Innovating for the Bottom of the Pyramid: Case Studies in Healthcare from India

Abstract

The much vaunted fortune at the bottom of the pyramid (BoP) has proven hard to reach. This is because realizing the opportunities provided by the BoP market faces several challenges, ranging from affordability to a lack of human and physical infrastructure. This paper argues that overcoming these challenges to achieve “frugal innovation” requires design strategies which deploy new technologies and organizational approaches. To substantiate its argument, the paper presents case studies of four firms and their innovations in the health care domain. All the cases are from India, which has emerged an ideal location for developing products and services for the BoP market. India not only has the skills to propose new technological solutions, but also a market characterized by socioeconomic diversity to demand various organizational approaches. Two cases focus on diagnostic devices and products: one is a portable ophthalmic imaging device to reduce preventable blindness, while the other is a baby warmer to lower infant mortality by preventing hypothermia. The other two cases focus on health care delivery: one relies on telemedicine while the other relies on mobile telephony to provide access for hard-to-reach populations. All four cases describe the circumstances surrounding the design, development, and deployment of the products and services. The paper will point to the challenges the firms faced, even as they successfully designed for the BoP context. For diagnostic devices, the challenge of positioning a new offering in the diagnostic devices ecosystem, especially in terms of quality and cost, figures prominently. For service delivery, the challenge is to negotiate and manage the balance between the technological and human elements in servicing those needing care. Each case provides insight into the factors responsible for the sustainable deployment of these innovations, thus enabling a degree of extrapolation of lessons.