The medical device development landscape in South Africa: Institutions, sectors and collaboration

A characterisation of the medical device development landscape in South Africa would be beneficial for future policy developments that encourage locally developed devices to address local healthcare needs. The landscape was explored through a bibliometric analysis (2000–2013) of relevant scientific papers using co-authorship as an indicator of collaboration. Collaborating institutions thus found were divided into four sectors: academia (A); healthcare (H); industry (I); and science and support (S). A collaboration network was drawn to show the links between the institutions and analysed using network analysis metrics. Centrality measures identified seven dominant local institutions from three sectors. Group densities were used to quantify the extent of collaboration: the A sector collaborated the most extensively both within and between sectors; local collaborations were more prevalent than international collaborations. Translational collaborations (AHI, HIS or AHIS) are considered to be pivotal in fostering medical device innovation that is both relevant and likely to be commercialised. Few such collaborations were found, suggesting room for increased collaboration of these types in South Africa

Analysis of orthopaedic device development in South Africa: Mapping the landscape and understanding the drivers of knowledge development and knowledge diffusion through networks

An orthopaedic medical device refers to a part, implant, prosthetic or orthotic which is used to address damage to the body's musculoskeletal system, primarily by providing stability and mobility. Orthopaedic medical devices play a role in injury-related disorders, which have been highlighted as a key element of the quadruple burden of disease in South Africa. In this thesis, orthopaedic devices are conceptualised as a technological field and a technological innovation system (TIS) framework is applied to understand orthopaedic device development in South Africa. Knowledge development and knowledge diffusion are fundamental components of any innovation system. The thesis hypothesises that the functions “knowledge development” and “knowledge diffusion through networks” of the orthopaedic devices TIS are influenced by contextual factors. The objectives of the study are: to identify the actors who generate knowledge for orthopaedic device development and to characterise the relationships between them; to identify focus areas of orthopaedic device development; to provide insight into the drivers and barriers to knowledge development and diffusion in the TIS; and to identify the contextual factors that influence knowledge dynamics in the TIS. These objectives are investigated using social network analysis based on bibliometric data (scientific publications and patents), keyword networks, a review of institutions, and a set of case studies where the primary data source are interviews with actors. Actors producing knowledge were from the university, healthcare, industry and science council sectors, although science councils played a small role. International actors were shown to bring new ideas into the TIS. The networks were fragmented, illustrating that knowledge diffusion through the networks was limited. This was especially the case in the patent networks as many actors patent in isolation. The keyword networks highlighted unrealised collaboration potential between actors based on their common research interests. The case studies revealed features of cross-sector interaction for orthopaedic device development not evident from network analysis based on bibliometric data. Drivers of knowledge development and knowledge diffusion were: inter-sectoral collaboration; the availability of resources; the affordability of available devices; and the positive externalities of allied TISs. The main barrier to knowledge development and diffusion was in the form of barriers to intersectoral collaboration. These include unmatched expectations from partners in collaboration, different views on intellectual property ownership, and burdensome university administrative processes. The orthopaedic devices TIS was structurally coupled to the embedded TIS and sectoral contexts, and externally linked and structurally coupled to its political context. Knowledge development and diffusion was found to be positively enhanced by innovation in the additive manufacturing TIS, with shared structural elements and resources. Knowledge development and diffusion was influenced by sectoral dynamics of the university, healthcare and industry sectors. This thesis makes the following contributions. First, it applies the TIS framework to a new focus area, namely medical device development, in a developing country context. Second, it makes two unique methodological contributions: it presents an index to capture the extent of sectoral collaboration in a network; and it develops a method for determining the collaboration potential of actors in a network based on cognitive distance

Medical device innovation in South Africa: Evolution of collaboration networks (2001-2013)

The evolution of medical device development in South Africa was investigated for the period 2001-2013. Collaboration networks for four sectors - academia, healthcare, industry, and science and support - were derived from a bibliometric study. Centrality measures identified dominant institutions. New actors entering the networks either exhibited preferential attachment to these institutions, or joined the network as part of an isolated cluster. Of the new institutions, foreign collaborators seldom stayed beyond five years, while local institutions seldom left after entering the field. Over the 13-year period, local collaboration activity persisted, while local-foreign collaborations were seen to decline. Over time, the network topology became more akin to that of a small-world network. The findings of the study may support innovation management by guiding institutional strategies for effective collaboration

From reverse innovation to global innovation in animal health: a review

Reverse innovation refers to learning from or diffusion of innovations developed in low income settings and further translated to industrialized countries. There is lack of consensus regarding terminology, but the idea that innovations in low-income countries are promising for adoption in high-income contexts is not new. However, in healthcare literature globally, the vast majority of publications referring to 'disruptive innovation' were published in the last ten years. To assess the potential of innovative developments and technologies for improving animal health, we initiated a literature review in 2020. We used a combined approach, incorporating targeted searching in PubMed using a key word algorithm with a snowball technique, to identify 120 relevant publications and extract data for qualitative coding. Heterogeneity of articles precluded meta-analysis, quality scoring and risk of bias analysis. We can distinguish technical innovations like new digital devices, diagnostic tests and procedures, and social innovations of intersectoral cooperation. We profile two case studies to describe potential global innovations: an integrated surveillance and response system in Somali Regional State, Ethiopia and a blockchain secured One Health intervention to optimally provide post-exposure prophylaxis for rabies exposed people in West Africa. Innovation follows no borders and can also occur in low-income settings, under constraints of cost, lack of services and infrastructure. Lower administrative and legal barriers may contribute to produce innovations that would not be possible under conditions of high density of regulation. We recommend using the term global innovation, which highlights those emanating from international partnership to solve problems of global implications

Focus areas of cardiovascular medical device research in South Africa

We investigated the focus of cardiovascular medical device research in South Africa over the 15-year period 2000 - 2014. Information drawn from journal articles was used for the analysis, with attention to articles describing a contribution to the development of a cardiovascular medical device, or a new application of an existing device. The findings suggest that research has focused on diagnostic and monitoring as well as prosthetic cardiovascular medical devices, with specific emphasis on vascular and valvular heart diseases

Collaborative Partnerships to Assist in Managing Adult-Onset Diabetes in Cameroon

Increasing rates of adult-onset diabetes in low- to middle-income countries (LMICs) present a growing healthcare concern that requires a regulatory approach and local community engagement. Cross-sector collaboration (CSC) is an effective strategy for improving community health. CSC is not effectively used to manage adult-onset diabetes in LMICs, nor is there public policy advocating CSC in the management of diabetes. This qualitative exploratory case study explored how leadership and resources affect the use of CSC to assist in managing the adult-onset of diabetes in a CSC in Cameroon. A purposeful sampling strategy was used to identify participants for semistructured interviews of 10 executives involved in the CSC. CSC theory provided a theoretical framework. Collected data were organized by audio recording, transcribing, translating, member checking, and thematically coding data using NVivo 12 software. Data from a review of documents and researcher observations were triangulated with interview data. Findings revealed that poverty, access to health care, and rising diabetes prevalence contributed to environmental turbulence. Goal-setting and objectives, intersectoral-communication, fostering trust and respect, and sharing data and motivating people presented leadership effectiveness challenges. The following resource challenges emerged in the CSC: public policy, money, skills and expertise, equipment and supplies, and connection to the target population. This increased scientific understanding could help government policy-makers and nongovernmental organizations expand public policy leading to a decrease in the prevalence and burden of adult-onset diabetes

ARIA 2016 : Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle

European Innovation Partnership on Active and Healthy Ageing Reference Site MACVIA-France, EU Structural and Development Fund Languedoc-Roussillon, ARIA.Peer reviewedPublisher PD

Shared Value in Chile: Increasing Private Sector Competitiveness by Solving Social Problems

Over the last few decades, Chile has experienced rapid and sustained economic, social, and institutional development. Crucial challenges remain, however, in the form of social inequity, lack of opportunity, mistrust, and social unrest. The Chilean private sector is at an inflection point in its relationship with society. The corporate sector has both contributed to and benefited from the growth and development of the last decades, but remaining social challenges pose significant constraints to the continued growth of the private sector. High levels of mistrust regarding the role of business in society reflect a widespread belief that profit making activities are merely a demonstration of corporate greed. The Chilean private sector faces a frequently antagonistic relationship with government and civil society that will likely worsen unless companies are able to find ways to authentically link their businesses to efforts to solve Chile's social problems. On the other hand, if government and civil society conclude that the private sector has no contribution to make to the country's social and economic development strategy, Chile will squander an important engine for creating shared prosperity. The good news is that there does not need to be a trade-off between private sector competitiveness and greater prosperity for all Chileans. Shared value, a concept explained in Harvard Professor Michael Porter and Mark Kramer's Harvard Business Review articles, suggests an approach for companies to increase their competitiveness and profitability by helping to solve social problems. The public sector and civil society can increase the social benefits from shared value by thoughtfully partnering with the private secto