Welcome to this learning module, where we will focus on technology innovations that support health systems in limited resource contexts. Some of the key capacities we will be developing include to:

• Identify community needs through observation techniques.
• Investigate differences in manufacturing capacity.
• Understand role of local context.
• Identify and address cultural issues that affect technology design and uptake.

We will be using the knowledge sharing platform, Scholar, where you will be undertaking three main kinds of activities:

1. In the "Community" app within Scholar, you will be viewing and commenting on updates made by the instructor.
2. Also in Community, you will be making updates for other students to view and comment on.
3. In the "Creator" app, you will be develop a project, peer review others' projects, and revising ready for publication. When published, we can all view and discuss each other's projects.

Scholar has features which work like social media and cloud-shared docs. So, if you are familiar with these, you shouldn't need any instructions - just watch out for updates in your activity stream in Community, and notifications in the top messages bar. If you do get stuck, though, you can take the Help link in the top right of the screen. Also, because everyone will be making updates, there will be a lot of activity, so here's a tip: to filter just for admin updates (which are essential), go to the updates menu and filter "admin."

Comment: What have been your experiences working in e-learning environments, or sharing knowledge in social media? What are your expectations of these kinds of spaces?

Create your profile page in Community:

1. Sign in to Scholar and create an account.
2. Hover over the avatar, and upload a photo.
3. Take the pull-down menu behind your name (see image above), select the "About" link. Tell us about yourself! Also from this menu, add your Interests.

Now, write a short introduction about yourself for other community members. This will be good practice for learning how to make updates.

1. Take the Updates link in the pulldown menu. Make sure you do this on our community page, not your personal profile page. (From your personal profile page, an update only goes to peers, or people with whom you have made one-to-one connections. From the community page, your update will go to all the members.)
2. Make an update for the community which tells others about some of the interests and aspirations that you bring to this course. This is a good opportunity to try out some of the features in the toolbar, including making links, adding images, or adding external media (such as a YouTuble video). Some things you may mention: Where are you from? Why did you decide to take this course?What are your expectations of this course? Tell us about a favorite technology innovation that has changed people's lives.
3. Comment on at least three or four other people's updates.

Comment: Any problems using Scholar? Make a comment here, and another community member can help!

Week 1 Overview:

Welcome to Week 1. This week you will be introduced to the overall aims of the course and we will see an overview for background and context on global health in the context of West Africa.

Time: This week will last 7 days and should take approximately 10 hours of dedicated time to complete, with its readings and assignments.

Goals and Objectives: At the end of this week, you will be able to:

• Identify key attributes for tracking health.
• Define communicable and non-communicable diseases.
• Understand differences in health issues based on socioeconomic, geographic, and cultural factors.

Key Phrases: Keep your eyes open for the following key terms or phrases as you complete the readings and interact with the lecture. These topics will help you better understand the content in this week.

• Communicable
• Global health
• Role of the WHO

Guiding Questions: Develop your answers to the following guiding questions while completing the readings and as you work through the week.

• What diseases and disorders are prevalent in West Africa?
• What can be done to prevent/reduce these diseases?

Instructional Activities: Below is a list of the activities and assignments you must complete in this week. 

Activity	Due Date	Estimated Time Required	Points
View Week 1 Lecture and read associated materials	1/15	1 hour	N/A
Submit your Week 1 Discussion: Initial Post	1/19	varies	50 points
Submit your Week 1 Discussion: Response Posts	1/23	varies	50 points

By default, all assignment is due at midnight (11:55 pm), central time in U.S.

Tips for Success: To do well in this week, I recommend that you do the following:

• When possible, provide tips and suggestions to your peers in this class. As a learning community, we can help each other learn and grow. One way of doing this is by helping to address the questions that your peers pose. By engaging with each other, we’ll all learn better.
• It’s always a good idea to refer to the readings we've read during this week and reference them in your responses. When appropriate, critique the information presented.
• Take notes while you read the materials for this week. By taking notes, you are interacting with the material and will find that it is easier to remember and to understand. With your notes, you’ll also find that it’s easier to write your assignments. So, go ahead, do yourself a favor, take some notes!

1.1 Background and Context of Global Health.

• Identify community needs through observation.
• Discover innovative ways of designing and implementing a solution.
• Understand the need for context in design.
• Identify cultural issues which affect uptake.

1.2 Course Layout: Modular design to step you through the design process.

• Sections 1-3: Background and Context for Healthcare in West Africa
• Sections 4-6: Human/User Centered Design Approaches
• Section 7: Cultural Concerns
• Section 8: Sustainable Design Process

1.3 The term "Global Health".

• Global health is a term that developed in the last few decades to capture the complex problems in healthcare.
• "Health problems, issues, and concerns that transcend national boundaries and which may be influenced by circumstances or experiences in other countries which are best addressed by cooperative actions and solutions" (Institute of Medicine, USA 1997)

 1.4 Many disciplines play a role in Global Health.

Examples of these disciplines are Social sciences, Behavioral sciences, Law, Economics, Engineering, Environmental sciences and Agriculture.

1.5 Determinants of health. 

1.6 Additional determinants of health.

Complicated issues that aren't directly captured in determinants of health are Malnutrition, Sanitation and Vehicular traffic.

1.7 Measurements used to determine health status by the WHO and UN.

Examples of these measurements are cause of death, life expectancy at birth, maternal mortality rate, infant mortality rate and child mortality rate.

8 Shift from communicable to non-communicable diseases.

Over the last 30 years, in developed nations, the shift is moving from communicable to non-communicable diseases.

Comment: What is one stand-out issue for you in this update? Talk with other members' comments on their stand-out issues by starting your comment with @Name. 

Make an Update: Infectious diseases are communicable, but could the following also be communicable? Why or why not? dietary changes, a lack of physical activity, automobile related issues, smoking, stress and urbanization. Give an example of one communicable or non-communicable disease, and discuss its key aspects which define it is communicable or non-communicable. Include links, data, media and other documentary evidence in your update. Comment on at least three or four other updates. (Look out particularly for updates that don't have comments yet.)

Week 2 Overview: Welcome to Week 2. Now that we know about the context of health in West Africa, we will go into details about specific diseases/disorders that affect the region.

Time: This week will last 7 days and should take approximately 15 hours of dedicated time to complete, with its readings and assignments.

Goals and Objectives: At the end of this week, you will be able to:

• Identify diseases and disorders that are prevalent to the region.
• Know details of key diseases, such as malaria and ebola.
• Use information on health metrics provided by the WHO to compare health metrics and gain insight into complex contributing factors.

Key Phrases: Keep your eyes open for the following key terms or phrases as you complete the readings and interact with the lecture. These topics will help you better understand the content in this week.

• ·Morbidity
• ·Stunting

Guiding Questions: Develop your answers to the following guiding question while completing the readings and as you work through the week.

• What types of complex contributing factors affect health care?

Instructional Activities: Below is a list of the activities and assignments you must complete in this week.

Activity	Due Date	Estimated Time Required	Points
View Week 2 Lecture and read associated materials	1/22	1 hour	N/A
Submit your Week 2 Discussion: Initial Post	1/26	varies	33 points
Submit your Week 2 Discussion: Response Posts	1/30	varies	33 points

By default, all assignment is due at midnight (11:55 pm), central time in U.S.

Tips for Success: To do well in this week, I recommend that you do the following:

• Review the readings a number of times to gain a solid understanding of the key questions and concepts introduced in this week.
• When possible, provide tips and suggestions to your peers in this class. As a learning community, we can help each other learn and grow. One way of doing this is by helping to address the questions that your peers pose. By engaging with each other, we’ll all learn better.
• It’s always a good idea to refer to the readings we've read during this week and reference them in your responses. When appropriate, critique the information presented.
• Take notes while you read the materials for this week. By taking notes, you are interacting with the material and will find that it is easier to remember and to understand. With your notes, you’ll also find that it’s easier to write your assignments. So, go ahead, do yourself a favor, take some notes!

2.1 Poor and Under-Resourced Disproportionately Affected.

Many diseases and disorders disproportionately affect the poor and under-resourced such as: infectious disease, Infections, Malnutrition, Cancer, Chronic respiratory and heart diseases, Mental health and Trauma.

2.2 Population Using Improved Water and Sanitation.

2.3 Utilization of Health Services.

2.4 State of the Health System Is Improving.

State of the health system is improving as of WHO report in 2014.

• National health plans in place.
• Health information and disease surveillance systems are weak. Some have district level reporting on a monthly basis.
• About 70% of the population lives within 5 km of a health facility.
• Only one doctor for 30,000 people in Sierra Leone and Liberia.

2.5 Public Health Spending

2.6 Country Statistics and Global Health Estimates.

2.7 Progress toward Millenium Development Goals.

Sierra Leone and West Africa are making progress toward the World Health Organization Millennium Development Goals.

2.8 Causes of Death for Children under 5.

Causes of death for children under 5 show stark differences.

2.9 Under-Five Mortality.

2.10 Malaria.

• Transmitted by mosquitos
• 198 million causes in 2013
• 584,000 deaths. (Majority children under 5 in sub-Saharan Africa).
• Socioeconomic impact (GDP for countries with high levels of malaria transmission is less than 1/5 of countries without malaria).
• Main prevention. (Mosquito control, Sleep with mosquito net).

2.11 Ebola Virus Disease.

• Transmitted through direct contact with body fluids of a symptomatic person. (Skin, Mucous membranes, Parenteral)
• Easily mistaken for other diseases. (Malaria, Typhoid fever, Yellow fever, Lhasa Fever).

 2.12 Personal Protective Equipment.

WHO recommends:

• Face shield or goggles
• Fluid-resistant medical/surgical mask
• Double gloves
• Disposable gown/coverall
• Head cover
• Waterproof apron
• Waterproof boots

2.13 Maforki Ebola Treatment Unit.

 2.14 Ebola Treatment Unit.

2.15 Admission.

2.16 Post-Ebola Effects on Social Aspects.

• Survivors: 1) Loss of employment, family, home. 2)Harassment. 3) Victims of violence
• Health workers: 1) Unnecessary quarantine. 2) Loss of employment, family, home. 3) Harassment.

2.17 Post-Ebola Effects on Healthcare.

Comment: What is one stand-out issue for you in this update? Talk with other members' comments on their stand-out issues by starting your comment with @Name.

Make an Update: Review the WHO statistics for the US and Sierra Leone. Pick one of the datasets not discussed in this lecture and compare the two countries. What is different? Why? What social or environmental factors might be at play? Include links, data, media and other documentary evidence in your update. Comment on at least three or four other updates.

Week 3 Overview: Welcome to Week 3. We will focus this week on technology in different healthcare settings.

Time: This week will last 7 days and should take 15 hours of dedicated time to complete, with its readings and assignments.

Goals and Objectives: At the end of this week, you will be able to:

• Identify different types of technology in use for healthcare.
• Identify key indicators for uptake in low-resource settings.
• Understand the complex system for vetting and adopting technologies in these settings.

Key Phrases: Keep your eyes open for the following key terms or phrases as you complete the readings and interact with the lecture. These topics will help you better understand the content in this week.

• Healthcare technology assessment
• Gross domestic product

Guiding Questions: Develop your answers to the following guiding questions while completing the readings and as you work through the week.

• What are the leading factors which affect healthcare uptake in a low-resource setting?
• Who has the most influence on the process?

Instructional Activities: Below is a list of the activities and assignments you must complete in this week.

Activity	Due Date	Estimated Time Required	Points
View Week 3 Lecture and read associated materials	1/29	1 hour	N/A
Submit your Week 3 Discussion: Initial Post	2/2	varies	25
Submit your Week 3 Discussion: Response Posts	2/6	varies	25

By default, all assignment is due at midnight (11:55 pm), central time in U.S.

 

Tips for Success: To do well in this week, I recommend that you do the following:

•  Review the readings a number of times to gain a solid understanding of the key questions and concepts introduced in this week.
• When possible, provide tips and suggestions to your peers in this class. As a learning community, we can help each other learn and grow. One way of doing this is by helping to address the questions that your peers pose. By engaging with each other, we’ll all learn better.
• It’s always a good idea to refer to the readings we've read during this week and reference them in your responses. When appropriate, critique the information presented.
• Take notes while you read the materials for this week. By taking notes, you are interacting with the material and will find that it is easier to remember and to understand. With your notes, you’ll also find that it’s easier to write your assignments. So, go ahead, do yourself a favor, take some notes!

3.1 Healthcare Economics Is Complex.

• As countries become richer, the health care costs for that country rise.
• Global health economy grows at a faster rate than the GDP because health and economics have a bidirectional relationship.

3.2 Example of the Vicious Cycle.

3.3 Operating Rooms in High-Resourced Nations.

In nations with access to high-technology resources, operating rooms are stocked with equipment.

3.4 Operating Rooms in Low-Resourced Nations.

Low-resourced nations have much less technology in the operating rooms.

3.5 Breakdown of Costs for OR Usage.

• For a baseline surgical center, the fixed equipment alone (beds, lights, anesthesia machines) costs $500K.
• Many disposables costs thousands each time a procedure needs to be performed.
• Costs vary based on GDP.

3.6 Reasons for Low Levels of Technology.

There are many reasons why a low-resourced nation does not have high levels of technology.

• High investment costs
• Inadequate repair and maintenance skill
• Poor access to consumables
• Lack of pressurized air and oxygen
• Electrical supply

3.7 "Back to Basics" Approach to Healthcare.

• Many clinics use a “back to basics” approach to medicine and focus on what they can do.
• Empathy and culturally appropriate care
• Physical exams for clinical signs
• Lab findings based on what is available
• Use medication from generic list. (May require more medications or combining medications for same effect).
• Treat multiple options for disorders that overlap. (I.e., malaria versus typhoid fever).
• Monitor patients and follow up to look for clinical evolution of symptoms.

3.8 Outcomes of Low Tech Care.

• Most patients recover to full function
• Average hospital stays are longer than in US
• Total costs to patients is much less

3.9 Innovations in Diagnosis and Treatment.

The past five decades have brought amazing innovations in the ways that we treat and diagnose diseases.

3.10 Healthcare Technology Assessment (HTA).

WHO performed a healthcare technology assessment (HTA) in 2015. The survey had five broad sections that aimed to measure

• Utilization of HTA in public sector decision making
• Scope of HTA and availability of guidelines 
• Institutional capacity and human resources supporting HTA
• Governance of HTA process
• Requirements for strengthening HTA capacity.

3.11 Countries Having a Formal Process for Information Compilation for Decision Making.

Respondents were asked to report if their country had a system for systematically collected data and if they considered the impacts of a particular health technology or intervention.

3.12 Purposes of Undertaking HTA.

What drives a region to take on new healthcare technologies varies based on the GDP.

 3.13 Link between Income Level and Focus of Healthcare Technology Assessment.

What drives a region to take on new healthcare technologies varies based on the GDP. 

3.14 Areas that Countries Considered in Evaluation for HTAs.

3.15 Medicines.

3.16 Vaccines.

3.17 Medical Devices.

3.18 Surgical Interventions.

3.19 Population Level Health Interventions.

3.20 Organizations Requesting HTAs in the Past 12 Months.

As shown in this graph, in order to be taken under consideration, the ministry of health has the most influence.

3.21 Overall Findings of the Assessments.

Fewer than half of all responding countries had academic or training programs to build HTA capacity. This appears to be a major barrier to increasing use of HTA. Other issues are listed below.

Comment: What is one stand-out issue for you in this update? Talk with other members' comments on their stand-out issues by starting your comment with @Name.

Make an Update: Watch WHO: The Power and Potential of Medical Devices (YouTube). Pick one of the devices that you saw/were mentioned in the video, and write a discussion post on the feasibility for its use in West Africa using the HTA framework.

• Safety
• Clinical effectiveness
• Economic considerations
• Ethical issues
• Acceptability to patients
• Education needed to support device

Include links, data, media and other documentary evidence in your update. Comment on at least three or four other updates.

Week 4 Overview: Welcome to Week 4. This week we will begin exploring design for low-resource settings and identifying areas for innovation. This is where the fun begins!

Time: This week will last 7 days and should take approximately 15 hours of dedicated time to complete, with its readings and assignments.

Goals and Objectives: At the end of this week, you will be able to:

• Be familiar with human-centered design (HCD) and its definition.
• Be familiar with the basic process and methods in HCD.
• How to define opportunities for health-technology design.

Key Phrases: Keep your eyes open for the following key terms or phrases as you complete the readings and interact with the lecture. These topics will help you better understand the content in this week.

• Human-centered design (HCD)

Guiding Question: Develop your answers to the following guiding question while completing the readings and as you work through the week.

• What solutions can we identify from watching videos of different healthcare settings?

Instructional Activities: Below is a list of the activities and assignments you must complete in this week.

Activity	Due Date	Estimated Time Required	Points
View Week 4 Lecture and read associated materials	2/5	1 hour	N/A
Submit your first draft of Week 4 Paper	2/9	Varies	20
Submit your peer Review of Week 4 Paper	2/11	Varies	10
Submit your final version of Week 4 Paper	2/13	Varies	30

In sections 4-8 of this learning module, we are now going to explore strategies and processes of Human/User-Centered Design.

4.1 Human-Centered Design (HCD).

• Approach to design that focuses on better understanding needs and finding innovative solutions to meet these needs and delivering them with financial sustainability in mind – IDEO
• Originally designed for NGOs who work with communities in Africa, Asia, and Latin America

4.2 Hear, Create, Deliver (HCD).

• Hear – prepare for and conduct field research, interviews, observations in a community. Observe needs and desires.
• Create – translate field research into ideas that may be prototypes, opportunities, or other solutions that are technically and organizationally feasible to meet needs.
• Deliver – realize solutions with financial sustainability in mind to launch tangible solutions in a community.

4.3 Key Steps along the Way.

• Gain knowledge so that you know the right questions to ask.
• Gain empathy with your target users by talking to and observing them.
• Create a point of view statement to inform your design. (User + need + insight).
• Generate as many ideas as possible. (High-tech and low-tech).
• Make, sketch, role play, etc. to explore your idea

4.4. Innovations.

The process has led to innovations such as the HeartStart defibrillator, CleanWell natural antibacterial products, and the Blood Donor System for the Red Cross.

Comment: What is one stand-out issue for you in this update? Talk with other members' comments on their stand-out issues by starting your comment with @Name.

Peer Reviewed Project: Look critically at the environments depicted in the videos, listen to the words in the interviews, and come up with a list of needs for the different environment/people/patients.

Weeek 5 Overview: Welcome to Week 5. We will re-examine key points of HCD and provide more guidance on how to identify innovative needs using the observations.

Time: This week will last 7 days and should take approximately 15 hours of dedicated time to complete, with its readings and assignments.

Goals and Objectives: At the end of this week, you will be able to:

Know how to implement HCD by

• Identifying existing knowledge and resources to collect information
• Selecting appropriate interview methods and stakeholders
• Designing interviews for information gathering
• Translating observations into design opportunities

Key Phrases: Keep your eyes open for the following key terms or phrases as you complete the readings and interact with the lecture. These topics will help you better understand the content in this week.

• Matching needs with observations and outcomes

Guiding Questions: Develop your answers to the following guiding questions while completing the readings and as you work through the week.

• What did I assume when I did this activity initially?
• Was I using inherent bias from my own context into what technology would help the healthcare provided?

Instructional Activities: Below is a list of the activities and assignments you must complete in this week. 

Activity	Due Date	Estimated Time Required	Points
View Week 5 Lecture and re-watch videos in Week 4 Lecture	2/12	1 hour	N/A
Submit your Week 5 Discussion: Initial Post	2/16	varies	33
Submit your Week 5 Discussion: Response Posts	2/20	varies	33

By default, all assignment is due at midnight (11:55 pm), central time in U.S.

Tips for Success: To do well in this week, I recommend that you do the following:

• Review the readings a number of times to gain a solid understanding of the key questions and concepts introduced in this week.
• When possible, provide tips and suggestions to your peers in this class. As a learning community, we can help each other learn and grow. One way of doing this is by helping to address the questions that your peers pose. By engaging with each other, we’ll all learn better.
• It’s always a good idea to refer to the readings we've read during this week and reference them in your responses. When appropriate, critique the information presented.
• Take notes while you read the materials for this week. By taking notes, you are interacting with the material and will find that it is easier to remember and to understand. With your notes, you’ll also find that it’s easier to write your assignments. So, go ahead, do yourself a favor, take some notes!

5.1 Ethnography

Ethnography is the study of humans in their natural habitat.

5.2 Use Ethnography to Identify Customer Needs.

Using ethnography at the beginning of the design process is key to help identify customer needs.

• Customer needs a car, not "bells and whistles."
• Don't impose your beliefs on a system.

5.3 Inputs to the Problems.

5.4 Defining the Problem.

Evaluate problems based on the inputs

• Why does the problem occur?
• What are the possible explanations and causes?
• What are the medical implications of the problem? (Anatomy, physiology, epidemiology, etc.)
• Who are the stakeholders? Who is impacted?

1. Patients? With what specific conditions?
2. Providers? What type, and in what specialties?
3. The overall healthcare system? In what ways? Other stakeholders?

• How are they negatively impacted? (Clinical outcomes, safety/risk, inconvenience, recovery time, ease-of-use, productivity, cost, etc.)
• How severe is the problem?
• In what setting does the problem occur?

5.5 Engineering World Health.

Needs finding methods.

• Basic research

1. Morbidity, mortality, incidence, and prevalence
2. Summary data of disease, economics, etc.

• Inventory

1. What they should have minus what they have equals what they need.

• Failure analysis

1. If something is broken and they want it fixed, there is a need.

• The long interview

1. 30-60 minute, in-depth interviews with doctors, nurses, staff, and patients

* Based on notes from professor Robert Malkin, Duke University.

5.6 Converting Observations to Needs Statements.

Comment: What is one stand-out issue for you in this update? Talk with other members' comments on their stand-out issues by starting your comment with @Name.

Make an Update: Re-watch videos taken at several different types of clinics, in Section 5. Reexamine the environment, list clinical needs for the different contexts using the empathetic approach. Use the HCD framework provided in lecture by using the Needs Template (above). Save or screenshot your completed from as an image (.jpg), and share with the group in an update. Comment on at least three or four other needs templates.

Week 6 Overview: Welcome to Week 6. Now that we have ideas, we will start to explore them using early prototyping or pretotyping.

Time: This week will last 7 days and should take approximately 15 hours of dedicated time to complete, with its readings and assignments.

Goals and Objectives: At the end of this week, you will be able to:

• Brainstorm ways to test ideas in a fast paced, efficient, and inexpensive format.
• Understand how to test the interest of your market.

Key Phrases: Keep your eyes open for the following key terms or phrases as you complete the readings and interact with the lecture. These topics will help you better understand the content in this week.

• · Pretotype

Guiding Questions: Develop your answers to the following guiding questions while completing the readings and as you work through the week.

• How do I know if I identified a good idea for my context?
• How can I test my idea in an efficient manner?

Instructional Activities: Below is a list of the activities and assignments you must complete in this week.

Activity	Due Date	Estimated Time Required	Points
View Week 6 Lecture and re-watch videos in Week 4 Lecture	2/19	1 hour	N/A
Submit your Week 6 Discussion: Initial Post	2/23	varies	33
Submit your Week 6 Discussion: Response Posts	2/27	varies	33
Begin work on project	Last day of class	5 hours	400

By default, all assignment is due at midnight (11:55 pm), central time in U.S.

6.1 Pretotyping.

The idea that you can prototype anything using meager means.

6.2 What Does It Mean to Prototype?

• Externalize internal thinking in a tangible form, rendering it more intelligible by others and the world.
• Allows you to play and explore design space.
• Answers big questions with as little energy and expense as possible.

6.3 Video

Tom Chi talks about several examples of early prototyping and success that has come from it.

6.4 Ways to Pretotype – Build a Physical Object.

• Cardboard is basically free and rigid enough to handle moving parts.

6.5 Ways to Pretotype - Skits.

• Just as in brainstorming, skits and role playing can gain insight into user needs
• Adds empathy to your design

6.6 Pretotyping Allows You to Fail Sooner.

Failing is good.

• Tells you where to invest your time in future prototypes
• Gives your client a chance to be a part of the design team
• Lets you see how others will interface with your design

6.7 Testing a Pretotype.

Just hand it over.

• Don't sell it to your client.
• Let the tester experience it, don't demo it.

1. You can provide explanation of what a particular symbol or part is
2. Expect and embrace misunderstandings

• Give live feedback
• Keep it, but don't dwell on it
• Always start new!

"Say it with numbers" – Google.

• Initial Level of Interest (ILI)

1. ILI = number of actions taken/number of opportunities for action offered
2. Snapshot performance

• Ongoing Level of Interest (OLI)

1. Tracking of ILI or other key performance variable over time

Comment: What is one stand-out issue for you in this update? Talk with other members' comments on their stand-out issues by starting your comment with @Name.

Make an Update: Brainstorm a pretotype for one of the sample projects on the WHO Compendium of Innovative Health Technologies for Low-resource Settings list. Describe your pretotype idea for your project and a testing plan using your pretotype. Include links, images, diagrams, in your brainstorming update. Comment on at least three or four other updates.

Week 7 Overview: 

Welcome to Week 7. We will learn about cultural and social issues for uptake in different contexts in more detail and apply these concepts to our ideas.

Time: This week will last 7 days and should take approximately 15 hours of dedicated time to complete, with its readings and assignments.

Goals and Objectives: At the end of this week, you will be able to:

• Identify cultural and social blocks to technology innovation.

Key Phrases: Keep your eyes open for the following key terms or phrases as you complete the readings and interact with the lecture. These topics will help you better understand the content in this week.

• Slow/stalled ideas

Guiding Question: Develop your answers to the following guiding question while completing the readings and as you work through the week.

• What makes some ideas take off and others fail?

Instructional Activities: Below is a list of the activities and assignments you must complete in this week.

Activity	Due Date	Estimated Time Required	Points
View Week 1 Lecture and read associated materials	2/26	1 hour	N/A
Submit your Week 1 Discussion: Initial Post	3/2	varies	33
Submit your Week 1 Discussion: Response Posts	3/6	varies	33

By default, all assignment is due at midnight (11:55 pm), central time in U.S.

Tips for Success: To do well in this week, I recommend that you do the following:

• Review the readings a number of times to gain a solid understanding of the key questions and concepts introduced in this week.
• When possible, provide tips and suggestions to your peers in this class. As a learning community, we can help each other learn and grow. One way of doing this is by helping to address the questions that your peers pose. By engaging with each other, we’ll all learn better.
• It’s always a good idea to refer to the readings we've read during this week and reference them in your responses. When appropriate, critique the information presented.
• Take notes while you read the materials for this week. By taking notes, you are interacting with the material and will find that it is easier to remember and to understand. With your notes, you’ll also find that it’s easier to write your assignments. So, go ahead, do yourself a favor, take some notes!

7.1 What Makes Ideas Stick?

7.2 Why?

7.3 Stalled Ideas.

• Attack problems that are big, but might be invisible to most people. Think global warming or sugar-laden snacks leading to diabetes
• We become infatuated with inventing new technologies and fail to look at what's in front of us.

7.4 What Makes Ideas Stick?

In our era of electronic communications, we've come to expect that important innovations will spread quickly.

• In-vitro fertilization
• Genomics
• Communication technologies.Twitter, Facebook, etc.

7.5 New Norms.

• To create new norms, you need to understand the landscape.

1. Existing norms and barriers
2. You are getting in their way.

• Try to make sure that you understand what your device can do for people so that you can sell it better.
• Make an emotional connection to your audience.

Comment: What is one stand-out issue for you in this update? Talk with other members' comments on their stand-out issues by starting your comment with @Name.

Make an Update: Pick one of the problems identified in the article “Sharing Slow Ideas” and describe the health problem and write a need statement. What technologies have been developed to address this solution? What are some reasons that the technology solution may not have been used for this issue in this setting? Include links, data, media and other documentary evidence in your update. Comment on at least three or four other updates

Week 8 Overview:

Welcome to Week 8. In this last week, we will address local repair/build considerations and entrepreneurial efforts to maintain a product in country.

Time: This week will last 7 days and should take approximately 20 hours of dedicated time to complete, with its readings and assignments.

Goals and Objectives: At the end of this week, you will be able to:

• Identify characteristics for market feasibility.
• Identify characteristics for manufacturing feasibility.

Key Phrases: Keep your eyes open for the following key terms or phrases as you complete the readings and interact with the lecture. These topics will help you better understand the content in this week.

• Feasibility

Guiding Questions: Develop your answers to the following guiding questions while completing the readings and as you work through the week.

• Now that I have a great idea, how can I make sure it's appropriate for the local context?
• Can it be built and marketed in country?
• What barriers will I encounter?

Instructional Activities: Below is a list of the activities and assignments you must complete in this week.

Activity	Due Date	Estimated Time Required	Points
View Week 8 Lecture and read associated materials	3/5	1 hour	N/A
Submit your Week 8 Discussion: Initial Post	3/9	varies	35
Submit your Week 8 Discussion: Response Posts	3/13	varies	35
Submit your first draft of Final Project	3/9	varies	100
Submit your peer review of Final Project	3/11	varies	100
Submit your final version of Final Project	3/13	varies	200

Tips for Success: To do well in this week, I recommend that you do the following:

• Review the readings a number of times to gain a solid understanding of the key questions and concepts introduced in this week.
• When possible, provide tips and suggestions to your peers in this class. As a learning community, we can help each other learn and grow. One way of doing this is by helping to address the questions that your peers pose. By engaging with each other, we’ll all learn better.
• It’s always a good idea to refer to the readings we've read during this week and reference them in your responses. When appropriate, critique the information presented.
• Take notes while you read the materials for this week. By taking notes, you are interacting with the material and will find that it is easier to remember and to understand. With your notes, you’ll also find that it’s easier to write your assignments. So, go ahead, do yourself a favor, take some notes!

In this final section of the learning module, we are going to consider the economics of developing nations as the context for local repair/build considerations.

8.1 Local Repair and Build Considerations.

According to the WHO report Landscape Analysis of barriers to developing and adapting technologies for global health purposes, several factors have been identified that tend to reduce the probability of technologies to be transferred, developed, or adapted for health purposes in low-resource settings.

• Inefficient, inadequate or non-existent data-gathering systems and information to understand: population health needs, medical devices required by clinical guidelines and protocols, as well as health care infrastructure and equipment to support health services delivery
• Lack of capacity development in LMIC markets to encourage local industry models to enter the medical devices segment, coupled with lack of innovation in these models to enable new technologies to meet market needs
• Low levels of protection and enforcement of intellectual property rights that challenge innovators and producers of medical devices, limiting rather than stimulating in-country innovation, production, and delivery of medical products to populations at the 'bottom-of-the-pyramid'
• Lack or insufficient technically trained and skilled workforce to ensure effective and safe use, as well as maintenance of, medical devices
• Limited implementation of international standards and regulatory procedures to promote quality products
• Evident lack of information and dissemination networks for innovative devices to allow selection, procurement, and safe use

(Landscape analysis of barriers to developing or adapting technologies for global health purposes. Geneva, World Health Organization, 2010).

8.2 Components.

The challenge to local device development requires the coordination of several components.

8.3 Feasibility of Local Production.

WHO created a tool to assess feasibility of local production for a medical device.

8.4 Questions to Determine Build Feasibility.

1. Can spare parts be obtained easily?
2. Would the manufacturer or related service provider offer training in the use and operation of the device/technology?
3. Does the manufacturer or related service provider offer maintenance or offer training in maintenance?
4. Is the necessary ancillary equipment for operating the medical equipment readily available?
5. Is there basic infrastructure such as water or electrical power?
6. Are environmental conditions like ambient temperature or humidity suitable for the use of the medical device/technology?
7. Are sufficient supportive health care services available (e.g., rehabilitation for follow-up services)?

8.5 Questions to Determine Market Feasibility.

1. Is there an adequate budget to purchase medical devices and technology?
2. Is the medical technology too costly for the remit or allocated budget?
3. Is there an adequate budget for maintenance of the equipment?
4. Are there sufficient numbers of skilled/trained personnel to operate the device/technology?
5. Are there sufficient numbers of skilled/trained personnel to maintain the medical device/technology?

8.6 Logistical Considerations.

Logistical considerations are another important factor in the decision to enter a market. 

• Delivery channels for consumables, spare parts, maintenance, and even delivery and installation of medical equipment once it is procured is an issue for companies.
• Lack of infrastructure such as roads, electricity or water, temperature control, remote health facility locations, or stable means of communication exacerbate logistical challenges.

8.7 Going for the Early Win.

• Industry representatives suggested that consideration also be given to the utilization or adaptation of existing, not necessarily medical, technologies rather than developing new technologies.
• One example is the growing area of eHealth, where mobile telephone technology is used in remote areas for consultations between healthcare professionals, training, or for sending health care information. This field of telemedicine is of high priority to WHO.
• Another example is the adaptation of medical devices to run on batteries or to be equipped with easy-to-use interfaces that allow even untrained persons to operate the device at the point of care, including in remote locations.

Comment: What is one stand-out issue for you in this update? Talk with other members' comments on their stand-out issues by starting your comment with @Name.

Make an Update: What are the factors that will determine build feasibility and market feasibility for your chosen design? You may need to consult additional outside research sources. Comment on at least three or four other updates.

In working through section 5, you identified clinical need statements for the videos. In sections 6-8, you learned various techniques to explore design solutions and perform feasibility of a design. For your design project, you will apply these techniques to your original project idea and propose a healthcare technology solution for the need you have identified. Your design project write-up will include:

• A video or online poster advertising your product to the Sierra Leonean community
• Needs statement with background research to support clinical need
• Technology assessment with considerations of safety, economic impact, ethical issues, acceptability to patients, and education needed to support the technology
• Pretotype plan with evaluation plan
• Build and market feasibility

Use Scholar's media capacities fully, including if necessary the math editor (if you don't know TeX, you can find tools on the web which will convert scanned handwritten equations).

In this project, you will be required to:

• Draft your design project write up. Look out for a project request in your notification area and take the link to the blank work created. Your first task should be to About this Work => Info => Title and give your work a title. Be sure to use the Structure tool in the "About this Work" area to create sections and subsections. You can find information about how to use this tool at section 3.5 in the Help area, top right of the Scholar screen.
• Peer review others' projects. Look out for peer review requests in your notifications and take the link. Respond against each of the review criteria, and make in-text annotations.
• Give the peer reviewers feedback on their feedback.
• Revise your work, based on the reviewers' comments. Look out for the notification to start revising.
• Write a self review beside the latest version of your work at Feedback => Reviews => Review Work. In what ways did you revise your work? Which peer feedback did you use? How would you rate your finished work?
• When published to your profile page and to the community, we can all discuss your projects. If you want to make further revisions then, it is possible to republish.