Digital Enablement

ut they are often unable to influence
broader thinking by demonstrating
successful approaches, and certainly,
a lack of peer communication and
consideration of similar initiatives is
causing duplication and wastage of
effort and resources in our view.
Fig. 2: mHealth PILOTITIS
Sales
Profits
CSR/innovation
Seed funding from donors,
industry players and sometime
the government
Commercial sustainability
No clear source of funding or lack of
business model: Donors? Government?
Insurers? Users/patients? Advertising?
Pilots are often so overly resourceintensive
that they can be too
expensive to scale-up using the
same approach, and each pilot is
undertaken in isolation without
involving other partners that may
help with scaling-up later. Ultimately
too many pilots focus on proving a
solution’s technical ability or social
impact without testing a business
model that allows the pilot to be
replicated or scaled-up. It may not
be a problem if 90 percent of tech
startups in the US fail, but in efforts to
address the digital divide where much
more is at stake; we are wasting time
and precious resources that could be
dramatically improving lives.
Measurable sustainability
Our research found three interrelated
concerns for solutions to be
sustainable: an economically viable
business model, users that value a
service in order to continue using it,
and proof of success.
In theory, every digital enablement
solution should have a business
model that makes provision for
Product
development
CapEx
covering program costs but a 2011
study of 280 solutions by Hystra 11
found more than half were still young
and/or not financially sustainable,
and a similar proportion were entirely
reliant on charitable funding. The
GSMA currently reports that 42%
of the mobile for development
services it tracks are reliant on
“PILOTITIS”
charitable funding (though this is
an improvement on the 74% pre-
2009) and their survey of 61 telecom
operators in 2014 found 57% agreed
that a lack of right business models
was the biggest barrier for services. 12
Business models should generate
Introduction
long-term value, and value shouldn’t
OpEx (recurring)
Maturity
Source: Catalysing mHealth Services for Scale and Sustainability in Nigeria, May 2015, GSMA
“While mHealth in Nigeria is flourishing, it faces various challenges,
such as fragmentation, lack of sustainable funding and suitable
business models, which would allow mHealth to move from
introduction/pilot to growth stage“
Catalysing mHealth Services for Scale and Sustainability in Nigeria. GSMA, May 2015
Growth
be viewed only in a pure financial
sense, but also in terms of tangible
and intangible benefits generated
for all stakeholders. Even with
services free to users, the funders
that are paying the costs should gain
value, not just the beneficiaries. For
example, individuals may value a
free government healthcare device
and advice line, but the government
also benefits by lowering its direct
and indirect healthcare costs. In this
case the government contribution
is more of a service fee with a
measurable benefit in return.
The Tinder foundation’s work in
the UK to provide digital skills to
marginalized individuals enables
those individuals to access health
knowledge digitally and reduces
the treatments costs that the donor,
the National Health Service, would
otherwise end up paying further
down the line. There’s nothing wrong
with getting something back; in
fact, it’s something to aim for and
will increase the likelihood of the
funder continuing to fund the service,
creating sustainability.
Decline
11
Leveraging Information and Communication Technology for the Base Of the Pyramid, 2001, Hystra. 12 Scaling Mobile for Development, August 2013, GSMA
13