From Theory to Action: Negotiating Win-Win Incentives for mHealth Public-Private Partnerships Andria Thomas, Dalberg Global Development Advisors Kai-Lik Foh, GSMA mHealth Wednesday December 10, 11:45am – 1:15pm

2 Agenda Case study presentation and room exercise Group exercises by table 11:45 – 12:15 (30 min) 12:15 – 1:15 (60 min)

3 Assumptions There is a diversity of experience in the room Many or most have knowledge of at least one mHealth public-private partnership Some tension areas are well known, such as o Commercial interests o Branding o Partner conflict / introduction of new partners o How to reflect local ownership o Fundraising responsibility o Pace of rollout All feel that incentives should be better recognized and accounted for in PPPs All are prepared to contribute to a highly interactive discussion!

4 Objectives for this session 1.Understand each group’s primary interests and challenges 2.Identify common tensions across all partners 3.Jointly negotiate “win-win” solutions 4.Leave with (at least) one specific tactic to enable “win-win” solutions in an mHealth partnership Development donor Corporation Health service delivery provider Government

5 The GSMA Trade association for mobile industry, 800+ organizations including most mobile carriers, handset / SIM manufacturers, internet players

6 Case study: Pan-African mHealth Initiative Founding: GSMA mHealth program launched PAMI in South Africa in 2012 to support scale-up of mHealth in nutrition and maternal and child health Funding: Department for International Development (DFID) and Norad Capture information on individual worksheet: For each stakeholder group, what is their primary interest? For each stakeholder group, what is their key challenge? TO DO: What does the private sector hope to get from PAMI – and mHealth in general? Growth: Expansion to Côte d’Ivoire, Ghana, Kenya, Malawi, Mozambique, Nigeria, Rwanda, Tanzania, Uganda and Zambia

7 The problem with mHealth Many successful mHealth pilots Few at commercial scale Untapped potential for mobile industry

8 Impressions on both sides “Responsibility to shareholders as a commercial entity” “mHealth should be provided free as a public service”

9 Right place at the right time? Greater awareness of the importance of mHealth by governments Current commercial models for mHealth largely not working Protecting price in the face of falling revenues no longer viable

10 Key frustrations Why so complicated?Why so expensive?

11 Key elements of partnership Unwind health service complexity by providing validated, aggregated demand Discount connectivity meaningfully for health services, with zero rating for basic health information

12 Key learnings Schoolyard economics works Ask what the operators really want Engage both group and local mobile organizations

13 Instructions for the group activity: one hour Introductions and knowledge sharing 1 Unpack interests 2 Negotiate 3 Share best practices 4 12: :25 (10 minutes) 1:00 - 1:15 (15 minutes) 12: :40 (15 minutes) 12:40 – 1:00 (20 minutes)

14 Introductions and knowledge sharing Table group: write and discuss a list of: – mHealth partnerships familiar to the group – Stakeholders for each partnerships Table group: select one mHealth partnership to use for the activity Each person: select a stakeholder to represent 1 Display list in upper left of flip chart paper TO DO:

15 Recap: workshop objectives 1.Understand primary interests and challenges for each stakeholder group 2.Identify common tensions across all partners 3.Jointly negotiate “win-win” solutions 4.Leave with (at least) one specific tactic to enable “win-win” solutions in an mHealth partnership

16 Unpack interests Each person: write the top 3 interests of your stakeholder on sticky notes Table group: discuss 1-3 sources of tension within the partnership; for example: – Commercial interests – Branding – Partner conflict / introduction of new partners – How to reflect local ownership – Fundraising responsibility – Pace of rollout 2 Display interests in bottom left of flip chart paper Display tensions in upper right of flip chart paper TO DO:

17 Negotiate Table group: identify and negotiate win-win compromises to address the most obvious tensions Each person: use sticky notes to rate how well each compromise takes into account the interests of your stakeholder – Use a scale of 1-5 – 1=not at all, 5=all interests taken into account 3 Display “win-wins” and stakeholder ratings in bottom right of flip chart paper TO DO:

18 Share best practices Full group: conclude with discussion to ensure that everyone leaves with: – One new reflection about the priorities of another stakeholder – One specific tactic to consider incorporating into a future mHealth public- private partnership 4

19 Setup of flip chart paper Dev. donor name Corp. name Health prov. name Gov. name List of mHealth partnerships and roles known Top partnership tensions Partnership #1 Dev. donor name Corp. name Health prov. name Partnership #2 Dev. donor name Corp. name Partnership #3 Gov. name Key partnership stakeholder interests Dev. donor name Corp. name Health prov. name Gov. name $ Partnership #2 Stickies in each category are the 1-3 identified interests of the stakeholder Tension #1 Tension #2 Tension #3 Rating of partnership “win-wins” “Win-win” # “Win-win” # “Win-win” #3 Each stakeholder rates each “win-win” from 1-5

20 Partnership example: Mobile Alliance for Maternal Action (MAMA) Source: MAMA Partners: USAID Country Ministries of Health J&J BabyCenter Praekelt Foundation, dNet, and others MAMA brings together leaders from across corporate, nonprofit, and government sectors, harnessing their strengths and assets to provide new and expectant mothers with access to vital health information via SMS, IVR, and broadband Funds country programs and global operations Coordinate with health service delivery providers who implement country programs; some governments take a more active role in running the programs J&J: Funds country programs and global operations BabyCenter: Provides all content for SMS, IVR, and broadband messages Implement and run country messaging programs Funding: engaging new corporate partners (including direct competitors) to fund expansion Branding: operating under the overarching MAMA brand, but still recognizing individual partner contributions Commercial interests: having a strong conflict of interest policy that clearly defines when/how individual partners can benefit financially from their work with MAMA Logistics: coordinating the different timelines of major funders Key issues for partnership: