Reproductive health services: “Business-in-a-Box” as a model social innovation

Abstract

Access to reproductive health services and products in remote and rural communities is a critical area of concern for developing countries. This article considers a pilot intervention in three districts of Pakistan where "Business-in-a-Box" as a model of place-based social innovation is used to improve the socioeconomic conditions of women in remote rural settings through socially responsible micro-franchising. It finds that such programmes help build a sense of community, ownership and grassroots capabilities and skills. The article also discusses the impacts of such actions on the individual and community life, and the need to upscale and sustain these initiatives.

The application of social innovation in healthcare: a scoping review

“…The outcomes of these models included positive behavioural change, building community social capital, and enhancing women’s participation and roles. The innovation within the entrepreneurial models were mechanisms to reduce costs of services [ 72 , 82 ], while also improving access to services and creating new employment opportunities.…”

“…The collective creation of social innovation in health (8/27 studies), either in cross-disciplinary actor teams or networks, has received greater attention. Firstly, the social innovation development process is used to overcome the siloed nature of health and to foster greater interdisciplinarity and intersectionality [ 61 , 62 , 66 , 67 , 69 , 81 , 82 , 87 ]. This is particularly well illustrated in relation to Chagas disease in Guatemala, where innovation in interventions involved collaboration from epidemiology, biology, anthropology, sociology, engineering and architecture, and various funding agencies, international non-governmental organisations, government and universities [ 61 ].…”

“…Throughout project implementation, training was delivered on leadership, accounting and other operational procedures to ensure the community can fully manage the initiative independently [ 65 ]. Another example, the Business-in-a-Box initiative in Pakistan, illustrates how adopting a micro-entrepreneurship approach to extending access to contraception can empower women to become self-employed income generators while meeting their health needs [ 82 ].…”

“…By building the capacity of marginalised or under-represented actors, they develop an enhanced level of agency and action which suggests a change in power relations taking effect. Many larger-scale social innovation care models had people-centredness as a core organising principle [ 76 , 80 , 82 ]. Models were designed to involve not only the patient or the beneficiary at the health centre, but also health workers.…”

“…The Buurtzog Neighbourhood Care model, for example, illustrated how, by enhancing patient and provider (nurse) autonomy, better outcomes in care provision were achieved and provider motivation and satisfaction were enhanced [ 76 ]. The iMOKO (New Zealand) and Business-in-a-Box (Pakistan) cases both illustrate empowerment of the local community by placing access to healthcare in the hands of trusted community members such as teachers, and by giving women in the community opportunities for income generation [ 80 , 82 ]. The Time Bank model ascribed dignity and worth to the life of each person, and this highlighted the value of community members as active participants in healthcare: “The first core value of the Time Bank operations is asset, something of value to share with someone else … no one is worthless in the world … everyone is a contributor to society in his or her own way” [ 84 ].…”