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Joshi, Pallavi
(2023).
DOI: https://doi.org/10.21954/ou.ro.000166bd
Abstract
This interdisciplinary study focuses on understanding the advances in conceptualising inclusive health innovations in low-resource healthcare settings. To this end, this research responds to two main gaps. First, an empirical gap exists to conceptualise inclusiveness in high-technology health innovations in low-resource healthcare settings. Second, no theoretical framework enables studying technical change in the health sector by linking unmet needs with industrial and health systems. In this research, I propose a novel Inclusive Health Innovation (IHI) framework, integrating and extending the sectoral system of innovation approach (Malerba & Mani, 2009) and the qualitative heuristics of the institutional triad of healthcare (Srinivas, 2012). This research employs the IHI framework to conceptualise inclusive innovations using cases of Medtech innovations for the early detection of cancer offered by startups in India. It identifies and investigates the actors and factors influencing various stages of the innovation process, including development, diffusion, and adoption. This research uses qualitative methods, comprising both primary and secondary data, for a landscape study and four case studies of point-of-care MedTech innovations for early detection of breast, oral, and cervical cancer in India. The research finds that MedTech innovations are driving inclusiveness in the early detection of cancer, both in process and outcomes, in low-resource healthcare settings. The analysis reveals a strong alignment of STI policy with industrial and health policies in the form of a robust MedTech ecosystem to support the development of these innovations. As regards diffusion, this thesis pinpoints that startup firms choose various business models, partnerships, and stakeholder interactions to create new markets and generate demand for the early detection of cancer. These are 'pocket wins' in increasing the availability of locally relevant solutions for cancer screening and early diagnosis. The last-mile adoption of these innovations in the healthcare delivery system hinges upon stronger policy alignment and regulatory changes in the health and industrial sector. The thesis contributes a novel theoretical framework and original analysis of rich empirical case studies. The thesis further contributes to observable characteristics of inclusive health innovations in the early detection of cancer in India. The research findings are relevant for designing targeted policy instruments for (i) cancer screening and early diagnosis using high-technology solutions in low-resource healthcare settings, (ii) digital infrastructure and regulations to support the adoption of innovations in the public healthcare system and (iii) data privacy and security for Medtech based on AI and ML.
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