Context & Purpose

Mesoma is a Nigerian youth inspired to respond to an open call for creative ideas to improve youth HIV testing in her local community. In partnership with other youth and a multi-disciplinary group, she developed a youth-led participatory intervention grounded in community needs and preferences. Her team pitched the idea to local public health leaders, dazzling the group and winning a commendation and support for implementation. However, given that many innovations will fail, public health leaders and funders would only agree to support more widespread implementation if specific measurable key progress indicators were achieved as part of the initial pilot. Specifically, the intervention had to increase HIV testing by at least 15%, retain at least 80% of youth, convene youth and steering committees, and address other key issues. While public health leaders and funders are familiar with monitoring and evaluation generally, they were struck with the important question – how do we measure and evaluate social innovations in health?

We define social innovation in health as inclusive solutions to address the health care delivery gap that meet the needs of end users through a multi-stakeholder, community-engaged process.¹

Social innovations may need a framework to guide monitoring and evaluation because the genesis of these innovations may be from disciplines outside of health, maybe for commercial purposes and may emerge from hackathons, open crowdsourcing calls, and other open events. What are feasible ways of demonstrating the health, social, and other impacts associated with social innovation beyond the typical health outcomes? Should social innovations in health be measured differently from other health interventions? How can we democratize research so that non-experts and a broader range of people are engaged in evaluation? These are some of the key questions that we will address in this conceptual framework. Brilliant social innovation ideas are developed every day in a wide range of fields.^1-4

Yet relatively few examples of social innovations have been carefully monitored and evaluated. The rapid growth of social innovation in practice and research has contributed to a wide range of important new health related devices and services detailed in this report. However, scaling up their use in the same location, iteratively improving the approach, and adapting the innovation for other settings all depend on high-quality monitoring and evaluation. Monitoring and evaluation are an essential component of social innovation in health in order to focus the lens on what works and what does not work. Responding to this need, the Social Innovation in Health Initiative (SIHI) in partnership with TDR (the Special Programme for Research and Training in Tropical Diseases, co-sponsored by UNICEF, UNDP, the World Bank and WHO) organized workshops which identified the need for social innovation monitoring and evaluation.^5,6

Purpose

The purpose of this document is to provide a monitoring and evaluation framework for social innovations in health. Supporting monitoring and evaluation will help to democratize research and engage more stakeholders to work in partnership with researchers. The evidence generated will help us to understand effectiveness and the potential for sustainability.

Stakeholders

This framework is designed for innovators, researchers, government leaders, community-based organization directors, implementers, implementation scientists, individuals who organize hackathons or crowdsourcing calls, people interested in social innovation, and other stakeholders. The process of social innovation is inherently tied to community engagement that demands close local partnerships. From a program perspective, monitoring and evaluation generate data to guide innovators, funders, policy makers, and others interested in the intervention.

Understanding the enabling and limiting factors of a project provides a compass for iteratively enhancing health services over time. Routine monitoring can be used to increase equity, expand service coverage, and improve health service quality. From a research perspective, monitoring and evaluation are critical for demonstrating individual and population-level impact, including both the benefits and the adverse outcomes associated with a social innovation. The framework focuses on monitoring and evaluating social innovations in health.

It identifies the core set of activities recommended to steadily progress towards achieving impact in short- and long-term scenarios. This framework aims to provide innovators, researchers, program managers, and other stakeholders with a useful set of tools when designing, implementing, and/or evaluating social innovations in health as well as help individuals iteratively improve their social innovation. Social innovation in health research includes both implementation and non-implementation research.