Inclusive Innovation Series: Stories Across the Ecosystem — Field Notes from Bangladesh
In this #InclusiveInnovation Series: Stories Across the Ecosystem, we are building upon the research frameworks lifted from our recent UNDP-Nesta ‘ Strategies for Supporting Inclusive Innovation: Insights from South East Asia” Report. For more context you can see a quick background on ‘The Why’, implications in the COVID19 era, and the full launch details plus report and recording here.
In this post, Anir Chowdhury (Policy Advisor to the a2i Programme of the Government of Bangladesh, with technical assistance from UNDP) and Ishtiaque Hussain (who leads Exploration and Strategy Development at a2i) are interviewed by Courtney Savie Lawrence of the UNDP Asia Pacific Regional Innovation Center (RIC). This week, we sat down to explore what it means to be working at the intersection of governance reform, digital transformation and inclusive innovation.
Courtney- RIC: Let’s begin from the start- the a2i Programme. We know that a lot has been moving since inception, and working in tandem to usher new collective intelligence and platform models. There is already a significant track record as well- can you tell us more about impact to date and the big picture moving forward?
Anir- a2i: Sure, let us start with some concrete numbers. a2i’s citizen-centered transformation of digital public services has saved Bangladeshi citizens nearly 2 billion days, over $8 billion and 1 billion visits, to date. We are soon to be formally established as Bangladesh’s national innovation agency. Over the last 12 years, a2i has emerged as the key facilitator of the Bangladesh government’s inclusive innovation agenda, Digital Bangladesh. It fosters an adaptive, inclusive national system for collective strategizing, planning, action and learning to catalyze truly unprecedented transformations in public service delivery. It also works as an innovation intermediary through a ‘whole-of-government’ approach and supports the government to be on the forefront of integrating new, ‘whole-of-society approaches’ to achieve the SDGs.
Courtney- RIC: There is no shortage of challenges either, so let’s connect with what we know is top of mind for everyone- COVID 19: what is the context, and how are organizations and the government working together to respond? This ‘new normal’ is opening up new ways of thinking and working:
Anir- a2i: We know COVID-19 will paralyze the country for weeks optimistically and months realistically. Beyond the formal lockdown period, an informal lockdown will grip the world’s most densely populated, still-poor country for many more months. What will happen to the country’s healthcare for non-COVID patients, education for all students, transportation of food, medicine and other essential goods, entertainment needs and financial services — all of which depend on physical establishments and physical movement of people?. Will all these sectors just stop functioning during the time of social distancing?
With that realization, from a2i, we developed 5 business continuity plans for health, education, logistics, entertainment and financial services with guidance from Sajeeb Wazed Joy, the Hon’ble ICT Advisor to the Prime Minister, and Zunaid Ahmed Palak, MP, the Hon’ble State Minister for ICT. The BCPs were approved by the Hon’ble Prime Minister Sheikh Hasina in a day. We are now implementing them with the largest number of private sector partners that we have ever worked with.
From the Bangladesh COVID19 experience, which is only 3 weeks old, I believe the following are important as far as public service innovations are concerned-
- Human capacity to adopt new things (such as digital) is unlimited when there is a crisis. We’ve tried telemedicine for years without much success, but now it seems it’ll be the new normal. We need to spot the right opportunities.
- It is essential to unleash creativity of non-government actors to improve public service delivery. We need to experiment with various forms of public-private-partnerships. Crisis allows that.
- As we deploy things quickly, we need to avoid violating privacy protections. We must readjust and establish the right balance for our context. This is absolutely vital to ensure trust in the system.
- Designing appropriate communication strategy coupled with service delivery changes is a must. We need to implement communication strategies for scaling up.
- Relentless focus on the mission and egoless negotiation to move closer to the goal along with everyone are critical. We need to learn this behavior and reward it.
- Human productivity is sapped by over-adherence to log frames and procurement rules to pass audits. We need to find a way to conform without being straitjacketed because speed is of the essence and the government will appreciate it.
It’s a huge opportunity to learn quickly, across institutions, not only this region but others as well. We’ve never had such a fast-moving, common challenge. Climate change is too slow to generate this sense of urgency — unfortunate, but true.
Courtney- RIC: Can you share some specific, concrete examples of how new responses are being developed and who is involved?
Anir and Ishtiaque- a2i: The new digital governance that is emerging in the midst of the COVID-19 crisis in Bangladesh is creating what Martin Stewart-Weeks of Public Purpose in Australia interestingly terms as a ‘COVID dividend’. It is sweeping us off much faster the ‘4IR dividend’ and certainly even faster than the proverbial ‘demographic dividend’. Some concrete examples:
· The national information helpline 333 was repurposed to take in calls from people around the country. There is a simple triage system which automatically asks for symptoms (shortness of breath, fever, cough) of the caller and information on whether the caller has been in contact with anybody with such symptoms or anybody who has returned from abroad in the last 14 days. Based on the responses, the callers COVID19 risk category is determined.
· Because 60% of the population still carries feature phones, we needed to launch a USSD-based system to do a more extensive triage by encouraging millions of phone users to do self-reporting because the country has no other way to reach these millions. A million USSD calls came in within days.
· The 2 million plus calls into the IVR and USSD system — that is growing everyday — have given birth to a vast repository where big data analysis is possible to conduct disease surveillance on a daily basis. We are now using various algorithms and human interventions to identify high-risk patients and hot zones to conduct contact tracing.
· Also, we needed a lot of doctors trained to provide medical advice on the phone to callers who were considered high-risk. So, we trained 15,000 doctors, medical students, nurses and other health workers in a matter of days using an internationally award-winning e-Learning system called Muktopaath (which is Bengali for ‘open learning’).
· At the same time, we needed a lot of doctors to be on call to receive the rapidly growing number of calls — which escalated from a thousand to nearly a hundred thousand in 2 weeks after the launch of the IVR system. But we didn’t have the means to hire them. So, we innovated the ‘Doctor’s Pool’ app — an Uber-like system where the COVID19 e-Learning module trained doctors could sign in during their free time. Of the 15,000 who trained, hundreds of doctors are now available at any given hour of the day. Even at 2am you would find scores of doctors available on the system. The Doctor’s Pool app has become the largest telemedicine offering in the country overnight. Doctors are offering services ensuring their own safety and maximizing their productivity through virtual visits in the face of a massive patient surge.
· The national 333 helpline system was again repurposed after two weeks to take in and redirect to local administrators calls from the marginalized for food shortage and quickly emerging poverty zones in the country because of lack of employment and trade resulting from the lockdown. Without any kind of publicity, the system redirected 2,500 calls in the first half day.
· Operators of the 333 helpline are also trained to detect cases of marital rape, domestic abuse and violence against women — which have spiked due to the social distancing measures — and make referrals to counselors and medical professionals who can provide advice on women’s sexual and reproductive health.
· a2i’s iLab has taken on the responsibility of creating home-grown PPE gowns and face shields that we couldn’t import on time. The lab has partnered with the R&D team of Medtronics which has recently open sourced its ventilator. A private sector electronics and home appliance maker in Bangladesh has stepped forward to manufacture the ventilator. Given that the country has less than 2,000 ventilators for a population of 165 million, this is an important move.
· The Parliament TV, which sits largely idle other than when parliament is in session for a few hours each day, has been repurposed to broadcast programs for primary, secondary and vocational education. The programs were created literally within two weeks with recording studios and scores of teachers and education administrators working together. Parallel YouTube and web versions of the programs and assessments were also created in a very short time.
· The digital financial services system that a2i designed, developed and helped roll out to millions of social safety net beneficiaries is now enabling digital payments to COVID victims such as garment workers who have lost their jobs because of factory shutdowns, rickshaw-pullers and street vendors who no longer have customers.
So, the name of the game was repurposing and matchmaking. Massively. Across public and private sectors like it has never been done before. All it needed was a little bit of nudging and coordination, but not much.
Courtney- RIC: It’s incredible how many examples you give that have emerged in only the past few weeks. We know that COVID-19 is both urgent and important. Yet let’s also take a look in terms of medium and long horizon strategy. Shaping policy is a nuanced and complex dynamic for any country, and as emphasized in the Inclusive Innovation Report, it’s highly contextualized. For a country like Bangladesh, what does the process look like?
Anir- a2i: Although UNDP has repeatedly raised it as a strategic risk, at least regionally, this new coronavirus has clearly caught governments off guard. Most frontline leaders were still in “sensing the problem” mode while the situation demanded fast decision making and preemptive action.
Defeating COVID19 will take shifting from classical mechanics to quantum mechanics. In classical mechanics, things happen slowly, you can actually see and test things. You have the time for that. In quantum mechanics, you don’t. It’s probabilistic and in many cases, even unpredictable.
In terms of our own “real-time sense making”, we see the following paradigm shifts, typically where it’s a binary choice (x vs. y), we see it evolving with additive effects:
Life AND Livelihood- Over 90% of Bangladeshis are employed or self-employed in the informal sector with no health insurance. Social distancing is not a concern for people living hand to mouth. Many of them are left asking, what is this nonsense about social distancing while we’re dying of hunger!
Indeed, several studies find that equally effective social distancing policy would benefit advanced economies much more than poorer countries in Africa and Asia. They urge a rigorous examination of the costs and benefits of alternative harm-reduction measures (such as popularizing handwashing and good respiratory hygiene) that are less disruptive to the livelihoods of the poor and feasible in low-resource settings while reducing COVID19 related mortality to the greatest possible extent.
Government AND Non-government- The boundary between government and non-government is fading fast. Just looking at what we did in the last 3 weeks, there was no boundary at all in the way we worked. To effectively fight coronavirus, we needed to know where the high-risk cases were and whom they were transferring the disease to. But how do we find the people with and without symptoms in a country of more than 160 million people?
In an attempt to reach as many of Bangladesh’s 35 million plus households as possible in the middle of a virtual lockdown, the government formed an unprecedented collective data intelligence system (see below) consisting of self-reporting citizens, all four mobile companies — Grameenphone, Robi, Banglalink, and Teletalk — leading NGOs like BRAC, journalists, development partners with facilitation by a2i and technical support from the National Telecommunications Monitoring Centre.
Digital AND Analog- A crisis like this can make tectonic shifts happen. Governments are not prepared and citizens are not in a position to care — they need services today, this hour, now. And they will pick whoever is able to meet their needs. Governments will thus need to gradually move away from direct service delivery and more towards creating enabling, open and interoperable technology platforms (including unique digital IDs, payments and data) that enable the human ingenuity of social innovators, the private sector, academia and civil society to innovate and deliver the increasingly personalized services that citizens need, when they need them.
Data AND Privacy- There is an interesting quote going around, “We’re all China now”. Though initially, its origins may have been in terms of communicating a sense of solidarity with the people of Wuhan, we must take pause and reflect on what it means now. Does it mean we have to do what China has done in terms of its COVID19 response? Which, for instance, includes human surveillance. Just in the last week, we have seen two quite sophisticated demonstrations of facial recognition technology in Bangladesh. They have developed facial recognition capability even when a person is wearing a mask. For example, the obvious case, detecting whether someone who is supposed to be under home quarantine has actually left their premises. Or, someone goes to get relief and facial recognition technology is used to make sure they are not circling back for more than one handout.
But what happens if this falls into the wrong hands and perhaps even in the right hands? The same technology could be used, is being used for the purposes of exclusion in many countries around the world including in some large democracies.
Will these transformations from ‘VS’ to ‘AND’ stick? Only time can tell, but they certainly need to.
If you are keen to contribute to the agenda, you can continue the conversation with UNDP Regional Innovation Center’s Head of Exploration, Courtney Savie Lawrence here or through LinkedIn here. Let us know more examples you see from the ecosystem, as we run the #InclusiveInnovation Series: Stories Across the Ecosystem.