That’s not how the learning works – the paradox of Reverse Innovation: a qualitative study

Abstract

BackgroundThere are significant differences in the meaning and use of the term ‘Reverse Innovation’ between industry circles, where the term originated, and health policy circles where the term has gained traction. It is often conflated with other popularized terms such as Frugal Innovation, Co-development and Trickle-up Innovation. Compared to its use in the industrial sector, this conceptualization of Reverse Innovation describes a more complex, fragmented process, and one with no particular institution in charge. It follows that the way in which the term ‘Reverse Innovation’, specifically, is understood and used in the healthcare space is worthy of examination.MethodsBetween September and December 2014, we conducted eleven in-depth face-to-face or telephone interviews with key informants from innovation, health and social policy circles, experts in international comparative policy research and leaders in the Reverse Innovation space in the United States. Interviews were open-ended with guiding probes into the barriers and enablers to Reverse Innovation in the US context, specifically also informants' experience and understanding of the term Reverse Innovation. Interviews were recorded, transcribed and analyzed thematically using the process of constant comparison.ResultsWe describe three main themes derived from the interviews. First, ‘Reverse Innovation,’ the term, has marketing currency to convince policy-makers that may be wary of learning from or adopting innovations from unexpected sources, in this case Low-Income Countries. Second, the term can have the opposite effect - by connoting frugality, or innovation arising from necessity as opposed to good leadership, the proposed innovation may be associated with poor quality, undermining potential translation into other contexts. Finally, the term ‘Reverse Innovation’ is a paradox – it breaks down preconceptions of the directionality of knowledge and learning, whilst simultaneously reinforcing it.ConclusionsWe conclude that this term means different things to different people and should be used strategically, and with some caution, depending on the audience.Electronic supplementary materialThe online version of this article (doi:10.1186/s12992-016-0175-7) contains supplementary material, which is available to authorized users.

Parenting Programs for Underserved Populations in Low- and Middle-Income Countries: Issues of Scientific Integrity and Social Justice

“…The bi-directional communication among HIC and LMIC partners is not only beneficial for good practice of research grounded in social justice, but also to "bring back" lessons learned from LMIC. The notion that the knowledge gained in LMIC is relevant to HIC is not new, and is well documented in different areas in the literature (Harris, Weisberger, Silver, Dadwal, & Macinko, 2016). Different names have been used to label the process of "bringing back" the lessons learned to HIC, such as"reverse innovation" (Bhattacharyya et al, 2017;Immelt, Govindarajan, & Trimble, 2009;Trimble & Govindarajan, 2012), "innovation blowback" (Brown & Hagel, 2005), and "social innovation" (Chambon, David, & Devevey, 1982).…”

“…However, the field of global health still have a lot to learn as sometimes the innovations or lessons learned from LMIC tend to be discounted and not valued (Harris et al, 2016), including bias against publication and shared information from LMIC researchers (Harris et al, 2017).…”

Delivering cost effective healthcare through reverse innovation

“…Reverse innovation is a broad term, encompassing innovations that have been ideated, trialled, tested, and adopted in low and middle income countries, before being used by healthcare providers in high income countries 234. The term itself has problems, arguably perpetuating the view that innovation normally flows from high to low income settings, thereby undermining the shift in knowledge translation that it seeks to promote 5. Nevertheless, reverse innovation presents a broad range of opportunities and challenges in healthcare.…”

Review of the reverse innovation series in globalization and health – where are we and what else is needed?

“…So, is there a better term that we should be using that reflects the challenge and the ambition of the process? Suggestions have included 'co-development', 'bidirectional learning' and 'mutual reciprocity' but the field requires thoughtful reviews of the use of language in global health contexts and how these terminologies are applicable in certain settings and not others [22]. The pathway to global innovation flow may indeed be multi-fold and certain terms may resonate more in certain parts of the world than in others.…”