synthesize our understanding of nonprofits’ programs from both aspects at once…

New forms of collaboration

As recent critiques of collective impact have pointed out, the social sector has a long history of collaboration. Yet it has not always been the default operating model of nonprofits or their funders. The fragmented nature of the social sector today exposes an urgent imperative for greater focus on collaboration….

Yet the need for greater collaboration and new forms to incentivize and enable it is increasing. Deepening austerity policies, the shrinking of the state in many countries, and the sheer scale of the social issues we face have driven the “demand” side of collaboration. The collective impact movement has certainly been one driver of momentum on the “supply” side, and a number of other forms of collaboration are emerging.

The Young People’s Foundation model, developed in the UK by the John Lyons Charity, is one response to deepening cuts in nonprofit funding. Young People’s Foundations are new organizations that serve three purposes for nonprofits working with young people in the local area—creating a network, leading on collaborative funding bids and contracting processes, and sharing assets across the network.

Elsewhere, philanthropic donors and foundations are increasingly exploring collaboration in practical terms, through pooled grant funds that provide individual donors unrivalled leverage, and that allow groups of funders to benefit from each other’s strengths through coordination and shared strategies. The Dasra Girl Alliance in India is an example of a pooled fund that brings together philanthropic donors and institutional development funders, and fosters collaboration between the nonprofits it supports….

Disruption through technology

Technology might appear an incongruous companion to feedback and collaboration, which are both very human in nature, yet it’s likely to transform our sector….(More)”