GOFRUGAL STUDENT E-zine - Student Projects 2020-2021 by ICFI

#GOFRUGAL STUDENTS E-ZINE STUDENT PROJECTS 2020-2021 Centre for Frugal Innovation in Africa Leiden-Delft-Erasmus Universities

CONTENTS Introduction

Research Projects 2SCALE

Ecobora

Abdij Koningshoeven

SEMiLLA x DAB Lab

GOAL3

Healthy Entrepreneurs

NeLL

EnableMe

Inuka

TU Delft, LUMC, Mbarara University

Internship Providers

With this booklet we showcase the field assignment projects of the students participating in the Frugal Innovation for Sustainable Development minor (FI4SDG) 2020-2021. Despite the obstacles caused by Covid-19, the students were still able to successfully complete a series of different projects related to topic such as health, energy, agriculture and more.

HEALTH

ENERGY

WATER

AGRO-FOOD

The FI4SDG minor is a unique educational program organized each year for third-year bachelor students from Leiden University, TU Delft and Erasmus University Rotterdam. In this program, participating students have the opportunity to work with students from other universities and disciplines, allowing them to step outside of their mono-disciplinary frame of reference. This education program is set up and coordinated by the Centre for Frugal Innovation in Africa (CFIA), and is made possible in collaboration with the African Studies Centre (ASCL). Lecturers from faculties within the Leiden-DelftErasmus Universities such as Technology, Policy and Management (TBM), the Rotterdam School of Management (RSM), the International Social Studies (ISS) and other knowledge partner institutes contribute expertise from their respective disciplines. The minor combines theory, practice and societal engagement. Apart from gaining theoretical knowledge during academic modules, students have the unique opportunity to conduct a 12-week field work assignment in the Netherlands or abroad. This enables the student teams to reproduce and interpret knowledge about frugal innovation from a technological, entrepreneurial and developmental perspective. Participants learn from other disciplines, and relate this knowledge to, and integrate it into, their own disciplinary background, and from there, make a constructive contribution to the debate on frugal innovation and sustainable global development. PAGE 1

2SCALE

Incubator Program in Africa In Africa, entrepreneurial producer organizations and local small-sized enterprises that trade and process farmer produce allow for the development of base of the pyramid (BoP) products and markets. All products that are sourced from these farmers find their way to local and regional markets for BoP consumers. Many of these regions see a huge lack of nutritional food, so by supporting these clusters, access to nutritious food is improved for approximately 1 million BoP consumers. 2SCALE´s goal is to better the livelihoods of 750.000 farmers through training of agricultural practices and increased negotiation skills, while simultaneously boosting access to nutritious food for the one million Bottom of the Pyramid consumers in Africa. Inclusive business chains are employed in this effort.

2SCALE 2SCALE is an incubator program that works on creating and managing public-private partnerships for inclusive business in agri-food sectors and industries. They currently operate in eight countries situated in sub-Saharan Africa, namely, Ethiopia, Ghana, Ivory Coast, Kenya, Mali, Nigeria, Burkina Faso and Niger. 2SCALE is implemented by a consortium of state agencies and IOs/NGOs, as for example the BoP Innovation Center (BoPInc) and the International Fertilizer Development Center (IFDC). Funding is made possible by the department of inclusive Green Growth of the Directorate General of International Cooperation of the Dutch Ministry of Foreign Affairs. The way in which their program functions is that they focus on establishing agribusiness clusters and value chains built around business champions. These champions are either entrepreneurial producer organizations or local small and medium-sized enterprises that either trade or process the produce provided by farmers. 2SCALE wants to scale over 60 of its public-private partnerships

Base of the Pyramid Refers to the poorest two-thirds of the economic human pyramid. Currently, this is a group of more than four billion people living in abject poverty.

and promote inclusive and innovative agribusiness strategies with 5000 farmer producer organizations, of whom 50% are headed by women. They focus on four main agricultural sectors: protein and animal products (eg. milk and eggs), staple crops (eg, rice, cassava and maize), fresh produce (eg, onions, potatoes and local leafy vegetables) and oilseeds (eg. soy and groundnut).

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5,000 farmer producer organizations

The Student Team

Scouting renewable frugal technologies

The student team followed an internship at the organisation as part of the 2SCALE Innovation Agenda. The goal was to promote and facilitate the sustainable adoption of innovations among agri-food value chain actors in 2SCALE partnerships. These innovations solve pressing problems in the smallholder farmer value chains, contributing to better quantity and quality of produce, in light of the changing climate. Here 2SCALE aimed for the following program outputs: 60 partnerships that successfully implement their inclusive business models along the agrifood value chains, 50 off-farm innovations that increase value chain efficiency or generate new products in the partnerships, 375,000 hectares with on-farm innovations that promote ecoefficient agricultural practices exchanged or acquired via the partnerships.

375,000 Hectares with on-farm

Innovations

50 off-farm

Frugal Innovation

Innovations

Aspects and Objectives

The frugal innovation aspects are important for the success of the results. It has become clear that in order for new technology or innovation to be adopted and implemented into the value chains of the 2SCALE partnerships they need to be frugal since the smallholders do not have the time and money to spend on expensive and hard to use devices/technologies. Alongside using 2SCALE's criteria as their first and foremost method for evaluating innovations, two additional frameworks aid the team in scouting and screening suitable technologies for 2SCALE’s partnerships, as they share some similarities with the criteria used by 2SCALE. Finding frugal and sustainable technology will allow for higher and stronger yields which in turn allows for increased economic benefits as well as nutritional value for not only the farmers and their families but also the communities they operate in. These inclusive green innovations will promote food security and allow for the inclusion of women as farmers and entrepreneurs. The team delivered 10 frugal innovations that tackled agricultural sustainability and development issues.

Alexandra Knight, Urban Studies - Leiden University Laura Gaerdner and Sushruta Kokkula, International Relations and Organizations - Leiden University Samwel Tobiko - Digital Innovation Specialist, 2SCALE

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ECOBORA Solar Kiosks

How can a company not only contribute to enhancing rural access to green energy but also boosting local women entrepreneurs in a sustainable fashion? Justine Abuga, the founder of Ecobora, might have found an innovative solution in Kenya with inexpensive ‘rent-a-shelf’ solar retail kiosks. These frugally designed kiosks cost just a few hundred dollars, and are built by the community for the community, using local materials. Local women entrepreneurs use the kiosks to sell bio-fuels, their own agri-produce, and other beneficial products. Distributors can ‘rent-a-shelf ’ in the kiosk to sell their products such as solar lanterns and other fast-moving consumer goods.

Reaching the Last Mile The idea came about when Ecobora, like many organisations, experienced difficulty accessing remote communitieswhere people live below USD$8 a day. For such communities, products like solar home systems, clean cookstoves and fuels can be life-changing - but getting these products to them is a huge challenge. However, this challenge quickly became a motivation to innovate. Ecobora started a project that eventually became one of nine projects being piloted by the Global Distributors Collective (GDC) through its Innovation Challenge, which is made possible thanks to aid from the United Kingdom.

The challenge crowdsources innovations from GDC members (last mile distributors), helps to bring the best ideas to life, and supports the broader last mile distribution community to replicate and learn from those innovations. The Global Distributors Collective is hosted by Practical Action, alongside implementing partners Bopinc and Hystra; with Bopinc providing technical support to Ecobora’s solar kiosks pilot.

Including Women, Sustaining Green Energy The idea for Solar Kiosks was born from feedback given by small-scale farming entrepreneurs, namely, a collective of sales women. These women groups are quite common in Kenya and are called ‘Chamas’. They are groups of up to 50 women who work together as a collective and support each other in their entrepreneurial activities. These groups have built up a strong trust between its members and collectively make sure their entrepreneurial endeavours remain strong and sustainable. With this partnership between Ecobora and the women groups, there is a mutual benefit for each party as they help rural communities access green energy and other lifechanging products.

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Solar Kiosk Pilot The women groups and Ecobora started a pilot in January 2020, and in October the 8th solar kiosk was installed. The first 8 kiosks were initially financed by Ecobora and the GDC, but will eventually be solely owned by the entrepreneurs as they pay off the kiosk through the revenues they generate from it. But the costs of the kiosks will after this proof of concept be remitted by using the capital to set up new kiosks in another village. Thereby the model creates ownership for the entrepreneurs, sustainability and scale-up opportunities. Another important learning of the pilot focuses on the viability of the ‘rent-a-shelf’ model. On paper, this provides other distributors the chance to reduce costs of door-to-door marketing, transport costs, and education and training costs in rural set-ups in order to familiarize people with green products. By tapping into a vast network of entrepreneurial groups with existing financial means and sales experience the kiosks can become a vital sales force within communities that were previously not reached. The pilot seeks to engage at least 2 of these partner distributors.

The CFIA and Bopinc, with the assistance of the student team conducted a study on the contribution of this new Solar Kiosk infrastructure towards an inclusive and sustainable development of the rural communities by doing an assessment of the first 8 kiosks. The student team investigated and assessed the roll out of the pilot,

with a focus on to what extent the kiosk model works and how the women and Ecobora experience the pilot. The team’s objective was to provide recommendations for improvements in the model. Therefore, the team looked further into the business case of the women groups and Ecobora and came up with three recommendations, being a business in a box (providing a ready to go kiosk with all essential features), kiosk building improvements and marketing ideas. All with the purpose of generating enough income from the kiosk for the women to support themselves.

Amco de Jong Civil Engineering TU Delft

Marielle Portier Archaeology Leiden University

Ellen Zwerver Communications and Media Erasmus University Rotterdam

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ABDIJ KONINGSHOEVEN Circular Beer Production

Circular Production Methods As you may imagine, a brewery uses vast amounts of water. You need seven liters of water to produce just one liter of beer. Beer itself is 90-95 percent water, but we also have to take into consideration all the other areas of beer production that utilise water, from brewing to flushing out the beer bottles before filling. This makes a brewery heavily dependable on the region’s water supply. However, water is not freely available and is actually a limited resource. Globally, our water supplies face severe climate challenges. Groundwater levels are descending quickly, including in water-rich countries like the Netherlands. At the Koningshoeven Abbey in the Netherlands, Trappist Monks - who make a living out of making the renowned ‘La Trappe’ beer - are looking into translating their austere and sustainable lifestyle into the beer production process.

90-95% WATER

A Biological Water Treatment Plant The brothers at the Koningshoeven Abbey developed the ‘Biomakerij’ together with the regional water board - Waterschap de Dommel. It is the first Dutch biological treatment plant that purifies wastewater thanks to tropical plants and microorganisms, and reuses every drop. This waste water comes from the abbey and the brewery located on the site. The purified water is immediately reused to prevent the soil around the abbey from drying out. Later, the water is used as rinse water for the bottles in the brewery. In this way, all the water stays at Koningshoeven, which means that the cycle is perfectly closed. The water treatment system also creates sludge – an organic material caught in the water treatment process – that can be used to recapture a vast array of resources for the further production of energy and food. Hence, the Abbey is looking into the construction of an anaerobic digester at the

brewery in order to further extend the recapture of resources through the creation of biogas. The sludge placed in the anaerobic digester not only creates biogas and enables the creation of electricity, but the remaining material that is left in the chamber after the biogas process is complete can be utilised as fertiliser.

The social perception of circular recovery systems The student team undertook an internship at Koningshoeven/La Trappe Abdij which focused on the social perception of the use of circular (water and energy) recovery systems in the brewing process. The same technology is already in place in the Abbey’s sister monastery in Uganda – Our Lady of Victoria Cistercian Monastery - where the water treatment system has been integrated with other

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sustainable practices like biological manufacturing, energy recovery technologies, food production and community functions. It was the task of the minor team to investigate how the brewery’s stakeholders, mainly its customers, perceive the use of recaptured resources from wastewater treatment in the beer production process. Additionally, the team looked into different by-products that could be derived from sludge and the legislation that these processes are subject to in the Netherlands.

The anaerobic digester, which intends to create fertiliser and biogas out of a sludge that would otherwise be disposed of, is already in place in Uganda, at the Our Lady of Victoria monastery in Kijojo. Given that its first implementation was in the developing world, while now the intention is to install the same system in the Netherlands, the frugal innovation (or the digster) can be tagged as a reverse frugal innovation. The objective of the entire project is to close the water consumption cycle at the Abbey in order to maintain stable water levels in the region. Such objective falls in line with United Nations sustainability and development goals, which include (6*) ensuring access to water and sanitation for all and (12*) ensuring sustainable consumption and production patterns.

Frugal Innovation

Aspects and Objectives

This project put forward a research investigation into the perception of La Trappe’s stakeholders towards a reverse innovation being implemented at the Abbey.

Maartje van den Broek Technical Public Administration TU Delft

Rafael V. Padilla Kafati International Relations & Organisations Leiden University

Dorine van der Linde Communications & Media Erasmus University Rotterdam PAGE 7

SEMiLLA x DAB Lab Frugalising Space Solutions

It has been exactly 60 years since humankind has found itself in space for the first time. Since then, space missions have been becoming longer and more commonplace. This has certainly created issues of the sustenance of astronauts in space, as their survival requires very large masses of oxygen, water and food, which are too expensive and bulky to be transported. A possible solution to this problem is employing a circular life support system, and that is exactly what the MELiSSA space research consortium tries to do. The students of the minor are working with a part of the MELiSSA research program, SEMiLLA, which tries to apply circular space technology on Earth. However, while the SEMiLLA department together with the Delta Agrifood Business Lab in Bergen op Zoom are doing a feasibility study for (high-tech) space applications, the students will looked into “frugalising” these space applications to make them more generally applicable.

Delta Agrifood Business Lab The Delta Agrifood Business lab, is an agrifood that tries to bring innovative companies together to work smarter, more sustainably and circularly. It is an open innovation and expertise centre for business and education, as well as a breeding ground that gathers and shares knowledge about Agrifood. The students’ initial assignment was to work on the energy efficiency of the building. However, they quickly saw an opportunity to combine its knowledge with SEMiLLA's to try to combat an Earthly problem, namely, malnutrition in Kenya. One effective way to combat this and other national public health issues is an algae used in long-term space missions by NASA - spirulina. Spirulina has a protein content of 70%, which is three times the amount found in beef.

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It is also rich in various micronutrients like iron, zinc and different vitamin Bs, which could contribute to the healthy development of preschool children (6-59 months) who are the most susceptible to malnutrition in Kibera. For these reasons, the spirulina farm project was started. The project aims to bring cheap, protein rich products to the informal settlement of Kibera in Kenya, whilst simultaneously developing a small scale farm that is interesting for the DAB lab in Bergen op Zoom.

The Next Steps The student team worked on developing a first prototype of a spirulina farm in Curaçao to research how spirulina is best grown, how much can be harvested and how long it takes until the harvest. The spirulina was bought from an algae farmer working in Curaçao who is connected to a spirulina farm in Rotterdam, which Marjenka, one of the team members, managed to visit. At the same time, the design of the end product was constantly evaluated and improved, so the team could end up with various designs from which to choose.

To market the product in Kibera, the social context was analysed in more detail by staying in contact with people experienced in the agrifood business in Kenya, and by establishing new contacts with students living in Nairobi and Kibera. To analyse the market and to make sure the product was sold, the team contacted relevant influential people in Kibera that have the power to advertise the product successfully. Interviews with various experts were conducted continuously, ranging from spirulina farmers in the Netherlands to researchers conducting a similar project for MELiSSA in Congo.

Frugal Innovation Aspects and Objectives

The main objective of this project was increasing sustainability of farming in Kibera and the Netherlands (and in the future other locations) by creating a circular spirulina farm that draws its nutrient sources from wastewater, uses natural light for lighting and makes use of a built-in water filter to avoid wasting water. Spirulina is highly nutritional and using circular technology created for long-term space missions on Earth has the advantage of being space and resource-efficient. The project frugalises this technology by making it cheaper, less high-tech and adapted to the Kibera climate.

Gijs Woudenberg International Business Administration Erasmus University Rotterdam Charlotte Buder Governance, Economics and Development Leiden University

Marjenka de Bell International Business Administration Erasmus University Rotterdam

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GOAL3 Frugal Patient Monitoring Platform

In low-resource settings, early diagnosis is both the most essential and challenging task when trying to reduce the number of pediatric deaths. The medtech startup GOAL3 (inspired by Sustainable Development Goal 3: ensure healthy lives and promote well-being for all at all ages) is aiming to do something about this, and is working on the development of a tablet assisted pediatric monitor for low-resource settings called IMPALA. The IMPALA monitor tracks vital signs of the neonate (heart rate, blood pressure, respiratory rate, oxygen saturation) and by using predictive algorithms facilitates early diagnosis of severe infections.

Goal3 & The Student Team GOAL3 is a med-tech startup that wants to make quality healthcare available to all. They mainly focus on neonatal and pediatric care in low- and middle income countries in East Africa. Often the medical staff do not have the right knowledge and equipment to provide the proper aid to the patients. GOAL3 tackles this problem by providing an easy-to-use digital tool for health workers who work in an environment with limited means. GOAL3 wants to transfer the monitor into a platform to which experts can contribute, by compiling data an making it possible to use the system in an adaptable way on a broader scale.

This way they are addressing the needs of the customers. The student team looked at a potential separate project regarding maternal mortality rates and the quality of antenatal care in Kenya, and how an intervention called check2gether can make a difference. Check2gether is a portable backpack that enables health workers to conduct an antenatal care checkup in rural areas and consists of a comprehensivenon-invasive testing kit that incorporates BP measurement, HB, and protein glucose in urine tests as well as a mobile application that supports decision making.

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The Next Steps The job that the student team focused on is conducting a feasibility assessment on the implementation of check2gether in Kenya. The end goal was to provide GOAL3 with informed and wellrounded advice on whether to further pursue their cooperation with the research organisation TNO regarding check2gether. The students looked at the technical factors, organisational factors and the social and cultural barriers and facilitators to implementation. The students conducted intense background research on Kenya and have spoken to a lot of the people involved in development, as well as worked on problem statement and have started reaching out to potential beneficiaries and stakeholders for interviews. Both of the innovations (IMPALA and check2gether) help empower the beneficiary by empowering midwives and community healthcare workers, making their jobs easier, and allowing them to work more independently. Through this, a key resource that is available in abundance is employed efficiently: human resources.

SIMBA The team advised GOAL3 to take on the project in Kakamega County, Kenya, if certain conditions are met and rename it to SIMBA. The name SIMBA was established during one of our discussions about the aim of the project. SIMBA is one of the main characters of the movie “The Lion King'' which revolves around the topics of survival, fitting in and belonging. In addition, it presents important messages of cooperation, friendship and hope. SIMBA (Smart Innovation for Mother and Baby), in a literal sense, refers to the Swahili word for lion and is regarded as the national animal of Kenya.

Furthermore, SIMBA translates into small child and power, which is related to the mission of GOAL 3 and Check2Gether of decreasing neonatal mortality rates in low-middle income countries and improving antenatal care with the aim of decreasing maternal mortality rate, respectively. Lastly, it is related to GOAL 3’s product IMPALA, which is also an animal found in the Sahara. Hence, the name SIMBA provides ground for Kenyans as well as internationals to relate to the project.

Frugal Innovation Aspects and Objectives

The aim of GOAL3 is to build a monitor that has all the functions of a high-quality system but that can also be repaired with minimal resources, making it frugal. The neonatal care monitor is built in a way that it can be used in the environments that the device needs to operate in. The monitor design is easy to read which means that the doctors, midwives, and community health care workers that will be using it do not need to receive extensive training before being able to use the device. TNO’s antenatal care service´s main frugal aspect is its portability. It was developed to be used by community health care workers and midwives in remote areas which addresses the needs of the particular context for which it was developed. It also includes a smartphone application implementing medical decision support which is a frugal way of using what is already there to improve on innovation. Furthermore, the device empowers midwives and stimulates local entrepreneurship which could be seen as one of the desired outcomes of frugality. GOAL3 and TNO have been working hard to create innovations that are easy to use, robust, low maintenance, and culturally acceptable. In short: frugal.

Lilly Ann Acner Political Science/International Relations Leiden University Pim Steens Technical Medicine TU Delft

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Louisa Marie Truß Psychology Leiden University

Healthy Entrepreneurs Access to Basic Healthcare In Rural Areas of Kenya

Provision of Basic Healthcare Products

Enlarging Outreach and 'Circles of Change'

Joost van Engen was shocked when he personally witnessed the limited access people in rural areas of developing countries have to basic healthcare products and services. Therefore, he founded Healthy Entrepreneurs, a company which provides basic, affordable healthcare in remote, hard to reach areas. They are currently operating in four countries: Uganda, Tanzania, Kenya and Ghana and have reached over 6 million people in rural areas with basic healthcare products. They do this by employing existing volunteer community health workers and training them to become Community Health Entrepreneurs (CHEs). These individuals will ensure that their communities will be getting access to health products and services, and spread awareness. CHEs invest a small sum upfront for a two-week training program, after which Healthy Entrepreneurs will supply them continuously with products. They receive a mobile phone to facilitate and support them in their work activities. Healthy Entrepreneurs manages an end-to-end supply chain to ensure high quality and reliability of the products they distribute to CHEs. Once a month, cluster meetings are organised during which products are distributed, issues are resolved, and follow-up training is given.

The goal of Healthy Entrepreneurs is to enable basic healthcare for everyone, no matter your background or location. Furthermore, they are always looking for opportunities to scale up. This can be done within the counties they are currently operating in, for example, to different counties in Kenya, but can also mean expanding to different developing countries. The model Healthy Entrepreneurs uses to connect their scale of operating to the societal impact they are making is called ‘Circles of Change’. A CHE will serve one community, approximately 1.500 people, which will lead to an increased awareness of health care among the inhabitants. A group of 15-20 CHEs is called a cluster and will reach over 22.000 people. A region and a district include 75 and 150 entrepreneurs respectively, leading to market and behavioural change with regards to basic healthcare. A district impacts over 225.000 people, which clearly illustrates the reach of impact Healthy Entrepreneurs has when expanding to different regions. Their goals for the future include to have 30.000 CHEs by the year 2022, who will be able to deliver products and services to over 60 million people.

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Field Assignment for Healthy Entrepreneurs in Kenya The student team worked from a distance for Healthy Entrepreneurs in Kenya. The research project they performed was focused on the scaling of Healthy Entrepreneur’s outreach. In order to facilitate this growth it is important to optimise current processes and prepare them for scaling up in the future. Therefore, they came up with the question “How might we enable Healthy Entrepreneurs to upscale their outreach and impact in Kenya?”, which was the main focus of their field assignment. Specifically, the assessed the recruitment and selection process of CHEs and the process of delivery information and reporting of issues by the CHEs. Both helped in increasing scalability and impact for Healthy Entrepreneurs.

To be specific, they designed a client-relationship management (CRM) like process, in which issues from the field are properly reported and taken care of. This enhanced the feedback, helped the CHEs receive valuable information from the sales officers and contributed to higher levels of motivation and performance. An addition to this was the FAQ document they made, which ensured standardisation of answers to common questions among all employees of Healthy Entrepreneurs. Furthermore, they wrote a recruitment and selection manual, in which they tried to optimise the recruitment and selection of CHEs. As a part of this they prototyped a survey to test for entrepreneurial capabilities in potential CHEs.

Johanna Dekker International Relations Leiden University Floor Kloosterman Business within Liberal Arts & Sciences Erasmus University Rotterdam Vivian Meij Economics within Liberal Arts & Sciences Erasmus University Rotterdam

Frugal Innovation Aspects and Objectives

What makes Healthy Entrepreneurs frugal is their focus on providing the Bottom of the Pyramid with affordable, reliable basic healthcare products. They do this by enabling individuals to become entrepreneurs by training and equipping them. This approach means there are two beneficiaries from the work they do: the customers who buy the products, but also their own employees. These are largely women, who not only increase their income but also their capabilities as a community health worker. Healthy Entrepreneurs has a valuable impact through operating in this manner, which can be

seen in their roll-out of the doctor at a distance program. Though still working on a small scale, currently, this program can be seen as the culmination of training for CHEs. Participants are able to help manage and treat conditions such as high blood pressure and diabetes. As a result, access to healthcare is increased for a very wide group of people, achieved by empowering and employing women through a focus on support and training. This approach makes Healthy Entrepreneurs a company with great societal impact in line with five Sustainable Development Goals (SDGs), including: increased health and well-being, gender equality, clean water and sanitation supply, and ending poverty.

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NeLL eHealth Application Covid-19 has caused devastating effects around the globe, and health apps may be the frugal interventions that can provide some relief. The apps can help prevent infection, triage and monitor behaviour and symptoms, educate citizens when to contact a health professional, and provide governments with data to guide policy making to curb the virus. Other apps enable monitoring of vulnerable patients at a distance, assisting with rehabilitation, and can even be used to help citizens and frontline healthcare staff work at their health (food, exercise, sleep, and mental health apps) to stay afloat and prevent heavy symptom burden if they do get infected. But which apps are fit for their purpose, their context of use and deliver on their promise? And among this diversity, how will people know how to choose the right one? The National eHealth Living Lab (NeLL) intends to pilot Covid-19 apps and investigate the understandability of and trust in a standardized health app quality label in Mexico and Egypt, and compare the outcomes.

The App

The Next Steps

NeLL is based in Leiden and facilitates long and shortterm scientific research into eHealth. They are at the forefront in the development of validation methodologies and have a pioneering role in the development of internationally applicable eHealth standards.

Students from minor were involved in this project and were assigned tasks related to testing the feasibility of the standardised label for health apps in countries outside of Europe. The quality label is currently available in English and Arabic, and was tested with people with low health literacy in the Netherlands for adequate understanding.

The NeLL is mainly a research community. Also connected to the field assignment and the entire The task was to investigate the understandability of research program are digital health specialists from and trust in the label in two countries outside the the World Health Organization and the International European Union, namely, Mexico and Egypt, and Telecommunication Union. compare the outcomes. A standardised health app quality label is currently being developed by NeLL. This label is an assignment given by the European Commission and currently under review by the International Organization for Standardisation (CEN-ISO/DTS 82304-2). The aim of this project is to standardise quality labels of health applications, enabling users to make more informed decisions and trust apps, and hopefully increasing the uptake of mHealth.

The initial part of the investigation involved acquiring a translation of the standardised label and then testing it with 5 low health literates in the above-mentioned countries using think aloud testing.

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Interviews were conducted to investigate aspects of the lives of users that are of importance to the investigation. Some of these aspects might include who or what is trusted to make suggestions on health apps, possession of a smartphone, use of apps, healthcare access, and digital literacy.

Julia van Lent Econometrics Erasmus University Rotterdam

Sophie Cleton Industrial Design TU Delft

Frugal Innovation Aspects and Objectives

The health app label is specifically designed to increase the use of good health apps that can have a positive influence on the health of people. Health apps in general also can make healthcare more accessible and cheaper, especially for people at the bottom of the pyramid and living in areas where healthcare is not easily accessible. It can thus help lessen the divide in health outcomes in between different socioeconomic statuses. Next to this, the label is also an attempt to overcome the digital skills gap. By making the quality and purpose of apps more visible and easier to understand, people with low digital skills might feel more secure in the usage of apps and know which health apps best meet their needs and health issues.

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Max Mooij Mechanical Engineering TU Delft

EnableMe Online Platform for People with Disabilities

Around the world, people with disabilities (PWD) comprise approximately 15% of the global population, yet exist as some of the most marginalised groups within many societies. In some cases, an inability to fully participate in society is due to the severity of a disability. However, much more often these inabilities are a result of an environment that has not been properly adapted to meet the needs of this section of the population. In developing countries, the inclusion of PWD can be especially difficult to achieve, as environmental barriers such as a lack of proper infrastructure are much more prevalent. There are many spheres of life that people with disabilities are excluded from, meaning that inclusion is a challenge that is both diverse and large in scale. Inclusion must also be dealt with in an urgent manner in order to halt the cycle between disability and poverty that leaves almost 10,000 PWD dead globally every day. EnableMe is an organization focused on seeing every human for their abilities rather than their disabilities, and which aims to provide the tools that enable people to live to their full potential. Our challenge is to work within communities to discover the specific and individual needs of people with disabilities and work to create an online platform and community that provide relevant information and resources.

EnableMe

EnableMe is running a platform and online community for persons with a disability. Here people with disabilities can find information, help each other, be active in discussion forums, do online advocacy together, etc. With this worldwide online platform and community EnableMe wants to enable 1 billion people with a disability. This vision is based on the motto and purpose of EnableMe: “All human beings have some sort of disability. We however want to focus on abilities and enable people to live to their full potential.” A lack of information means people with a disability are often misunderstood by their communities, families or don’t know their medical conditions themselves. EnableMe provides the needed information on an easily accessible platform and makes people connect through their community. “Information is Power” as said by EnableMe.

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The Next Steps The main taks of the was building up EnableMe for the anticipated launch on January 11 2020, and adding to the content of the website. The main tasks retained a focus on the empowerment of youth with a disability. On an ongoing basis, the team created content that EnableMe can provide such as information, blogs, art, and other ways to connect and educate PWD. To enrich this content the student team contacted people willing and able to provide content, co-created content with community members, researched further information, and brainstormed successful ways to reach out to youth with a disability. Furthermore, the student team worked on promotional activities such as creating a video for the company in hopes to attract visitors, donors and partners.

Vivian Graham International Studies Leiden University

Additionally, the team assisted the Social Media Team in Kenya with designs and a social media push for the launch of the website in hopes of reaching a large audience to ensure impact. Lastly, a project that the student team worked on for EnableMe is about DIY solutions for PWD in lower resource settings. This project aims to provide the information to the user about which solutions are out there, for their specific disability, that they can make themselves using limited resources or in collaboration with a local makerspace. Through this, the student team and EnableMe wanted to create some agency for PWD to find and create their own solutions catered to their context. This was done with the help of preexisting solutions that have been compiled to one place to facilitate a simple search.

Pleun de Goede Industrial Design TU Delft

Frugal Innovation Aspects and Objectives

The primary aspects of this field assignment that entail Frugal Innovation are the affordabilityand accessibility of the service, as well as a focus on the functions that provide the highest customer benefits. Additionally, EnableMe is a platform that aims to cocreate with local communities in order to create specialised content that fit the needs of the target group, and thereby produce optimised performance. EnableMe has begun to develop a service for partners in low- and middle-income countries, and by doing so, they aim to make their service and information accessible for consumers at the Bottom of the Pyramid. This accessibility will increase by providing free and low-cost services. In order to gain a holistic perspective, both the price for the platform and the price for the internet connection must be considered. Taking all of these aspects into account, EnableMe

Sarah Fürstenberg Management of International Social Challenges Erasmus University Rotterdam

aims to provide a simple solution as there is no dependency on the type of internet device used to access the information, nor on ownership due to the fact that Kenya contains numerous internet cafes. Furthermore, Kenya has relatively good connectivity thus allowing EnableMe to reach a broad potential audience. In the creation of the content for the online platform the students had to consider the price and availability of the internet and of mobile data to ensure that the platform will not require a large amount of data or time to load. This means that there is a need to focus on the minimisation of clicks and webpages reloads before a user can find the desired information. Co-creation with local communities allows EnableMe to not only gain content created by community members, but additionally allows EnableMe to become more well known in these places. Partner organisations will also help build and expand the EnableMe network, allowing for the spread of innovation through processes such as word of mouth.

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Inuka

Improving Asylum Seekers' Mental Wellbeing

The Origin of the Inuka Venture The enormous burden that mental wellbeing is putting on the world is finally starting to be acknowledged. The WHO reports that mental health problems account for 1 in 5 years lived with disability globally, with over 80% of people experiencing mental health issues unable to receive affordable, adequate treatment. Yet, the global community is finally starting to understand how much positive impact it can generate if more effort is put into designing affordable and effective mental health interventions. What do these affordable and effective health interventions look alike? In Zimbabwe, the psychiatrist Dixon Chibanda had an inspiring idea to improve mental wellbeing. As one of the few psychiatrists in a country with almost 15 million inhabitants, Dr. Chibanda is taking an approach that is very different from what his colleagues are doing; he is teaching community members, especially grandmothers, a problem-solving method. With this technique, the community members become coaches for people in their community who are facing mental issues. In cooperation with the Friendship Bench, an organisation that provides mental health education and awareness campaigns in Canadian secondary and post-secondary schools, Chibanda’s project makes coaching accessible to people who otherwise would have never received it.

Inuka Coaching Inuka was founded with a clear goal: making mental wellbeing accessible to anyone. Using Dr. Chibanda’s principles from Zimbabwe, Inuka has designed a coaching app that helps people to improve their mental wellbeing. Users take a short self-scan to identify how they are coping with challenges, after which they can plan a booking with a trained coach. In an anonymous chat-session, the coach helps the user to identify and tackle a specific challenge. It has been scientifically demonstrated that the problem-solving techniques used by Inuka coaches improve the mental wellbeing of their users.

Inuka Helping Dutch Asylum Seekers with the Inuka Method As a social enterprise, the focus of Inuka lies on helping as many people as possible. Touched by the ongoing global refugee crisis, especially those unfolding on the Greek islands of Samos and Lesbos, Inuka is determined to contribute to improving the mental wellbeing of those fleeing prosecution and war. The company is curious if it can improve the mental wellbeing of people seeking refuge in the Netherlands, also known as asylum seekers. Since this is a new context for Inuka to operate in, the social enterprise first wants to know if the Inuka method truly fits the context of asylum seekers in Dutch asylum-seeking camps. The student team investigated the possibilities for Inuka. The students researched if the Inuka method can benefit asylum seekers with problems that disrupt their wellbeing. By reviewing academic literature and by talking to professionals, academics and (former) asylum seekers, the team helped Inuka in deciding

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whether the Inuka method is suitable for the context of asylum seekers in Dutch asylum-seeking camps.

Reversing Frugal Innovation to Make Well Being Accessible The Inuka Method is a great example of what is known as reverse frugal innovation: the introduction of durable, effective products or services from relatively poor areas to wealthier (Western) contexts. Inuka bases its problem-solving techniques on research done in settings such as Zimbabwe: what are effective methods to help people overcome their mental issues?

Evidence-based interventions, such as those designed by Inuka can help the world in staying on track to meeting the Sustainable Development Goals (SDGs). Inuka can especially contribute to SDG 3, Good Health and Wellbeing. This is mostly due to the fact that their method is easily accessible and available almost everywhere nowadays in the digitalised world. During the course of the project the student team developed a better understanding of the context and needs of asylum seekers in the Netherlands. They even held a focus group in which they led an exchange of experiences between the Inuka team and former asylum seekers. The students’ work contributed key insights for the decision-making process of Inuka.

Starting a new research project from scratch was a very valuable experience. After three months you almost forget how much you learned and grew compared to when we started. - Marleen

I am inspired by frugal innovators all across the world, including those at Inuka - Joris

I appreciated that Inuka trusted us and our work, and I appreciated the freedom we had to navigate our process. - Lisa

Lisa Führer Psychology Leiden University

Marleen Kop Cultural Anthropology Leiden University

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Joris Pijpers Political Science and International Relations Erasmus University College

TU Delft, LUMC, Mbarara University

MRI Scanner

Detecting paediatric hydrocephalus in Uganda MRI? Low-field? In case you are not fluent in medtech jargon, an MRI scanner is a device that allows you to see inside a patient’s body using a magnetic field. Unlike conventional scanners, where superconducting electromagnets and liquid helium are used, this scanner uses permanent magnets. The resulting magnetic field is thus much weaker, leading to the name low-field. MRI scanners can be vital instruments when it comes to treating certain diseases such as hydrocephalus, a serious condition that consists of an accumulation of cerebral fluid that puts pressure on the brain. In Uganda and in many other Sub-Saharan countries there is a high need for appropriate medical technologies. Child mortality rates caused by hydrocephalus are still very high as it can only be treated with brain imaging and neurosurgical treatment. However, regular MRI devices are very high in cost and bulky and therefore out-of-reach for many (small) hospitals in Uganda.

patients and ultimately being used in hospitals. Finally, they programmed a user-friendly web interface that turns the MRI output data into good quality images. The magic algorithms crunching the data have been written by experts at the TU Delft, but it is the website that connects user and program.

A Frugal Technology The MRI is an innovative frugal technology as it is compact, cheap, and uses almost no power. This gives the low-field MRI also many advantages over a regular MRI scanner. Ultimately the goal of the project is to make MRI technology more widely available in developing countries, starting with the CURE hospital in Uganda where children are treated for the neurological disease hydrocephalus.

This project tackles the out-of-reach MRI problem by developing a much more basic machine that is sufficient to treat hydrocephalus. Two former assignments have been done on the MRI project, and the hardware is in place. This year’s challenge was to look more closely at how the innovative scanner can be brought from the research labs in the Netherlands to the people in Uganda.

The Project The student team helped the project in four distinct ways. Firstly, they developed a new business plan that helped the scanner go from a scientific innovation to a commercial product. This allowed the new MRI technology to have a widespread impact and help as many people as possible. Furthermore, the team researched the certification of medical devices and investigated any ethical concerns. Though these are two different topics, both need to be looked at in order for the scanner to move towards being tested on

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Leo X. Driever Aerospace Engineering TU Delft Anna Paardekooper Technology, Policy and Management TU Delft Cassandre Verhelst International Business Administratio Erasmus University Rotterdam

Internship providers 2020-2021

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Text: Minor FI4SGD students 2020-2021 Editing & Design: Zofia Kostrzewa, Jasmin Hofman 2021, CFIA - info@cfia.nl Address: Kortenaerkade 12 2518 AX, The Hague

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