Over the course of two classes, we discussed the idea of “conceptual frameworks” and how we could integrate them into our specific ventures, but also how we could use them to look at the Global Social Impact Fellowship as a whole. By identifying the key systemic issues that are creating the problem of focus for our venture (maternal mortality in Sierra Leone for Ukweli’s case), and a little bit of artistic talent, we created a two part conceptual framework, one which highlights the issues causing high maternal mortality and the other focusing on how Ukweli helps resolve those issues to create situations where mothers can safely deliver their babies.

This graphic illustrates the barriers, or the “mountain”, that inhibits pregnant women from either reaching a Peripheral Health Unit for screening, or from reaching a PHU at all, which is a major factoring in the high maternal death rate of Sierra Leone. The barriers that exist consist of transportation issues, poor education regarding health and maternal health, cultural stigmas surrounding urinary tract infections and preeclampsia, low income of the patients, and a lack of medical resources nearby to the women who need maternal health assistance.

This is the graphic of the conceptual framework that outlines how Ukweli is working to bridge the gap between the women in communities and screening services for their maternal health. By instituting a system that is specific, affordable, accessible, and empowers the health workers within the communities in which pregnant women live, Ukweli is able to create a service and a product that is more effective in potentially lowering the maternal mortality rate than the current system in place. The affordability helps alleviate the barrier of low income for these women, as Ukweli’s strips are a fraction of the cost of current strips on the market, while the accessibility and the fact that CHWs are now able to screen takes away the barrier of women having to potentially travel hours to the nearest clinic to get screened, which usually discourages women from getting screened at all.

GSIF Conceptual Framework

This conceptual framework outlining the Global Social Impact Fellowship revolves around the 3 main individuals or groups that allow for the projects and program as a whole to be successful, with those being groups being students from multiple disciplines at Lehigh, the professors and faculty that oversee and serve as mentors to the projects, and the in-country partnerships that allow for effective communication and logistics to be organized in the countries of focused. Together, those three players utilize their unique skillsets and expertise to create the large, overarching goal of the GSIF program, which is Impact. Using the resources available, some of which are outlined in the blue ring, these players are capable of creating Impact on many aspects of life, which are outlined in the outer ring of the visual. The aspects of life that positive impact are being created for include things such as reduction of maternal mortality, providing sustainable and locally sourced food that provide employment for individuals, reducing stunting and malnutrition in children, and many other issues that are looking for solutions.

 

Our class prior to pacing break revolved around the idea of forming partnerships and creating coalitions in order to progress our ventures forward and create sustainable and effective impact. When this concept was broken down in class amongst our specific ventures, we were able to identify a multitude of outside individuals and groups who could provide us with insights and skills beneficial for our project, even though some may not have appeared as likely contributors at the commencement of the project. Through these partnerships, many of these individuals and groups benefited personally and professionally as well. Some of the partners and collaborators identified for Ukweli included: 

• Hassan:
  • Hassan acts as our translator in country, but also maintains a role in Ukweli while we are at Lehigh serving as the projects Distribution Manager by training health workers and selling test strips to those individuals in order for community members to be screened. This is a symbiotic relationship, as while Ukweli is progressing due to Hassan’s work, he is being financially compensated and being provided a stable job.
• Allieu:
  • As the health director for World Hope International, Allieu provided Ukweli with a lot of logistical support in country and also used his position to progress our project’s push forward to obtain our product registration license. While a job like this is something that would already be included in his job title, a symbiotic relationship exists because working on this venture could help him gain more of a standing through communication with the pharmacy board and could improve his status within World Hope. 
• Bockarie:
  • Bockarie serves as the finance manager for World Hope’s Makeni office, but also serves a pivotal role for Ukweli, as he takes the lead on monitoring the inventory of test strips and the money collected through Ukweli’s operations. 
• Saidu:
  • As the country director for World Hope, Saidu oversees many of the largest funding and operation decisions for the program, and makes calls that impact Ukweli and how we operate in Sierra Leone. Allieu and Hassan also report to him, which gives him a role that oversees the two main employees in country for Ukweli. A symbiotic relationship exists, as his calls benefit Ukweli, but Ukweli’s progress enables World Hope to benefit. 
• Carrie Jo:
  • As the World Hope Consultant of healthcare issues, Carrie Jo was crucial in helping us meet the DMO in 2018, as well as helping us collect data and organize radio meetings this past summer. While she is helping us, Ukweli is creating positive impact in the field she is most focused on, which is maternal health. 
• We also had beneficial individuals outside of our immediate Ukweli team in the United States who contributed to our project. One was Sue Baggot, who was a connection of Khanjan’s who works as one of the heads of a Cincinnati angel investment group and consulting group. Over the summer, she provided us with a large amount of help in terms of running our crowdfunding campaign to raise money for operations, and continues to occasionally provide insights on how to go about our future funding endeavors. Professor Lori Herz also provided us with help throughout the course of this project, as she has provided us with guidance on the science end of our venture and allows to access to lab space at Lehigh University. 

 

If we were to create a coalition, this group would be focused around the idea of creating a world with a maternal mortality rate of zero, starting with Sierra Leone. A shorter term goal would be to have this coalition create enough of an impact to the point where it is recognized and then adopted by the government of Sierra Leone, and then have the ability to spread into neighboring countries. This coalition would include the previously mentioned individuals, but would also bring in larger players both on a foreign scale but also domestically in the United States. Some of the potential members for this coalition would include: 

    – Funders in US and international markets

• • • Grand Challenges Canada 
    • Venture Well
    • USAID
    • Gates Foundation
    • NORAD
    • DFID
  • Nurse society (from Freetown)
  • World Hope International
  • Human rights NGOs and some doctors
  • Doctors Without Borders (MSF)

With a strong coalition that includes a plethora of multifaceted partners all focused on a common goal, the dream of largely reducing the maternal mortality rate could be reached. 

 

1: The eight tenets of systems thinking

1:Multi-finality

Multi-finalty consists of the idea that multiple outcomes have the potential to occur even though the inputs that go into the system remain the same. The idea of multi-finality is present within Ukweli Test Strips’ operations. Although the fact that Ukweli’s physical product (test strips) and training and messaging documents are the same, different outcomes are produced from that system. With these inputs, women will be screened for UTIs and preeclampsia, but produces another outcome where CHWs are able to receive a supplemental income

2: Equifinality

Equifinality is when the same outcome is produced in a system despite different inputs being used frequently within that system. This is present in Ukweli’s system when you consider the CHWs and Clinics as inputs in the system. These CHWs and clinics could be very different from one another in terms of culture, location, and ways they conduct their work, but the outcome of screening women is the final outcome produced.

3: Abstraction

The idea of describing a system in more than one dimension, speaking to the interconnections and interdependence of the system. The healthcare system of Sierra Leone that Ukweli operates in can be seen as an abstraction in the system. CHWs, NICs, and other healthworkers all operate in a different dimension of the healthcare system, and carry out different roles to work towards a healthier Sierra Leone.

4: Leverage Points

Leverage points are important points in a system that if altered or removed will create a large impact within the system. The ingredients in NewTrition’s muffins are leverage points within their specific operations, as removal of certain ingredients severely impacts the nutritional values and outcomes of the food they produce.

5: Regulation

The idea that in order for a system to be successful, it requires feedback in multiple aspects of said system to manage the high points and pitfalls of a system. Ukweli Test Strips utilizes multiple data collection methods that oversee how each operation within the project is working. We then utilize the data collection forms to make appropriate changes to certain operations.

6,7,8: Interdependence, Holism, Interdependence

These three systems idea thinkings revolve around the ideas that different parts of the system need to operate together to achieve an end goal, and each part has a specific task to take on that needs to be paired with the tasks of other pieces to effectively operate. For the NewTrition muffins, none of the ingredients used would be as effective alone as opposed to when they’re all baked into one food product, and each of these ingredients bring a unique characteristic to the table that allow the muffins to be effective.

2: Emergence

Emergence occurs when an entity is observed to have properties or behaviors its parts do not have on their own. This is similar to the idea of differentiation, where a system needs different solutions that work together to create a cohesive solution that the individual parts on their own cannot achieve. Ukweli showcases examples of emergence, as on the surface one would see a test strip that helps detect urinary tract infections and preeclampsia in pregnant women, but there are many parts that go into this end work that do not have this characteristic in of itself but contribute towards this end goal being possible. Ukweli has a multitude of different inputs into the system, such as a distribution manager who delivers strips and trains CHWs through messaging and training protocols, data collection methods to ensure smooth operations, and certified health workers throughout the Bombali district who will be sold the test strips, and many other important factors. On their own, none of these players have the capacity or resources to do carry out Ukweli’s operations. In other words, they do not have the properties or behaviors individually that Ukweli as a whole is able to achieve.

3: Multifinal solution to the Water Hyacinth problem

One solution that our team had discussed to solve the issue of locals being upset over the profiting of water hyacinth that grow in their communities could be to hire willing workers in the communities where the water hyacinth are growing to one day contract situations where they assist the company in harvesting the hyacinth out of the bodies of water and are compensated relative to the amount of water hyacinth returned to the company at the end of their shifts. If the local workers act in accordance with what the company expects of them, then these individuals will be able to continue to make themselves available to the company for hyacinth extraction on daily contracts. Under this proposed solution, this solves the issue of community members being upset over the fact that they are having this profitable product being taken out of their communities with no benefits being transferred to them, and the extra hands helping to harvest this resource allow the company to be more productive. This strategy exhibits multi finality in the context that this system creates a few different outcomes. First, it provides the locals living near the water the opportunity to get paid for work and to be recognized for helping out with things present in their communities. Additionally, an outcome includes increased production of water hyacinth retrieval for the company since there are more people working. Another outcome possibility is that, with more people working to remove water hyacinth, transportation through these waterways could benefit since there will be less water hyacinth that could inhibit travel. Holism is also present in this situation, as the company and the locals working alone could not achieve as much in terms of extracting water hyacinth as if they partner together to get the work done. Additionally, allowing productive, rule following daily contract workers to return for additional work can serve as a form of regulation, as it provides a system of feedback to manage different processes or outcomes within the work that is being done. By setting guidelines that lay out how people can continue to work and be paid, these volunteer workers know exactly what they have to do in order to be productive and continue to be able to work and be paid.

Team Name:Ukweli Test Strips

Date:10/6/2019

Goals

Cassidy: Ensure that the marketing license gets approved so our test strips can be distributed and sold to CHWs and clinic staff around Makeni. Maintain communication with Allieu to ensure he is working and collaborating with the Pharmacy Board.

Jordan: Solidify funding sources for the team moving forward as a means to comfortably fund operations and Hassan’s salary and help out with logistics as the project moves forward (with our product registration in the near future) and as issues arise.

Naakesh: Maintain and monitor the interactions between our partners on the ground in Sierra Leone and Lehigh. Optimize Ukweli’s operations while the Marketing License is still being processed. Optimize the con-ops for when the Marketing License gets approved. Identify and address potential failure modes for the venture.

Rohan: Perform necessary lab work like comparative accuracy results for the test strip. To research and find a company that can perform proper sensitivity and specificity analysis at an absolute level.

Sage: Finish and publish Gabi’s paper. Keep internal budget of project expenses on World Hope end and flag any discrepancies. Searching for funding sources to sustain Ukweli. Government relations with Sierra Leone.

Zach: Create a WhatsApp group to communicate with Community Health Workers and other Ukweli Health Workers to provide them with information on how to market and use the test strips. Another goal is to produce at least 1 article that is published for Engineer 4 Change, which will help publicize Ukweli and help with possible funding plans.

Project Goals/Scale of Goals: One of the shorter term goals for Ukweli is to expand fully throughout the Bombali District. Currently we have the resources to create relationships with PHUs and CHWs by having Hassan travel throughout the district, but further expansion will require more resources.

Metrics of Success: Hassan’s relationships with clinics and CHWs based on the number of test strips sold. The CHW responses we get from Jawaras randomized calling.

Roles

We all depend on each other to succeed. However, there are some roles we have designated on the team based on the team member’s major. For example, Rohan and Naakesh collaborate more closely on the lab and quality control side of operations. We do try to play by strengths and people’s interests for when we assign a task. However, we also like to encourage anyone to take up certain tasks because they can offer a different perspective.

The roles and responsibilities our team typically takes are:

-Naakesh: project management

-Zach: graphic design, marketing and messaging

-Rohan: quality control, assay research & development

-Sage: budgeting, grant writing, research

-Jordan: messaging, grant writing

-Cassidy: device and medical regulations, messaging

Procedures

In terms of decision making, Ukweli has generally been able to discuss our plans and then modify them to the point where the whole team can come to a consensus on what to implement.

The team meetings that we hold are more than doing work on the project. The meetings are more used to discuss steps to take for the immediate future and to update the rest of the team on the progress of individual team member’s work. Zach usually keeps notes on the meeting as a whole, but the rest of the team contributes to note-taking when necessary. The team keeps up good communication through GroupMe where the whole team is responsive to any requests and questions other team members may have. Ukweli utilizes Google Drive for the majority of the teams work so the team can see any changes a team member makes as soon as the changes are made.

Relationships

Our team is fortunate to have built, maintained and sustained solid relationships between the six of us. Each team member not only is committed to the success of the project, but also remains steadfast in supporting one another. No matter what occurs, we are all ready and prepared to jump in and be flexible and do whatever is required to correct or resolve the situation or advance the project. The connections we have developed have allowed us to understand one another in a more personal way outside of the project, which in turn translates to greater chemistry and a smoother experience when doing work related to Ukweli.

During the most recent case study our class looked at, we read about a United States company coming into India to make Neem products and in the process disrupting a generations long local company. Our team was presented two cases regarding this situation, and assessed them utilizing ethical decision making and grassroot diplomacy steps.

 

Aspects relevant to both cases:

Step 2: Stakeholders of the Situation(s) & Step 3: Motivation of Stakeholders

• Chetan
  • Professional
  • Chetan wants to maintain his business without the royalties charged by OOPS ruining his venture
  • Wants to see his families generation long venture continue
  • Personal
  • Can be assumed that Chetan would struggle supporting his family members if his co. collapses bc royalties
• OOPS
  • Prof: They want the business to work in India. 
  • Personal: they want to provide effective organic solutions to pesticides so people do not get sick and that they can protect the patent 
• Tom Johnson
  • Prof: Tom wants money and he wants his business to be successful. He wants to tap into the market in India 
  • Personal: He might want to give back.. I.e. help indians
• Chetan’s Family
  • Prof: not really
  • Personal: Wants to see the business grow. Distrust for westerners. They know the market very well. They hold the plant sacred and might be sus of the westerners. 
• Chetan’s employees (60+)
  • Personal: Want to keep their jobs to provide for their families. Same distrust of western influence as Chetan’s family. 
  • Professional: Want a stable job that gives them income. Love u @ maria THX
• OOPS investors
  • Personal: n/a
  • Professional: Want the company to be as successful and profitable as possible. Also want the company to act ethically so that there are no scandals. 
• Other small Indian ventures that will have to pay royalties
  • These ventures will be charged royalty by OOPS on products that are tied to their patent. This would negatively impact their ventured greatly and may put them out of business
• Indian People
  • Personal: want the product to stay the same price or go down 

CASE 1:

1. Facts of the situation

Neem is a plant that is native to India, is viewed as sacred by many people in India, and has been used to make a variety of products for centuries. Currently the neem industry in India employs roughly 100,000 people, and one of the companies that deals with neem related products is run by Chatan, who has had this company in his family line for generations. Meanwhile, Tom Johnson, the director of Oregon Organic Pesticide Services (OOPS), has realized the potential of the neem industry, and has taken the steps to put their successful neem-based product in India, where they can sell for a cheaper price than what Chatan can offer. Additionally, the patent allows for Tom Johnson to enforce royalties on Chetan and other companies like his.

2: Refer to “Aspects Relevant to Both Cases”

3: Refer to “Aspects Relevant to Both Cases”

4: Forming Alternate Solutions

This situation is not so much revolved around ethics and morality, but more about legality since a patent is involved. Therefore, this leaves few options on how to deal with the situation.

• Chetan can go about the situation in the legal manner that is presented, and pay the royalties as he is legally required to do so. The pros of this option is that even though Chetan is losing money, he will not get caught up in any legal trouble, and Tom Johnson receives the money that he is entitled to with the patent. However, these royalties could put Chetan and many companies like his out of business. 
• Chetan could fight the patent. We discussed in class that an organic element, such as neem, could not be patented in many cases. With this in mind, Chetan could challenge the validity of the patent Tom Johnson has. This challenge could be successful and the patent could be rescinded, but if it is not then Chetan would have wasted all this effort to still have to pay royalties.
• Chetan could take his neem related products out of his companies mix. Chetan’s business carries many different products, and although taking neem products out would impact his business, he would no longer have to pay royalties.

5: Seek additional assistance

With a patent, companies like Tom Johnson are entitled to enforce royalties, and therefore if Chetan doesn’t pay, Johnson’s company could target them. Additionally, the likelihood of a small business (Chetan’s) effectively challenging a patent to the point of it getting removed is low.

6: Choose best course of action

Chetan would have to analyze the costs associated with paying the royalties compared to removing neem products from the mix. If it is found that paying the royalties would be less of a negative impact than removing neem products, then Chetan’s company should just pay the royalties on the neem based products. If removing the neem products is less costly than paying the royalties, Chetan should do that. 

7: Implications of choice

If Chetan decides to pay the royalties, then those royalties could continue to add up and kill Chetan’s business, even though he sells many products that would not warrant a royalty to OOPS. Removing neem based products from his mix could hurt his business worse, however. Although Chetan would have to pay royalties on his neem products, he would still be making some sort of profit on it, so removing those products completely removes those profits. However, if Chetan’s other product lines are productive enough to the point that the removal of the neem products doesn’t impact them too much, then they would benefit greatly by not having to pay royalties. 

 

CASE 2:

1. Facts of the situation

Tom Johnson implemented his neem based product into the Indian market, where it is wildly successful. Chetan had approached Johnson about OOPS leaving the market, and although Johnson had refused to leave, he was open for a collaboration between Chetan’s and his businesses. Johnson staying in the market means that Chetan will have to lay off many of his workers. Although Chetan will be well off financially, he feels sorry for having to lay off the workers, and to make matters worse, the employees believe Chatan hs been working in collaboration with Johnson and see him as a traitor.

2: Refer to “Aspects Relevant to Both Cases”

3: Refer to “Aspects Relevant to Both Cases”

4: Forming Alternate Solutions

• Chetan retires and offers his workers letters of recommendation for other jobs. Chetan is at the point in his career where he could comfortably retire, s him retiring would mean he takes himself off out of the whole conflict. However, this probably would not do anything in terms of changing the workers newly formed attitude about Chetan.
• Chetan cuts a deal with Tom to use Chetans’ business’ image and brand name to further penetrate the Indian market, Chetan receives compensation from this deal (for using his brand) and his employees receive jobs. This would be beneficial for both Chetan and Tom Johnson, as Tom Johnson will be using a brand image that has been present in the Indian market for generations, and Chetan receives compensation and could probably retire peacefully while his employees receive new jobs. However, it may be hard for Chetan to just give up the family business.
• Chetan does nothing and continues to run his business in the hopes that they can still be effective in the market. Although this allows Chetan’s company to remain independent, Tom Johnson’s company could run Chetan’s company out of business.

5: Seek additional assistance

It seems as though that the way Tom Johnson’s business is growing, there is no way Chetan would be able to effectively run his business in a way that will continue. 

6: Choose best course of action

Chetan should form a sort of collaboration where Tom Johnson will use Chetan’s company’s brand to maintain a reputation in the marketplace, while Chetan could retire while his employees receive new jobs working under Tom Johnson. 

7: Implications of choice

Chetan will receive compensation for giving over his brand image to Tom Johnson, and he will be able to retire peacefully. However, this will only allow Tom Johnson’s company to grow larger, which means other companies similar to Chetan’s would be driven out also. Although Chetan would benefit, other business owners like him will not.

 

During the past lecture, our class looked at two separate case studies that revolved around a women’s cooperative in East Africa intended to produce a nutrient-rich porridge to ween young children off of breast milk, and therefore reducing their risk of contracting HIV from their mothers. Using ethical decision making and grassroots diplomacy strategies, my group formulated potential solutions to take to solve the issues at hand.

Aspects relevant to both case studies:

Step 2: Defining Stakeholders for the situation

1. Children at breastfeeding ages (More for Case #1)
2. Lactating mothers (More for Case #1)
3. Women joining/working in the co-op 
4. Women’s cooperative grant donor
5. You as a researcher 
6. Local farmers (More for Case #1)
7. Doctors / Health network (More for Case #1)
8. The actual cooperative
9. Families with women working in the cooperative

Step 3: Motivations of Stakeholders:

1. Children at breastfeeding ages

This stakeholder is mainly focused on receiving food that tastes good and something they would actually want to eat. At the age they’re at, they would not be as focused or aware of the nutrients or risk of HIV.

2. Lactating mothers

This stakeholder would be concerned with the health of their children, and delivering to them sufficient amounts of nutrients while reducing their risk of contracting HIV.

3. Other Women

This stakeholder may could benefit from this cooperative with a potential job with it in the future. Additionally, if they had a child in the future, this cooperative and the product created would directly impact their baby.

4. Women’s cooperative Grant Donor

This stakeholder would want their money to go towards a productive venture that eventually achieves the goal that the money is going towards.

5. You as a researcher

You would want to create a successful cooperative that achieves it’s goal and creates impact in the community, both for personal and professional reasons.

6. Local Farmers

The local farmers in this region of East Africa could benefit from this cooperative by providing crops to the porridge production and thus making a source of income.

7. Doctors

The doctors in this region would be happy to see a healthier community as a result of the porridge.

CASE 1: 

Step 1: Determine the facts in the situation

In the East African region that is being focused on, 35% of children have stunted growth, and until they are around 24 months old receive their nutrients from breastfeeding in addition to a maize and banana gruel that is not very nutritious. The issue with this is that the HIV rate in this region is very high, and when children breastfeed for an an extended period of time, they are at a higher risk of contracting HIV from their mothers.

However, you are tasked with creating a women’s cooperative intended to produce a nutrient-rich porridge to ween young children off of breast milk, and therefore reducing their risk of contracting HIV from their mothers. This cooperative already has 500 women interested, but many in the area are skeptical of the porridge due to the mindset of breastfeeding their children as well as the potential pesticides that are used in the porridge’s ingredients.

Step 2:

Refer to “aspects relevant to both case studies”

Step 3:

Refer to “aspects relevant to both case studies

Step 4: Formulating alternative solutions

Solution 1: Form a section of the cooperative to educate women on the different risks of the porridge and HIV and let them decide if they want to buy the porridge or not.

From a virtue based thinking, this is a good idea because the good thing to do in this situation would be to properly educate your customer base about the risks and benefits of the product. The pros of this solution is that it properly educates potential customers and allows them to make their own decision on what to buy, but this also presents a possible con in that some of the women may not interpret the information properly and still make a decision that is riskier than the alternative choice.

Solution 2: Create the porridge and privately test for pesticides on the assumption that the pesticides are better than contracting HIV. After testing, sell to the communities without disclosing the risks and educate the women to stop breastfeeding after the child is 6 months of age.

Looking at a consequence based thinking approach, if the goal is to choose the healthier option for the community in the fastest way possible, then this would be a solid choice. However, hiding findings about a product that will be fed to children presents a whole other set of ethical issues. Other pros include that the image of the cooperative is not tarnished because the community is unaware of the risks.

Solution 3: Create the cooperative and create packaging that allows potential buyers to recognize if they are at risk for or potentially have HIV. The packaging also has educationally information that strongly urges women to not breastfeed if they are at risk of/potentially have HIV.

This situation is similar to solution #1 presented, but places it on packaging instead of creating education programs. The pros is that it is more time and cost efficient than creating a whole educational program, but poses the same risk with the possibility of potential customers misinterpreting the information.

Step 5: Seek additional assistance & Step 6: Select the best course of action

Many companies list information about the risks and benefits of their products on their packaging, which would make solution 3 the most viable option. This solution is ethical in that it provides more information to the customer, but is also more time and cost efficient than the other option of informing customers about the product.

Step 7 Implications of the venture

Placing educational information on the packaging instead of taking time to go out and implement a educational program gives the cooperative more time to focus on other aspects of the business that would allow more porridge to be sold and for the project to reach a larger customer base. Informing potential customers about the product will also probably make people more comfortable buying the porridge, which would help the cooperative.

 

Case 2:

Step 1: Determine the facts in the situation

Although the cooperative has been effective and the porridge is selling well, and thus helping provide nutrients to children while reducing the risk of them contracting HIV, there is a problem on the operational side. Despite the fact that the women working in the cooperative are earning money, that money is being handed over to the men in the households and then spent on alcohol and other frivolous objects. Although the women are upset that the money isn’t going to help feed their family and provide other necessities, there isn’t anything they can really do.

Step 2:

Refer to “aspects relevant to both case studies”

Step 3:

Refer to “aspects relevant to both case studies

Step 4: Formulating alternative solutions

Solution 1: Incentivize families to spend money responsibly by showing receipts spent on food, water, etc. If they are spending the money responsibly they get an X% raise so long as they continue spending responsibly.

This solution incentivizes the families working with the cooperative to spend their money on more useful things for the whole family, but this solution could create a lot of extra costs to the cooperative by providing raises for smart spending. It saves face for the men involved, as it doesn’t directly call them out for their spending, but could lead to some sort of issues in the long term if the men caught on to the scheme.

Solution 2: Create a point system that rewards the women’s work instead of giving wages. The women can use these points at a store the cooperative sets up so they can get things that are necessary for their family.

The biggest takeaway of this situation is that money isn’t being brought back to the households for it to be taken by the men and spent poorly. However, this situation could make the men angry, which could hurt the cooperative. The store created could also create a lot of costs for the cooperative and the store may not even store what the workers would want.

Solution 3: The cooperative keeps the money and keeps track of what each women has earned. The women are then able to take money out by specifying what they will buying and giving a few days heads up. 

This situation takes the money out of the households for it to be used by the men, but also allows the family to take the money out and spend it on goods for the family. Giving a required heads up before taking the money out also takes more measures to ensure that smart choices are made for spending.

Step 5: Seek additional assistance & Step 6: Select the best course of action

Many cooperatives run a payment system similar to solution 3, where employees can use their wages as a sort of “share” that they could take out whenever they choose. With this knowledge, solution 3 would appear to be the best course of action to take.

Step 7 Implications of the venture

With the money not going directly home and presumably to the men of the house, spending from the cooperative workers will be more focused towards helping their children and their family as a whole.

 

 

During our previous CINQ class, we looked at a case study as a team that involved an American volunteering at a youth center in Kenya. After reading through and understanding the case, we were tasked with coming up with a solution to take for the American boy stuck in a dilemma surrounding gifts that were presented to the children at the youth center. Here is the seven step process our team came up with to resolve the issue Jack, the American volunteer, had faced.

1: Facts of the Situation

In the case study, Jack is an American working at a youth center in Kenya for a five month period. During his time at the center, a shipment of presents arrives for the children, and a ceremony is planned to present the children with the gifts. During the gift giving presentation, all of the children were ceremoniously presented gifts except for four children, as presents could not be found for them. After the ceremony had concluded, four black hats were found at the bottom of the box and given to the kids. Although the children received hats, it was done so unceremoniously and the gifts were not as good as what other children had received. Although the children did not call out Jack for their presents and the situation, it was clear they were unhappy and Jack felt guilty. However, the staff at the center were unconcerned with the situation and actually seemed upset at Jack for caring about the situation.

2: Problem and Stakeholders

Problem:

–The four kids who received hats afterwards are upset and feel like they weren’t given the same treatment as the children who received hats ceremoniously.

–Jack is afraid that this situation will hurt his reputation with the children, which could make his 5 months a lot more difficult.

–The youth center workers do not believe that the four kids receiving hats afterwards isn’t a problem, and think Jack is creating a problem by caring about the situation.

Stakeholders:

-Jack: he is at the center of the controversy since the children blame him for the bad presents and the youth center workers think he is causing an issue.

-Youth Center Workers: They are working with Jack during this time, and are receiving requests from Jack to deal with the issue, who they think is making a problem out of a non-issue.

-The children: Specifically the four children who didn’t receive hats are stakeholders in this situation, although they are not as much of a stakeholder as Jack or the workers.

3: Motivations of the Stakeholders:

Jack: Wants to help the children as who he believes were mistreated. He wants the children to see him as a good person, which will help his time during his volunteer work. He also wants to maintain a good relationship with the health workers, who also can heavily influence his five months at the center.

Youth Center Workers: The youth center employees don’t see the situation as a huge issue, so they may not want to be bothered by making an effort to make everyone happy and may think there are bigger issues within the center that should be focused on instead. Professionally, they may not want to have their work criticized by an outside helper (Jack), which may influence them to dismiss his call for action to help the kids.

The children who received the hats:  The children who were left out of the gift giving ceremony probably see themselves as left out from the rest of the children and just want to be seen as equal from the perspective of the workers and Jack as well as the fellow children.

4: Alternative Solutions

1: Get the same gifts that were given to the other kids and give them to the four kids who received hats in some sort of public event.

This situation would make the four children feel equal to the other children, since they are receiving the same gifts that were given out and it is being done in a public setting. However the other children may get mad that these four kids received a hat and other presents. The relationships between Jack with the children could possibly be fixed, as they would understand that Jack cares about them, and the youth workers may appreciate that Jack is sorting things out on his own.

2: Give the four kids some sort of leadership role in an upcoming event in order to make them feel like they are on the same social level as the other children.

This situation could make the left out children feel equal through a small action that won’t make the workers upset at Jack.

3: Work in collaboration with the youth workers to help them understand what was wrong in the situation and work to plan something small but nice for the four left out children.

This situation won’t backdoor the workers, which they may appreciate, and also teaches the workers how to deal with situations like this that could arise in the future. This also provides the four children with an event that could make them feel equal, but may upset the other children.

5: Additional assistance

In general, people usually care more about the social standing and how others perceive them than the material objects that they may receive that have little monetary value. Therefore doing something that helps the four children be seen as equal to their peers would be effective. This could also be applied to the health workers, who would most likely benefit by having the kids view them in a more positive light.

6: Selecting the best course of action:

During the course, I believed that our third course of action, where Jack works with the youth center workers to come up with a solution, was the best course of action. I believed this situation would help the workers understand how to deal with situations like this in the future, while also repairing the situation that is currently presented in the case study.

7: Sequence of actions to take:

1: Meet with the youth center workers to try and help them understand the situation better, and how issues like this could be resolved in the future.

2: Work with the youth center workers to plan an event that is small enough so the other kids don’t get upset but the children who received hats feel like they are appreciated by Jack and the youth workers.

3: Implement the plan for the four kids.

During our previous CINQ class, we were looked at a case study as a team that involved conducting research to test water in Lesotho. After reading through and understanding the case, we were tasked with coming up with a solution to take for the research project using an ethical decision making methodology, a seven step process to determine the best course of action in certain situations. Here is the ethical decision making methodology our team came up with.

Step 1: Determine the facts in the situation 

In this case study, the main facts of the situation were:

• A team of 11 academic researchers are going to Lesotho for two weeks to test water sources in various communities.
• The tests are to identify disease causing pathogens in the water and understanding their life cycles and characteristics. These pathogens are only located in Lesotho and these findings could produce multiple publications and a development of chemical additives to make the infected water safe to drink in the future.
• The team will need help from community members in terms of finding the water sources that communities drink from and learning how the drinking water is stored. The team does not see the need to pay the community members assisting the project.

Step 2: Define the Stakeholders / Step 3: Assess the motivations of the Stakeholders

Stakeholders and their motivations for this situation include:

 

• The Research Team: This group can benefit from this research through publications of papers related to their findings, as well as accolades that can bring them professional opportunities down the line.

• The Community Members in Lesotho: This group has stake in the project because their drinking water sources are being used. They will be drinking this water that may contain these pathogens, and the findings from the research team could produce a solution to make the water safe in the future. In addition, community members who assist in the project could receive possible compensation and other perks.

• People who read the findings of the research: This group of people could take the information about the pathogen that was found during the two weeks in Lesotho, and use it to create a chemical additive or product that makes the water safe to drink. This could create a profit for those people and get them recognition in that field.

• The University that is overseeing the research: The University could gain recognition through this research project, primarily through the publications of papers that their names will be attached to. This could lead to more money and grants for the school.

• Government of Lesotho: The government of Lesotho could benefit from this research, as it could help them identify the reason for the pathogen-containing water and in the future could allow the government of Lesotho to provide their communities with safe drinking water.

 

Step 4: Formulate (at least three) alternative solutions 

Solution 1: You can pay community members who assisted in the research project. The pros of this is that it is a nice thing to do and may also motivate the community members to be more helpful. The con of this option is that it would require the research project to use more money that they may need later on at some point, and it also creates a situation where it can become unclear on who should be paid for their help and how much.

Solution 2: You do not pay the community members who helped you. This situation would mean that you avoid any confusion about payments mentioned in the cons section of solution one, but no pay could make community members more hesitant to assist you, and make the members who do work with the project less motivated to assist to the best of their ability.

Solution 3: You reimburse the community members who assisted in the project only up to the amount of capital they gave up to help. This could include transportation costs and things of that nature. You also distribute the findings of your report back to the communities whose water sources were tested and make these findings available to the public back in America. This allows a company to take your information and create a solution to clean the water and makes the communities in Lesotho aware of the water issue, but can also create payment issues for the community members that helped, similar to what was mentioned in the cons section of solution 1.

Step 5: Seek additional assistance, as appropriate 

Personal Experiences from the CINQ Team: The Ebola Team that traveled to Sierra Leone this summer conducted many interviews with community members and other individuals in Sierra Leone. The team provided reimbursements for things such as travel, but did not pay the individuals for taking part in the interviews. Although they made this clear to the participants that they would not be paid, they still received good cooperation and were able to conduct effective interviews.

Past Cases: In many cases of clinical trials, the teams conduct their research and leave without any real solution to what they were collecting data on, similar to what this project is doing. Although it is not the most ideal scenario, this sort of process is still used very widely. 

Step 6: Select the best course of action/Step 7: (If applicable) What are the implications of your solution on the venture. 

Our team decided that we would conduct solution 3, which is to reimburse the community members for any personal expenses they may have put into helping the project, then after research has been conducted distribute the findings to the Lesotho government, the communities at the center of the experiment, and make the findings available to anyone who is interested in America. We believe this is the best course of action, because from a community side of things, the people who are assisting in the project would not be losing any money in order to help, and the community will be made aware of the issues with their drinking water and can figure out how to deal with it. By distributing our findings with certain sectors of the Lesotho government, help can be given to the communities on the federal level to try and solve their drinking water problem. By making the findings of the research and data available to potential stakeholders, someone can take the knowledge gained from the research project to create a chemical additive that would make this water filled with disease causing pathogens safe to consume. Therefore, even though the research project ended after the distribution of the data collected, a new team can head up a mission to make the water in these communities safe to drink.

 

1: What are the top 3 things you have learned during your GSIF trip this summer?

1. In terms of the operation and business side of my GSIF project and the fieldwork trip, I learned you and your team often times have to constantly be checking in on progress and actions that need to be done, especially when dealing with a complex and foreign system of operations such as the Sierra Leonean government. This realization came when the team found out that although we gave money to one of our partners in Sierra Leone to pay to start the product registration process, we learned while we were in Sierra Leone that that payment had not been completed yet and the process of getting our product registered had not started. We sent the money over to Sierra Leone and more or less relied on the process to be carried out smoothly, but now seeing how that turned out, it is important to see everything through that relates to the project you are working on, regardless of if it is out of your hands or not.
2. I also learned how much of a role culture plays in terms of how a project or venture operates in a foreign country. While my team was working on the venture in America, we tried to take into consideration how what we were trying to implement could be viewed differently in Sierra Leone. Although we tried to make edits to our training protocols and such to better reflect Sierra Leonean culture, upon arrival to our fieldwork and after having our employee, Hassan, read through the training and messaging protocols we realized that there was a lot more about the culture that we did not take into consideration. We realized how many of the things we had that would not make sense to Sierra Leoneans, and we realized how many things were necessary for us to add into our operations to best present our venture to Sierra Leone.
3. One of the things I learned that meant the most to me was getting an actual understanding about how grateful the people in Sierra Leone were for us implementing ventures that will help their communities. Prior to fieldwork, I had an understanding of the impact we were making andI knew that we were doing good for their communities, but actually being in Sierra Leone and communicating with the people in the clinics/markets/etc made me realize just how much they appreciate all the work we were doing in their country.

2: How did the GSIF trip facilitate your professional development?

1. This three week fieldwork trip made me much more communicative and a leader in group work and in projects. Prior to coming to Sierra Leone, I would not have considered myself a strong leader who felt comfortable calling shots or being the first person to bring up ideas. However, while I was in country, I became much more confident directing certain parts of the operations, like working with Hassan on the messaging and training sessions, because I realized that my teammates and me were the experts in how the venture should be run.
2. Spending three weeks completely dedicated to a venture that experienced a lot of twists and turns during our time in Sierra Leone made me more comfortable dealing with adversity and having to pull things together when projects hit road bumps. The biggest example of this came when the news broke that our product registration approval would not come during our time in Sierra Leone, and that we could not launch our venture until later into the year. Although this was a big blow, however, we realized that we had to pull something together that would allow our project to still be productive during our extended wait to launch. In the end, myself and the team created a messaging protocol to get the word out about Unwell and the service it offers prior to us being able to sell our test strips.
3. Working on this venture also forced me to look more at the bigger picture when working on projects like Ukweli Test Strips. After spending time at clinics in the Bombali District and witnessing Sierra Leonean culture and the healthcare system, I started to try to understand how an action that Ukweli takes could impact the health workers, the patients being screened, and the healthcare system that Ukweli is trying to implement itself into.

3: How did the GSIF trip help you grow personally? 

1. During my time in Sierra Leone, I became much more comfortable branching out and getting to know and communicating with people I didn’t really know well. I realized that I would be spending three weeks with these people so I realized how important it would be for my enjoyment of the trip to get to know everyone in SL. I think this growth from SL will carry over and make it easier for me to communicate with people in the USA also.
2. Prior to visiting Sierra Leone, I had been to a few countries before, but none that were similar to Sierra Leone. I have always been curious about cultures and countries around the world, and doing this three week fieldwork project helped me gain a much better understanding of a culture that I knew very little to nothing about only a few months ago. It was extremely interesting for me to understand the viewpoints of people of Sierra Leone and the type of lives they live, and having that experience makes me want to continue to travel and learn more about people throughout the world.
3. What helped me grow the most personally in my opinion were the relationships I created with the World Hope International workers and translators. It was very impactful to create these relationships and see how friendships can so easily be created despite extremely different cultural backgrounds. I loved spending time talking to them about their lives and their views on different subjects, and it was extremely rewarding and eye opening for me to hear from them how appreciative they were that we came to their country to work on projects that will eventually have an impact on so many citizens of their nation.

 

1. Develop a M&E plan for your project.

 

Below is a Monitoring and Evaluation Framework layout for Ukweli Test Strips.

	Indicator	Definition	Baseline	Target	Data Source	Frequency	Responsible	Reporting
Goal	Reduction in the maternal mortality rate in Sierra Leone.	The number of maternal deaths reported by the government of Sierra Leone at some point in time during our venture subtracted by the maternal mortality rate .	1,360 maternal deaths per 100,000 live births.	A number hopefully much lower than 1,360 in the long run	Utilize medical data from hospitals/other PHUs and records from Sierra Leone’s Government.	Every other year might be a good frequency but more frequent may work.	World Hope International, our partner on the ground will most likely be measuring and collecting the proper data for this goal.	This statistic will be reported to the Sierra Leone government and other global health programs most likely.
Outcomes	Number of women who are screened and screen positive for UTIs and/or Preeclampsia.	Records kept by community health workers and other clinics regarding how many women were screened and their outcomes compared to the number of screenings prior to this venture (If that information is available).	A current value of amount of women screened for UTIs / Preeclampsia is not available.	The target would be to get as many women at risk for UTI / Preeclampsia in the operating regions screened.	Utilize records made up by Ukweli of how many women are screened.	This data could be collected pretty frequently, probably multiple times a year.	This data would be kept by the health workers administering the tests to pregnant women.	This outcome would be reported to World Hope International, as well as the Ukweli team in the United States. Might be beneficial to be reported to the government.
Output	The mindset of seeking help and being open to communicate  when experiencing symptoms, rather than doing nothing (current problem)	Track how many times women got screened or were referred somewhere else to get screened. Shows initiative to actually do something.	No data available for this.	A noticeable increase in women who come to doctors to get screened / talk about their health in regards to UTI / Pree	Utilize records made up by Ukweli of how many women are screened.	This could be monitored pretty frequently to get an idea of the change in attitude	The health workers who are administering the strips/talking to patients about their symptoms/referring	This output would be reported to World Hope, the Ukweli Team, and possibly different government organizations.

Some of the assumptions used to create this framework included:

• Messaging, communication, and advertising measures are effective and reach enough of the intended audience. If this assumption is carried out, then the goal, output, and outcome will be reached.
• The tests will be accurate in its screening. If they are not accurate, then women who have UTIs/Preeclampsia may not screen positive, which is detrimental to helping women with these problems. If these women are not helped, the maternal mortality would not be lowered as much as it could, and not as many women would seek out this screening.
• The strip is priced appropriately. If the strip is too expensive in the eyes of the women, then the goal and outcome cannot be reached

The logic model that would be in place would look something like this:

 

Inputs	Activities	Outputs	Outcomes	Goal Alignment
-Funding -Partnerships with OEMs, World Hope International -Team of college students/professors	-Delivery of test strips to health clinics/workers in Sierra Leone -Training of health workers on UTIs/Preeclampsia, how to use the strips, how to advertise it to women	-Number of women screened -Number of women that screen positive -Number of women referred to other health clinics to get	-Better health for mother and baby -lowering of the maternal mortality rate and infant mortality rate	-If all falls into place the way Ukweli is intending it to, then the outcomes of the operations would align very well with the goal.

 

 

2) Estimate the Social Return on Investment for your project.

 

For this social return on investment, to see how much money is generated per $1 spent, I am deciding to look at it in terms of $1 spent solely on test strips due to the fact that the strip costs are most traceable and factoring the overhead spent and other costs associated would make this very complicated. Therefore, assuming we produce each test strip for two cents (the current rate), we would multiply the social return for one strip by 50 in order to get it in terms of $1 spent. We would also have to assume the price that a health worker buys a 100 strip box for from World Hope and how much they sell each strip for in order to figure out the profit per strip they would make. We would also have to assume how much a women in Sierra Leone would have to pay for a strip that is currently on the market in order to see how much money they would save purchasing an Ukweli test strip. Assuming a health worker purchases a 100 strip box for $5 ($0.05 per strip) and sells each strip for 2,000 Sierra Leonean Leones ($0.23), they would be making a profit of $0.18 per strip, or $9 if they sold $1 worth of strips (50 strips). According to our crowdfunding video, a single UTI screening test at a clinic costs roughly $2, so assuming that is the actual price, women will save $1.77 buying an Ukweli Test Strip for $0.23 from a community health worker. Therefore, when only considering the money associated with buying and selling test strips, for one test strip Ukweli generates $1.95 of social impact between the health worker administering the strip and the women getting tested. This equates to $97.50 generated for $1 spent solely on test strips. However, since this only focused on the cost to produce strips and not the money spent on overhead, etc, the number calculated for generated money may be higher than it actually is.