¿What is the secret to building solutions that will be sustainable over time? We asked this question to our partner in Ghana, and here is his advice.   

These are his 5 lessons: 

1. Ensure Stakeholder Investment: “All the stakeholders in the solution must be invested so at the core of it everyone is involved. Do a strong stakeholder mapping in the beginning and try to identify the message that will resonate with each one of them. My message to the politicians is very different from my message to the doctors,” he says. Also, work to remove some hostile elements away from them: it can be paperwork, verification, or validation, so when the ministries and the partners mustput int a little push in the beginning to get the systems up and running, they see a pathway of sustainability. Ask yourself if this initiative can transcend beyond your daily involvement: “If you cannot get there, then the model is built around you, and the moment you lose motivation, the model will crumble.” 

2. Ensure Political Sustainability: “Make sure that the solution you are developing aligns with how the Ministry of Health or the government thinks of solutions. This works not just for the political leaders but for technocrats. Political leaders may come and go, but make sure that the people who stay identify with your solution and will be happy to see your success as their success. Also, work with people they trust. For instance, we work with the professional bodies because they trust those leaders, and when those leaders tell them that this solution is the way forward, they fall into it.” 

3. Build Models Around Public-Private Partnerships: “If you commit, the government will commit some resources too. That ensures that they are in for the long haul as well as you. Governments sometimes see healthcare as just a bucket with holes under it, and a lot of healthcare innovators don't talk the language needed to convince people to finance their solution. Show them that this investment has a multiple effect or a sustainable effect three to five years from now. It makes a huge impact. I remember my first conversation with the National Health Insurance Authority to partner, and the question was, 'We are not a pharmacy, why should we commit our resources?' But when we showed them that by tracking every prescription, amassing all the data, and being able to run analysis, they were saving themselves 20% of today's payments, that is what got them sitting up. Also, people get funding and they overhire, and the model breaks quickly because you have too many people without enough inflow or results.” 

4. Motivate Workers at Hospitals: “A very important factor is how you get the people who work at the hospitals or pharmacies to see themselves as part of the ownership of this solution and that this is not an extra chore or work for them. To me, that is probably the most important factor when it comes to building digital solutions that will last. To create ownership in the health facility, you need to hit the core of what they care about and find the reason why the person working in the hospital would take the solution as part of their everyday work. Create that value for them; then they will realize this is important.” 

5. Have Determination and Endurance: “That comes from believing in what you're trying to do in the long run. There are many mornings when you wake up and run into hurdles, and you ask yourself: is this even worth it? But then it comes back to ‘we need to make a permanent change, a permanent impact.’ And so, when the door is shut in your face, or someone doesn't understand why you need to do this, you return to it. I see a scenario where many people think to solve a problem, they need a team of 100 people to solve it. I need 20 of the best software engineers around the world to come together and help me solve it. But what you really need to think about is whether you can solve this problem having only three people with you on this journey.”