By Anushree Banerji, Portfolio Manager
Earlier this fall, I joined our ecosystem partner, Insight Health Advisors (IHA), in Kisumu, Kenya, for the signing of a Memorandum of Understanding (MOU) with the Lake Region Economic Block (LREB) to co-implement the Mountain Model. The LREB, a bloc of 14 counties, is one of the six regional blocs established in Kenya for policy harmonization and resource mobilization. This makes it ideal to scale the Mountain Model – a demand-driven innovation adoption framework that leverages domestic resources to address urgent health challenges. Mountain Model implementation is currently funded by Grand Challenges Canada (GCC) in Kenya via IHA.
(L to R: Victor Nyagaya, CEO – LREB, Anushree Banerji, Portfolio Manager, GCC, Dr Nelson Gitonga, CEO- IHA. Photo Courtesy: IHA)
Emerging from a GCC-funded landscape analysis spearheaded by our partners Results for Development (R4D) and IHA, the report highlighted that top-down, donor-driven models are causing an innovation pile-up rather than fostering a pipeline for governments to adopt. This is worrying, given the heavy reliance on government adoption (doer-at-scale) as a long-term impact strategy for social enterprises.
The Mountain Model framework centers government demand to enable innovation adoption – it enables governments to articulate their innovation needs clearly, identify suitable solutions, and allocate resources for adoption and scale. Pioneering counties Makueni and Kajiado were early adopters in 2022, committing resources (both in-kind and financial) to adopt two innovations each:
Makueni County
- Vaccibox (Drop Access Limited): A solar-powered, Internet of Things (IoT)-enabled last-mile vaccine delivery and storage solution.
- CHUSLA (Financing Alliance for Health): A revolving loan and income-generating scheme for Community Health Promoters.
Kajiado County
- Waste processing system (Sanivation): Collaboration on a comprehensive waste-to-value processing solution to address severe sanitation challenges. Sanivation has received our Transition to Scale (TTS) support.
- Sonomobile (Health-e-Net): Implementation of a point-of-care mobile maternal ultrasound system linked to an AI-supported telemedicine platform
Innovation Investment Cases (IIC) were another creative tool that counties utilized for fundraising and internal advocacy, especially important given Kenya’s devolved structure and complex public procurement policies.
Other themes emerged as we conducted a collective deep dive with IHA, county leaders, and innovators:
(L to R: Samon Saigilu – Kajiado County Director, Anushree Banerji (GCC), Zawadi Kirisuah (IHA) and Bernard Njibu (IHA))
Relationship building — A strong intermediary organization is central to the successful set-up of this framework. Norah Magero, CEO and co-founder of Drop Access Limited noted, “Having IHA on our side, gave us a platform and credibility when talking to county governments” — a notable advantage given the lack of formal entry points for governments and innovators to engage.
Addressing information gaps — Since there is no formal checklist to guide innovators through the various eligibility requirements for governments, providing relevant guidance and support in this area can be transformative, especially for early-stage organizations.
Unbiased partnership — IHA gained the trust of county leadership through their ability to strike a balance between neutrality and collaboration. This was reiterated frequently at in-person meetings with county leadership.
Leadership — Committed leadership remains the single biggest driver of success. Kajiado County’s willingness to coordinate with different ministries to secure land for a waste processing plant was noted as exceptional by Sanivation, who are accustomed to collaborating with various county utility companies.
Innovation for Diverse Needs — Alex Kilowua, the CECM (Minister) for Health Services, emphasized that innovation is the future, and as a large diverse county, Kajiado needs service and product innovations that cater to urban and rural, pastoral, communities.
Prioritization: Samson Saigilu, Kajiado County Director, Public Health and Sanitation, highlighted the creative approaches the county was taking to secure additional resources to contribute to the feasibility studies, a critical step in the implementation of Sanivation’s activities. “Mountain Model has taught us to prioritize and be creative with our budgets.”
Counties in LREB and their average contributions to the bloc’s Gross County production (GCP). Kisumu and Kakamega contributed the highest to the LREB at 12% and 10.2%, respectively.
The Mountain Model faced typical government challenges, including staff transitions, highlighting the need for patient capital to fund ecosystem initiatives. The addition of the LREB bloc requires coordination across 14 counties, each with its own budgeting and planning processes and diverse stakeholders.
Managing the wide range of stakeholders requires alignment on the goal – meaningfully addressing health challenges. Selected innovations must be ready for scale, with a sustainable pathway to long-term impact and credible evidence. However, given the sector and context-specific variances, there is no common understanding of a “ready-to-scale” innovation that speaks to organizations’ capacity and government-specific criteria (though existing resources such as Spring Impact’s diagnostic tool are useful).
To increase transparency and decrease reliance on funder-driven “pileups”, GCC is supporting the Million Lives Collective Regional Hub to develop a set of criteria that meets the needs of governments in East Africa across different health services.
Additionally, Grand Challenges Canada has partnered with WHO (leading to their call to action) to drive demand articulation in multiple countries. R4D’s efforts in Ethiopia, supported by BMGF, show similar trends. While implementation approaches may differ based on context, we are excited to see countries beyond Kenya shifting from donor-driven mandates to local and government-driven demand-driven innovation adoption.
