Mobilizing the private sector is essential to closing persistent gaps in financing, infrastructure, and innovation.  While much of this capital and innovation originates in Western or global markets, its application and value must gear towards that of emerging economies, where health systems face the greatest climate risks. Done right, this approach can protect the most vulnerable from climate-health risks while also reinforcing economic stability, reducing long-term costs, and opening new markets for inclusive growth.

Private sector engagement must therefore be framed not only as a corporate social responsibility, but as a return-on-investment opportunity: healthier, more resilient communities reduce supply chain risks, stabilize workforces, and expand consumer markets. The report outlines four key domains where private sector action can strengthen health system resilience: 

• Innovative Financing, such as blended finance, green bonds, and outcome-based mechanisms.
• Infrastructure & Technology through renewable energy-powered facilities, and scalable digital platforms and solutions.
• Risk Management & Insurance, including climate-triggered insurance models; analytics, and protection products.
• Collaborative Partnerships that align commercial expertise with public health priorities and that build capacity to ensure workforce resilience.

Despite this potential, private sector engagement remains limited by misaligned incentives, regulatory uncertainty, weak impact measurement frameworks, and structural challenges. This report presents actionable solutions ranging from policy incentives to standardized metrics and inclusive investment models—to unlock meaningful participation.

The report calls for a shift toward more practical, results-driven collaboration between sectors, with equity—especially inclusion of women, youth, and local communities—as a core design principle for health system resilience.

Learn more about our Climate & Environment sector portfolio.

The post Report: How Private Sector Involvement Can Enhance Climate Adaptation within Health Systems appeared first on Camber Collective.

Around the world, over 5,000 Certified B Corporations in over 70 countries receive this designation, demonstrating they have met the highest verified standards of social and environmental performance, transparency, and accountability to all their stakeholders. While many corporations state a commitment and actions to ESG (environmental, sustainable, governance) best-practices and positive social impact, B Corps are legally required to consider the impact of their decisions on all stakeholders: customers, workers, communities, and the environment.

While there are B Corps represented across more than 150 industries worldwide, there are but a handful of strategic advisory firms in the mix. Camber Collective is elated to have become a certified B Corporation at the end of 2022, receiving a score of 100.9 points on the B Impact Assessment, a rigorous measurement of a company’s overall impact on its workers, community, customers, and environment. (The minimum performance score required to meet the requirement is 80.)

I recently talked with our co-founders Brian Leslie and Ted Schneider about what Camber Collective hopes to both gain and model by being a Benefit Corporation. This article has been edited for length and clarity.

Q: The B Corps has been around since 2007 and many of us recognize their “circle-with-the-letter-B-inside’ as a seal of approval. Not everyone knows what’s behind the logo though—a commitment to using the power of business to solve our most pressing global challenges. B Corps certification provides an immensely powerful way for corporations to build credibility, trust, and added value in the marketplace. Is this why you sought to pursue B Corps certification for Camber Collective?

A: One of the primary motivators for our pursuit of certification was to show our commitment to social impact. Camber, as a strategy consulting organization, strives to address today’s most urgent challenges, systemically, sustainably, and equitably. Our values aligned strongly with the principles of B Corps, and we saw many further benefits to becoming affiliated.

We would not only have proof, as it were, that we are committed to positive social impact goals, but we would also be accountable, in a transparent and public fashion, to measure and sustain that commitment.

Q: Yes, because certification has to be renewed every three years. So, certification creates a built-in requirement, making sure that we walk the talk.

A: Another element of being a B Corp is there is a measure of transparency insofar as B Labs publishes a summary version of every B Corp’s Impact Report, so that the public can see how the company compares to other businesses in their industry or sector across a variety of social impact measures.

How to Walk the Talk

Q: This is an interesting point. There are not a lot of consultancy firms in the B Corps cohort I imagine; there must be some evident advantages in the market for us in gaining this certification.

A: There are a lot of advisory organizations and consultancy firms that say they are values-driven, and while they might measure one or two elements of social benefit and progress, the B Corps certification process is quite rigorous. A B Corp must demonstrate excellence in areas, such as management practices, that can sometimes be opaque when corporations report on themselves, and entirely control the narrative of what they wish to divulge!

The certification process helped shine a light on some of the ways we had already differentiated ourselves – for example, we introduced a transparent and equitable compensation model 7 years ago. We now possess a framework for how we manage the firm in a way that keeps us above a certain threshold. So, it’s not just words, it’s a level of assurance and demonstration that we have to execute, measure, and maintain.

Many firms use the words that B Corps includes in its mission: building an inclusive, equitable, and regenerative world, but if you are a B Corps, you are required to show it, on an ongoing basis. There is nothing in that statement that is misaligned with our own values or the way we try to operate and grow our firm.

Tax Code Does Not Equate Virtue, or Lack Thereof

Q: Let’s stay with the self-governance topic for a minute more. Camber is a social impact advisory firm that works for equitable and sustainable outcomes. At the same time we are an LLC, and not a nonprofit corporation, which is the legal entity people generally associate with altruism, positive impact, and social good. Foundations are not-for-profits, for example. How does our identity as a for-profit firm create both opportunities and misconceptions, and does being a B Corps help mitigate this dissonance?

A: We sometimes hear what almost approaches a purity test in the social impact space, wherein nonprofit equals good, and for profit equals harmful, extractive, and bad. One of the great strengths about the Benefit Corporation certification is that it models a third way out of that binary.

These are companies that not only perceive themselves as enacting positive outcomes in the business world, they are given the opportunity—and the mandate—to demonstrate that, through both hard data and ways of working.

Q: I like that framing of it as an opportunity. Sometimes there is a knee-jerk assumption that if you are a for-profit company, your goal is to make the most return on investment, full stop. If anything good for society comes out of your venture, that’s secondary. But it seems like B Corps provides industry a way to model that defining and tracking positive impact is not that hard. In this moment of climate emergency, consumers, investors, and employees alike are all asking for companies to demonstrate they are good.

Some might not have knowledge or access to the tools to know how to best accomplish this; so the examples and resources B Corps provides through its outreach and brand actually have trickle down benefit even to companies who do not or cannot at present pursue certification. There are over 75,000 businesses actively using B Lab’s B Impact Assessment and benefit corporation governance structure, and many more who are incorporating B Corp Talking Points into their theory of change and business model.

A: That’s true. It is a good entity, for both direct and indirect impact in the business world.

Q: Yes, and now that they are more global, the potential for world-changing is even bigger. OK, I see that values alignment and accountability were key drivers in the decision to pursue the certification. I imagine there are also significant upsides in terms of the brand and market differentiation.

A: Yes, and this assertion extends the notion of pushing past the nonprofit/good, for-profit/bad binary we were just discussing.

We believe that being a B Corps is wonderful for Camber in terms of, again, not just saying, but proving that as a consulting firm and an advisory firm, we bring a profound set of social impact values and activations to our practice. And in our sector, that is a market differentiator.

We didn’t join B Corps expressly to attract more clients, but we sense becoming part of this cohort will over time connect us more readily with the kinds of agencies and entities we want to work with and assist, and it will provide opportunities for learning and exposure to positive impact best practices to improve Camber’s practices.

One facet of this, with broader lens, one with which you are very engaged, is the complexity around navigating internal equity and belonging. The B Corps has a growing body of work around SDG tracking, and increasingly so when it comes to DEI, racial equity, and anti-racism. They are growing their awareness, communities of practice, and bodies of work around these concepts, and indeed, we expect to not only to learn from these cohorts, but to be able to contribute to the discussions as well.

Q: And not just regionally or nationally… B Corps is a growing transnational entity, which I imagine will open networking and community-building opportunities for us as a global firm.

A: Most definitely. We are not approaching certification from a hardcore business development lens of: “let’s go find new clients,” but more from a viewpoint of, “how can we build an even more robust network with familiarity and trust,” which can lead to collaborations,  brand visibility, influence, and certainly referrals too.

To put a finer point on it, many B Corporations are consumer brands, which we are not. But we know that people not only want to buy from companies whose demonstrated values match their own, but they want to partner with them, hire them, and work for them. All of these facts provide tremendous opportunity for Camber.

Q: Yes, indeed, this looks like a very impressive community of peers to interact with—as they say, a community of “high performing peers.” I have seen many indicators around B Corps on the aggregate that show we are entering into “good company”: To pull from their fact sheet, compared to ordinary businesses, B Corps are:

• 9% more diverse
• 33% more likely to have gender-inclusion trainings
• 48% more likely to have LGBTQ-inclusion trainings
• 45% more likely to have Diversity and Inclusion training (on people of color)
• 49% more likely to employ managers from traditionally underrepresented groups in comparison to ordinary businesses (in the U.S.)
• 41% more likely to have conducted a pay equity analysis by gender, race/ethnicity, or other demographic factors and, if necessary, implemented equal compensation improvement plans or policies to manage and improve workforce diversity and inclusivity in comparison to ordinary business (which 43% of B Corps do)

Opportunities for Impact

These are impressive DEI levers. I also found impressive data around ESG impact. Compared to ordinary businesses, on the global level, B Corps:

• Protected 200,000 hectares of land, offset 16 million tons of carbon, saved 225 million liters of water, and diverted 207 thousand metric tons of waste in 2020
• Outperform on natural-resources conservation by 15%
• Are 2.8x more likely to use 100% low-impact renewable energy 9% of B Corps in developed markets have offset 100% of their GHG emissions, and are 2.5 times more likely to be carbon neutral
• Are 1.1 times more likely to donate more than 1% of their revenue to charity
• Are 28% more likely to have hosted or organized company service days in the last year and 71% more likely to offer paid time off for community service
• Are 75% more likely to hire workers from chronically underemployed populations
• Are 150% more likely to have supplier policies that encourage purchasing from local suppliers
• Screen suppliers based on use of positive social and environmental practices 210% more often 
• 32% of B Corps have a policy to give preferences to use suppliers that are owned by underrepresented groups (400% more likely than ordinary businesses)
• Are 1.9 times more likely to provide training/resources to improve the social or environmental performance of its suppliers, either through the company itself, or through a third party in comparison (23% of B Corps achieve this standard)

A: These data indicate congruence in practice with our theses around Just Transition and equity. And even though many of these measures don’t apply to our business model (we don’t manufacture products or sell consumer goods, for example), the shared thought leadership is very exciting, as is the alignment with the goals of our clients and partners.

Influence and Be Influenced

Q: Since we have been on our own ESG journey, specifically around racial equity, I would imagine we see many opportunities to influence companies in our circle as well, through some of what we are learning and experiencing as we grow as an advisory firm. What opportunities to learn and teach excite you?

A: There are so many opportunities to learn and upskill within the B Corps ecosystem. We were attracted by the depth of technology, talent, and expertise accessible within the B Corps community. And there is something really terrific about being in cohorts that have already figured out a lot of the issues around growth, scale, etc. that we are facing as a firm.

These include nuts and bolts topics like managing distributed teams, working across time zones—and even things one doesn’t necessarily correlate to strategic consulting, but which do touch upon some of our work with health care and product distribution, such as global supply chains. Additionally, our climate and environmental work is very focused on Just Transition and influencing the private sector to be better environmental and sustainable citizens. So, we see many ways to be in circles of influence and develop our own theories and practices more deeply.

Camber is now connected within a network, which provides some opportunity for building relationships with organizations that are also on a pathway to positive impact. Both when it comes to climate, or when it comes to equity and anti-racism, and even issues like how do we manage travel: client visits and workshop delivery while also trying to grapple with our own carbon footprints?

Such discussions and solutions are so essential, and existentially important. It’s encouraging to feel we aren’t going this alone, but are part of a global group of enlightened companies and entities all navigating similar challenges and driving towards the same kinds of positive solutions.

Q: Yes, B Labs has some 15 or 20 years in this game, and have a profound track record of driving positive social change. It’s unique.

The Power of Many

A: And furthermore, the opportunity to network is tremendous. We pride ourselves in being functional experts, but we are not deep content experts in every single are, nor in every single geography. There will be lots of opportunities for Camber to continue building networks of organizations and firms doing best-in-class work around everything from sustainability, to how they manage across geographies, to the efficiency tools and methods they use, just to name a few.

Take one of the most visible examples, Patagonia. They set the standard for ESG and social impact as a B Corp, and now they have shifted their model to be employee-owned. Seeing what they do gives all of us a vision for how we can become better, and evolve, and grow with what our models and realities evolve into.

I think the influence and learning and osmosis of being in these very enlightened corporate thinking spaces is going to be enormously impactful for Camber.

Q: And while we won’t be sitting in weekly meetings with hundreds of B Corps companies, there are formal and informal spheres of interaction and influence we will engage with. What other ideas or opportunities do you see in this aligned space that can help us positively influence our new peer circles in the B Corps?

A: Well, the B Corp itself is ever-adapting, and learning, and growing. And so we are all in a way on a similar path of evolution. Racial equity for example is becoming a bigger part of what they’re trying to do. In fact, when we first started in on the assessment process, their racial equity component was just starting to emerge.

I think we, and other firms that are paying close attention to these levels, will have a lot to bring to the table. And congruently, we as Camber will find ways to elevate important aspects of this shared work to our peers in the advisory space, and nonprofit, government agencies, and foundations we work with, over time.

Q: This is all a great deal of upside. Why isn’t every corporation with a good mission statement a B Corps?!

The post Camber Collective is a B-Corporation appeared first on Camber Collective.

Once the child turns 18, they can use the funds for eligible wealth-building purposes (such as continued education, homeownership, or establishing a business), provided they meet certain basic requirements. Baby bonds target support to children from low-wealth households by using income or other wealth-proxies (e.g., Medicaid) as eligibility criteria for account establishment or as a determining factor in the size of government contributions.  

In the US, wealth is acutely concentrated among a small subset of households (many of whom have benefitted from inter-generational wealth transfers), while many others struggle to get by. In 2019, the Survey of Consumer Finances (SCF) found that the wealthiest decile holds over three quarters of total household wealth, while the bottom half of the distribution holds just one percent of the wealth (see Figure 1). Not only do families at the bottom of the distribution hold little wealth, but over 13 million actually have negative wealth (i.e., debts exceed assets).[i]

Confronting the Racial Wealth Divide

In addition to wealth inequality, a persisting racial and ethnic wealth divide characterizes wealth distribution. For example, in the US, the median Black family ($23K) held just 13% of the wealth compared to their White peers ($184K), and the typical Hispanic family ($38K) held around 20% (see Figure 2). While not all races and ethnicities are represented in wealth data sources (e.g., SCF), income poverty and other wealth-related metrics show that Native Americans and many communities within the Asian American and Pacific Islander category are also excluded from wealth.[ii]

Baby Bonds Legislation

The racial and ethnic wealth divide is primarily the result of historic and continuing systemic inequities that affect people of color in the United States (e.g., land theft from indigenous tribes, enslavement of Black people, the G.I. Bill, redlining and housing discrimination, etc.). Baby bonds policies could, using a race-neutral approach, begin to correct some of those inequities that underlie the racial and ethnic wealth divide. Gaining access to one’s baby bond account at age 18 could mimic the advantage of intergenerational wealth transfers that wealthier, typically, white) families, and propagate inequalities through generations. By providing young adults with money specifically for wealth-building purposes, baby bonds can help interrupt the status quo and create opportunities for BIPOC*, lower-income, and other disadvantaged communities to seed wealth for themselves and for future generations.

While economists William Darity Jr. and Darrick Hamilton first proposed baby bonds as a way to close the racial wealth divide in 2010,[iii] it wasn’t until eight years later that the first federal legislation was put forward. Senator Cory Booker (D-NJ) proposed the American Opportunity Accounts Act, in which every child’s account would be seeded with a $1,000 deposit upon birth, with tiered annual contributions dependent on family income.[iv] As a result, children from the poorest households would have an estimated balance of $46,000 at their 18^th birthday, while peers from the wealthiest households would receive under $2,000.

While Booker’s initial proposal did not advance, he, along with Massachusetts Representative Ayanna Pressley (D-MA), reintroduced the American Opportunity Accounts Act in 2021 with broader support from co-sponsors.[iv]

In addition to federal legislation, several states have proposed—and even passed—local baby bonds policies.

• Connecticut: In July 2021, Connecticut paved the way by enacting the CT Baby Bonds legislature.[vii] CT Baby Bonds will automatically enroll babies born under HUSKY (the state’s Medicaid and Children’s Health Insurance Program) starting in July of 2023. Upon birth, the state will deposit as much as $3,200 into the CT Baby Bonds Trust, to be invested and managed by the Office of the Treasurer. In order to access funds, beneficiaries must be 18-30 years old, complete a financial literacy course, and currently reside in the state. When those conditions are met, young adults can then make a claim to request funds for one of the designated eligible purposes: higher education, homeownership in the state, investment in a business in the state, or retirement savings. See the full legislation here (Sec. 104-110).
• District of Columbia: The DC Council approved the Child Wealth Building Act by a unanimous vote in October 2021.[viii] The Child Trust Fund Program established by the act will automatically enroll babies whose birth is covered by DC Medicaid and that are born to households with income 300% or less of the federal poverty line and enrolled in DC Medicaid.[ix] Accounts for eligible babies will be seeded with an initial $500 deposit and grown with annual contributions of up to $1,000, dependent on family income. If the previously eligible child’s household becomes ineligible at any point before their 18^th birthday, annual contributions will cease but the existing balance will still be available for later distribution. At 18 years of age, beneficiaries of the Child Trust Fund Program residing in the district can receive distributions to be used for the following purposes: education, ownership or investment in a DC business, ownership of a DC property, or retirement investment. See the full legislation here.

Beyond Connecticut and DC, baby bonds legislation has been discussed in California[1], Delaware[2], Iowa[3], Louisiana[4], Maryland[5], Massachusetts[6], Nevada[7], New Jersey[8], New York[9], Washington[10], and Wisconsin[11].

Washington Future Fund: Camber’s Work in Baby Bonds Policy

In 2022, the Washington Office of the State Treasurer (OST) contracted Camber Collective, with partner Prosperity Now, to conduct a wealth inequity study. The Washington Future Fund Study Committee—made up of elected officials, community representatives with lived experience, and members of economic empowerment organizations—would then leverage the wealth inequity study, along with their other work, to make recommendations to the state legislature regarding baby bonds policy in Washington. To present a comprehensive understanding of wealth inequities in Washington, we utilized quantitative analysis of household- and individual-level data, qualitative analysis of interviews with low- and middle-income Washington residents, and secondary research of exiting literature throughout the study.

Our research identified racial/ethnic and geographic wealth divides in the state, informed by stories from individuals experiencing challenges in building wealth. The final report (excerpts included in OST’s report to legislature contextualizes wealth disparities with exploration of why wealth matters, summary of how inequities are created and perpetuated, and discussion of the implications of wealth inequities on households and the state economy. The insights surfaced through the research study, complemented by Prosperity Now’s expertise in baby bond policy, resulted in a series of evidence-driven policy recommendations for the state legislature’s consideration in the 2023 session. This work, along with the research study report, was highlighted recently in the Seattle Times.

[i] Can ‘Baby Bonds’ Eliminate the Racial Wealth Gap in Putative Post-Racial America? – Darrick Hamilton, William Darity, 2010 (sagepub.com

[ii] An exclusive look at Cory Booker’s plan to fight wealth inequality: give poor kids money – Vox

[iii] Booker reintroduces ‘baby bonds’ bill to give all newborns a $1K savings account – POLITICO

[iv][Can ‘Baby Bonds’ Eliminate the Racial Wealth Gap in Putative Post-Racial America? – Darrick Hamilton, William Darity, 2010 (sagepub.com)

[v] An exclusive look at Cory Booker’s plan to fight wealth inequality: give poor kids money – Vox

[vi] Booker reintroduces ‘baby bonds’ bill to give all newborns a $1K savings account – POLITICO

[vii] CT Baby Bonds

[ix] DC Council unanimously ‘baby bonds’ bill – WTOP News [1] Chapter 6D. Building Child Wealth. | D.C. Law Library (dccouncil.gov)

[1] California approved budget for the Hope, Opportunity, Perseverance, and Empowerment for Children Trust Account Fund, which will target low-income children who lost a primary caregiver to COVID-19 and foster children

[2] Legislation introduced in 2022

[3] Legislation introduced in 2021; note that this policy would have created opt-in accounts for all babies in the state, regardless of wealth

[4] Resolution passed in 2022 to commission study on baby bonds to be delivered for 2023 session

[5] Proposed by governor-elect

[6] Task Force conducted study in 2022

[7] Treasurer requested legislature to draft a bill for baby bonds

[8] Legislation re-introduced in 2022; note that, in 2020, Governor Murphy called on lawmakers to implement baby bonds, though budget was finalized without the necessary allocation

[9] Legislation introduced in 2021 (multiple versions)

[10] Legislation introduced in 2022; study committee established to provide recommendations for 2023 session

[11] Legislation introduced in 2021

Rebecca Drachman is an analyst at Camber Collective. Her work at Camber thus far has included several projects in the Shared Prosperity sector, including with a direct services nonprofit, large family foundation, and, most recently, state government. Before coming to Camber, Rebecca studied Psychology and Neuroscience and conducted neuro-imaging research at Yale University. She is passionate about leveraging quantitative and qualitative research approaches to solve pressing problems and elevate marginalized voices.

Marc Allen is a Director at Camber Collective and heads the firm’s Shared Prosperity portfolio. Drawing on his toolkit as a strategist and former policy attorney, Marc leads teams working to strengthen and reimagine our economic and democratic systems. His experience spans strategy and investment design, human-centered research/insights, and coalition-building services for philanthropies, government agencies, multilateral institutions, nonprofits, and socially-invested corporations. More broadly, Marc guides the effectiveness of executive teams in mission-driven organizations, helping to advance their theories of impact, program design, business models, and cultures of belonging.

The post How Baby Bonds Can Address Wealth Inequality appeared first on Camber Collective.

Food Security, Urban Migration, Healthcare, Economic Wellbeing & Population Displacement

The Global South, particularly countries in Sub-Saharan Africa (SSA) face the highest risk of climate vulnerability and developmental issues exacerbated by climate change. For example, the African continent contributes only a small percentage of global greenhouse gas (GHG) emissions, but its inhabitants are among the most vulnerable to the effects of climate change and have the least infrastructure for climate resilience. These issues brought about by climate change impact local environments and trigger several serious problems that threaten the livelihood of most residents. If progressively left unchecked, these issues will undoubtedly create a near-term catastrophic retrogression in the region’s economy.

According to a study on the effects of climate change, a mere 1 °C increase in temperature in developing countries has been found to cause 2.66% lower growth in agricultural output (1). This factor alone leads to, for each degree of warming, an estimated average 1.3 percentage point-drop in economic growth.

Survival on the Line

To put it simply: as humans, our survival is based on the availability and access to Food, Clean Air, Water and Shelter. With any one of these basic needs unmet, humanity can no longer survive. Indeed, climate change threatens the availability of these resources. Of course, this is not new news – but it is urgent. A great deal must be done to return to a state of equilibrium. In rural areas of developing countries, the impacts of climate change dangerously affect the agricultural industry. Particularly, in the SSA region, farming and agriculture are the sectors at the forefront of food security and sustainable jobs. The sector also employs roughly two-thirds of the regional labor force.

The yield potential of many African crops is however not fully realized, due to over-reliance on resources such as inadequate (rain)water and a dearth of nutrients to boost crop production. Rainfed agriculture yields fewer crops, further contributing to a stunted agro sector in Africa. This dearth impacts both livelihood and survival. In addition to creating drag on local economies, poor crop yields force smallholder farmers to seek additional or alternative sources of livelihood, initiating a cascade effect that leads to forced migration to now over-populated urban areas and cities.

While urbanization is generally beneficial, most of Africa’s city dwellers live in extreme poverty—and economic suffering that is likely to increase as climate change worsens. As urbanization rates increase in some developing countries, we are beginning to see a corollary of negative wellness outcomes such as poor nutrition, pollution-related illnesses such as respiratory disease, a rise in communicable diseases, poor sanitation, and uninhabitable housing conditions. (2)

These detriments further strain available resources in urban areas. For example, Lagos is one of the world’s 10 largest cities, sprawling across 1,000 sq. km and housing 20 million inhabitants in a largely chaotic and impoverished setting. Most residents live in informal settlements, also known as slums. With no holistic water or sanitation system, disorganized transportation and extreme traffic congestion, and massive environmental issues such as noise and air pollution, this coastal city is a cataclysm waiting to happen. Indeed, it is predicted that by 2100, Lagos will be the world’s largest city, squashing 100 million people in a grave environmental and social setting.

The predicted major health problems of Lagos residents are further exacerbated by the generally poor quality of health service delivery. Less than half the continent’s population has access to health care, and family planning services are unavailable to half the continent’s women and girls.

While private healthcare is available to some, its high cost makes it unattainable to most people, as the region’s largest social challenges include unemployment and vulnerable employment, which are often linked with the effects of climate change. These challenges are growing in severity, as population growth remains high, and poverty and unemployment are also on the rise. Likewise, climate vulnerability is aggravated as there are little to no infrastructure for climate adaptation. 

Job Demand Outweighs Supply

The World Bank reported in 2013 that there would be 10 million new entrants to the labor force every year. As of 2017, other institutions—such as the International Labor Organization (ILO)—have reported that there are at least 20 million young people looking for work every year. The number of job seekers on the African continent is increasing significantly and despite all efforts so far to create more formal jobs for young people, very few of them currently stand a chance of finding employment. The statistics are stark: each year 20 million young people enter the labor market, with only a few gaining formal employment. On the potentially brighter side the International Renewable Energy Agency (IRENA) estimates that if the sector continues to develop, renewable energy jobs could employ 43 million people by 2050.

An example of this discrepancy between job supply and demand can be seen in the country of Uganda. 400,000 young Ugandans enter the job market annually, competing for approximately 52,000 formal jobs.(3) For girls and young women, the job attainment situation is particularly dire. With fewer opportunities to work in the formal labor market, young women are often forced to seek work in the informal economy. As previously noted, climate change continues to disrupt agricultural productivity and supply chains, leading to further regional displacement from rural regions and larger cities alike, with many having no choice but to undertake the long and treacherous journey of (illegal) migration to the EU.

A Moral Obligation to Act

The Global North is responsible for 92% of excess global carbon emissions, according to a study published in The Lancet Planetary Health (4). The findings, based on the idea that the atmosphere is part of the global commons, are worrying considering many experts consider it critical to protect against global warming and climate change. There is a moral obligation to deliver upon the Polluters Pay Principle (5). It spurs sustainable development through the development of innovative strategies for climate mitigation, adaptation, and resilience for developing countries in Sub-Saharan Africa, particularly in rural regions to ensure sustainable development.

Each further delay in redressing the detriments of climate development disequilibrium will result in future situational overload, making climate mitigation even more difficult to reach, and destroying the wellbeing and livelihood of millions of people in the not-very-distant future. For those who remain unswayed by the humanitarian imperative, a parallel emergency, based on economic is also evident: delay or lack of climate investment, infrastructure, and innovation applications in the rural and super-urban and rural areas will only make sustainable transition even more exigent. Tangentially, it will also make change, which will become necessary one way another, extremely more expensive.

Over the next series of blog posts, we will further examine the intersection and impact of climate induced changes and development.

Dr. Chidiebere E.X. Ikejemba is the Director of Climate & Environment at Camber Collective. His body of work focuses on climate equity and justice, building resilient climate-smart development programs, strengthening political will for urgent climate change action and many other levers of activation. His theory of impact operates across both the upstream and downstream of a systems chain. that encompasses investment, agriculture & food security, migration, economic & rural development, climate education, waste management (circularity), healthcare, corruption and democracy, energy access, gender inclusion and other dimensions. The circularity of Camber’s approach and theory of influence is, we believe, the most congruous path to balancing economic reality and humanitarianism.

Sources

1 – Dell, M., Jones, B. F., & Olken, B. A. (2012). Temperature Shocks and Economic Growth: Evidence from the Last Half Century. American Economic Journal: Macroeconomics, 66-95.

2 – Kuddus, A., Tynan, E., & McBryde, E. (2020). Urbanization: a problem for the rich and the poor? Public Health Review

3 – Kappel, R. (2021). Africa’s Employment Challenges – The Ever-Widening Gap. Bonn: Friedrich-Ebert-Stiftung e.V.

4 – Hickel, J. (2020). Quantifying national responsibility for climate breakdown: an equality-based attribution approach for carbon dioxide emissions in excess of the planetary boundary. The Lancet Planetary Health, 399-404.

5 – The Polluters Pay Principle is the commonly accepted practice that those who produce pollution should bear the costs of managing it to prevent damage to human health or the environment.

The post Climate Change & Survival in Sub-Saharan Africa appeared first on Camber Collective.

Opportunity youth (OY)—defined as individuals aged 16-24 who are neither in school nor in work—have become a focus of the national conversation on economic mobility for young people. 2020 Census data from the American Community Survey estimates that, of the 38 million 16-24-year-olds across the US, almost 5 million are OY.[1] This equates to more than 1 in every 8 youths nationwide being out of both school and work during a period of life that is critical for acquiring the skills and opportunities required for lifelong upward mobility.

Longstanding and systemic racial inequities in high-quality education access, employment opportunities, household stability, and justice system exposure mean that disconnection from work and school disproportionately affects BIPOC youth. Compared to non-Black youth, Black youth are 1.6 times more likely to be OY. [2] Similarly, both Native and Pacific Islander youth are 1.3 times more likely to be OY, and Hispanic youth are 1.1 times more likely to be OY, while white youth are 1.4 times less likely to be OY. Due to the heterogeneity of Asian Americans, inequities in youth connection to work and/or school are not visible on a group-level; however, youth identifying as Bangladeshi, Burmese, and Cambodian are more likely to be OY than the national average, highlighting the importance of disaggregating racial and ethnic categories.[3] On top of race and ethnicity, youth who report limited English skills[4] are 1.9 times more likely to be OY, while male youth and those residing in rural areas also face increased risk of disconnection.[5]

The issues faced by OY, and the implications of youth disconnection, are far-reaching and pertinent to diverse funders and service providers across the social sector. This is because OY aren’t just distinct from their in-school / in-work counterparts in terms of their educational and employment status; they are also typically experiencing other cross-cutting risk factors. For example, many OY are also navigating early parenthood, lack of health insurance, limited educational attainment—e.g., lack of secondary degree—, disability, and exposure to the penal and/or foster care systems.[6] Reconnecting OY to opportunities for advancement, as well as preventatively serving at-risk youth, is of critical importance to many different entities in the social sector with intersecting missions. As a result, community-based organizations, philanthropies, government initiatives and policymakers, national coalitions, and think-tanks across the country seek to help OY succeed in school and work to, ultimately, open the door to opportunity for all young people.

What do Opportunity Youth need to succeed?

In analyzing the landscape of organizations supporting opportunity youth nationwide, and in partnering with some of these organizations as strategic advisors, we have identified 4 sequential categories of needs that must be met in order for OY to experience upward economic mobility and thrive within the workforce:[7]

1. Basic needs and personal wellbeing: housing, food, physical and mental health care, trusted adults, childcare
2. Personal effectiveness and workplace competencies: interpersonal skills, job search and resume experience, basic computer and analytical thinking skills, dependability and professional
3. Vocational skills and industry competencies: stackable credentials, vocational training, industry-specific skills, on-the-job experience in industry
4. High-wage occupational requirements and management competencies: highly specialized capabilities, advanced degrees and credentials, networking and connections, access to highly upwardly mobile careers

Each step on this ladder provides the necessary foundation to enable the development of subsequent skills and competencies. For example, before a young adult can focus on showing up to work shifts on time and communicating effectively with a supervisor, it is important that they have a safe place to live and access to critical healthcare services. Similarly, refining vocational skills depends upon underlying interpersonal and workplace competencies that enable effective communication, learning, and working. Finally, industry-recognized credentials are often pre-requisites for OY to progress along upward career trajectories, as most do not have traditional 4-year degrees. This framework of needs required for upward economic mobility for OY acknowledges the barriers that these youth face and the importance of continuously establishing a strong foundation at each level to best position youth for success.

How can Opportunity Youth be best supported to climb the ladder?

When considering how to support OY along the path to upward economic mobility, it is helpful to return to this 4-step ladder. Given this wide range of needs—from emergency housing to advanced technical training—it is implausible and counter-productive for most organizations or programs to advance youth up every step of the ladder. Instead, it is more efficient and effective to develop a complementary ecosystem of organizations, each providing services to youth targeted at 1 or 2 steps of the economic ladder.

An MDRC analysis of different youth employment programs proposes two arguments in favor of this conceptualization of programs providing youth with support along different steps of the ladder.[8] First, they point to the relative brevity of most programs: “a 6- or even 12-month program is not enough to remove barriers to employment and education that have been years in the making.” By adopting distinct niches, programs can together provide youth longer-term support by “handing-off” youth along the scaffold as they move up the ladder, without implementing impractically long individual program durations. This approach also breaks down large and overwhelming hurdles for youth (e.g., challenges that may take over 5 years to fully address) into more approachable programs, thus lowering the risk of youth attrition.

The second argument put forth is that “any given program can only do so much.” It is unreasonable to expect that a given program could possess sufficiently broad and deep capabilities to specialize in serving youth at each step of the way. This is not to say that one organization could not offer a wide range of services—and in practice, many do—but rather that the guiding organizational objective should focus on just one or two steps on the ladder. Further, organizations targeting two steps of the ladder should ensure that their scope of services addresses two consecutive steps and does not omit an integral intermediate step. This approach allows programs and staff to become experts in the skills and knowledge required to deliver targeted and comprehensive support for youth at a given point on their progressive journey of economic mobility.

Through a landscape analysis of various programs involved in workforce development for OY and at-risk youth, we found most programs can be categorized as one of four archetypes, according to the step of the ladder that they prioritize for youth:

This framework for thinking about programs serving OY highlights the importance of each step, and thus each type of program. Work on either extreme of the ladder may more naturally provide the most visible or flashy impact stories (e.g., Stabilizers’ critical intervention during crisis or Accelerators’ immediate outcomes demonstrating high-paying jobs); however, the intermediate Grounder and Trainer roles are crucial in bridging the gap and bringing youth along from Stabilizer to, ultimately, Accelerator programs. By grounding services in the needs of OY, connecting specialized and focused programs in a broader ecosystem of scaffolded support, and valuing each step of the ladder to economic mobility, we can open doors of opportunity to OY for deep and sustained impact. For locally focused philanthropies and government entities, in particular, it pays to ensure that local investment is strategically planned so as to span the full spectrum of Stabilizer, Grounder, Trainer, and Accelerator service-providers, rather than picking a single OY-serving organization and expecting that organization to offer a full suite of services.

Not only are organizations playing each role—Stabilizer, Grounder, Trainer, and Accelerator—necessary in order to best serve OY; direct service organizations will also be most effective and efficient with their resources when they intentionally focus on 1-2 of these steps in the mobility ladder. Our advisory work has allowed us to test and confirm, first-hand, the reductions in cost per youth served that can be achieved over a multi-year period by strategically shifting to a more focused approach. Through refining a program’s objective, organizations will bring about both internal and external improvements, ultimately enabling greater impact for the youth they serve. Internally, prioritizing youth outcomes along 1-2 skill steps will streamline operations for codified and scalable program delivery; allow for greater specialization and deeper expertise; focus impact metrics and evaluation on most relevant youth outcomes; and guide staff and internal decisions. Externally, articulating organizational objectives in terms of the 4 archetypes creates a more cohesive story to obtain funding; incentivizes strong and intentional partnerships with other service providers; and clearly conveys the organization’s role in the broader ecosystem. These benefits will strengthen direct service providers individually, as well as the collective scaffolded support that they provide to OY.

[1] Analysis of 2020 ACS 1-year data

[2] Analysis of 2020 ACS 1-year data by dichotomous race/ethnicity variables

[3] Analysis of 2020 ACS 1-year data

[4] As compared to those who speak only English or who speak English well or very well

[5] Comparing those outside of a metropolitan area to those within

[6] Measure of America, A Decade Undone

[7] Inspired by and adapted from U.S. Department of Labor Employment & Training Administration’s tiered competency model (Competency Model Clearinghouse – Building Blocks Model (careeronestop.org))

[8] MDRC, Helping Young People Move Up

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As government, philanthropy, and the private sector become increasingly aligned around the need to share prosperity more equitably in the US, particular momentum has grown to strengthen economic mobility – in the form of breakthrough research, ambitious policies, and powerful coalitions.

However, as strategic advisors in this field, it is clear that varying definitions of economic mobility can lead to misalignment and misunderstanding among the stakeholders working to advance it. In the US, this definitional ambiguity explains conflicting headlines: some suggest economic mobility has not declined over recent decades, while others underscore the fading American Dream. Such diverging narratives can be explained by the fact that each of the four most common measures of economic mobility tells a different, and valuable, story regarding the current state of economic mobility.

Stakeholders in this space ought therefore to be clear about the definition they are using; intentional in selecting the definition that best elucidates the questions they consider to be priorities; and cognizant that a complete view of economic mobility requires regular consideration of all four measures as complementary sources of insight.

What is Economic Mobility?

In simple terms, economic mobility denotes the change in economic status of an individual, household, or group over a defined period of time – typically by reference to income or wealth. Within each measure of economic mobility, an improvement in economic status is termed upward mobility, while a decline is referred to as downward mobility.

Why Track Economic Mobility?

Tracking economic mobility allows us to determine, with some empiricism, the answers to questions that are central to our socio-economic policies and social investments. These questions include:

• How many people are experiencing a particular economic status at any given time, and how has their economic status evolved over time?
• Which variables correlate most closely with changes in economic status? Are these merely correlative, or demonstrably causal?
• Which individuals, households, demographic groups, or geographic localities are most likely to experience a change in economic status?
• For whom is intergenerational prosperity most strongly / weakly sustained?

The answers to these questions, in turn, allow us to test how far national narratives around equality of economic opportunity hold true. In the case of the United States, these include testing whether the US really is a land of greater economic opportunity than others, as is often claimed – and if so, under what definition of opportunity, and for whom?

Income vs. Wealth as Proxies for Economic Status

First, a framing issue: perspectives on the current state of economic mobility in the US and many other nations vary, to a certain degree, according to whether income or wealth is tracked.

Income captures the flow of money received from sources such as a salary, business income, dividend pay-outs, and state benefits. Typically, income therefore represents immediately deployable resources (e.g. a salary provides cash reserves that can be used instantly to pay for goods). It tends to be more evenly spread across a population than wealth, as illustrated in the first graphic below.

In contrast, wealth provides a more expansive view of economic status, reflecting net financial worth. Wealth includes elements such as savings, assets in possession, and other financial interests, minus any liabilities. It is usually less evenly spread across a population than income and has become even more so in the US over recent decades, per the graphic below. However, the value of one’s wealth may not all be instantly realizable (e.g. a property is a valuable asset, but can take time to sell).

While wealth is, logically, a better indicator of the true distribution of prosperity across a population, exact definitions of wealth vary – leading to difficulties in sourcing complete and consistent data. Data on income is more readily available and less contested. As a result, many pioneering analyses of US economic mobility over the last decade have relied on income data and this article will also adopt income as its focus.

*All figures in 2018 US dollars
Visuals recreated from Pew Research Center: 1. Trends in income and wealth inequality
Data Sources: Pew Research Center analysis of Current Population Survey, Annual Social and Economic Supplements and Pew Research analysis of the Survey of Consumer Finances

Indicators of Economic Mobility

Once either income or wealth has been chosen as the subject of study, there are four potential measures of economic mobility to choose from. Each measure may generate a different top-level insight, and each may resonate to varying degrees with different stakeholders, depending on their social interests and objectives.

The four potential measures all involve some combination of two key indicators:

These are distinct measures. As such, absolute mobility does not always correspond to relative mobility.

By way of example: Income for Household A may increase in absolute terms from, say, $60,000 to $70,000 per year over a particular timespan. This indicates absoluteupward economic mobility of $10,000 (note: this increase will need to be adjusted for inflation, to calculate the increase in income in real terms). But if many other households in the population also experience a similar rise in their incomes over the same timespan, then the rank of Household A’s income relative to others may not materially change. The relative mobility of Household A in this case would be neutral, even though it was upwardly mobile in absolute terms. How far this should be of concern will depend on your social interests and objectives – as discussed further below.

Again, the indicator chosen here enables different analyses. Intra-generational mobility is largely disconnected from inter-generational mobility, as a subject of study.

To continue the example cited above: It is possible to see an intra-generational increase in household income from $60,000 at age 30 to $70,000 at age 40. Assuming this increase in income is true in real terms (i.e. it has been adjusted to take account of inflation), this would indicate intra-generationalupward mobility. However, if that same individual’s parents earned a greater household income than $70,000 when they were aged 40 (also adjusting for inflation), then that individual has in fact experienced downward mobility on an inter-generationalmeasure, despite income having increased in absolute terms.

Therefore, the four potential measurement permutations that can be derived from combining the two indicators of Economic Status and Timespan are:

Now that definitional bases have been covered and illustrated with examples of the differing insights each measure can potentially generate, the next step is to understand how each measure is valuable for informing different points of inquiry.

Analytical Implications: Absolute vs. Relative Economic Mobility

Absolute mobility

Absolute mobility can theoretically be experienced by all individuals at the same time, if there is a period of sustained economic growth and the economic benefits of that growth are distributed across the entire population (whether to equal or unequal degrees).

This measure naturally resonates with stakeholders interested in overall evolutions in living standards over time and the alleviation of absolute poverty. It may be the single purest measure of economic mobility for understanding aggregate changes in economic status from a strictly numerical perspective. It is also the default measure of economic mobility for a number of eminent stakeholders at the present time, and a focal measure for the most large-scale analysis of economic mobility data conducted in the US to-date.

However, looking exclusively at this measureoverlooks the importance individuals may attach to their sense of economic rank within society (often called class), and our ability to move up or down in that rank (sometimes called social mobility, or relative economic mobility as above). These shortcomings are important to acknowledge for two reasons:

• First, at the theoretical level: one founding aspiration of a free market economy (whether it follows a completely free market model or a more ‘social democratic’ model) is that it should, in principle, enable the meritocratic movement of a meaningful proportion of individuals up and down the quintiles of the income distribution (i.e. economic rank) according to their oscillating economic fortunes and misfortunes. Where this is not occurring with moderate frequency, it is often an indication of an economy that has been skewed by policy choices and power dynamics to preserve particular economic interests for some, while maintaining barriers for others. If a fixed economic ‘underclass’ exists and only a small minority of aspiring individuals in that lowest quintile of wealth, or underclass, are able to reach the middle quintile or higher, then something is structurally amiss.

• Second, at the level of the individual: a sense of diminished power, belonging, and social cohesion can be felt even byindividuals who experience a material increase in income in absolute terms, if the income of others has risen by an equal or even greater proportion. In practice, this can drive status anxiety in the same way as wealth inequality more generally, and ultimately threaten our democracy, political stability, and sense of collective identity if left untreated over time – as is the case in the US and certain other high-income countries currently.

These factors suggest that absolute measures of economic mobility are a powerful and prevalent, but also insufficient, method of measuring economic mobility if used as the sole measure.

Relative mobility

On the other hand, relative mobility seeks to measure the degree to which people can move among different levels of economic outcomes. Relative economic mobility is a zero-sum game of constantly evolving ‘winners’ and ‘losers’ analyzed within the paradigm of a competitive hierarchy. If incomes are grouped into quintiles (as is often done to simplify analyses of relative mobility), then each quintile represents exactly 20% of the population. In order to achieve upward relative mobility (i.e. a movement up into a higher income quintile), someone else must necessarily drop down to a lower quintile so as to make space.

While this analytical lens may initially appear at odds with the progressive ideals of some stakeholders working to advance economic mobility – in the sense that it forces individuals into a competitive paradigm and is often cited by more conservative thinkers – the insights it can generate can in fact be applied to inform and reinforce profoundly progressive concerns.

Indeed, stakeholders focused on eroding class systems and maximizing social mobility (i.e. changes in economic rank), rather than on aggregate increases in income or poverty eradication, can draw immense insight from tracking economic mobility in this way. This tends to include stakeholders who define their objectives in terms similar to the traditional definition of the American Dream: the idea that those who find themselves at the bottom of the income distribution maintain a realistic shot at climbing to the top of the distribution over time.

Similarly, those focused on equality of opportunity may favor this measure as a means of assessing the prospects of specific groups moving out of the lower wealth quintiles, which are associated with reduced power and autonomy.

Lastly, a relative mobility lens reveals how evenly or how fairly the benefits of aggregate increase in economic status are being shared across a population: while an absolute measure of mobility might show an overall picture of a numerical rise in incomes in a particular country or region, a relative mobility lens shows how proportionately the aggregate rise was allocated to specific groups of interest relative to others.

However, relative mobility also has its drawbacks. Stakeholders who ground their analyses in a relative measure alone risk missing the ‘bigger picture’ on the overall changes in economic status of the population. Strong or stable levels of relative economic mobility are considered by many stakeholders to be a vacuous goal, if absolute economic mobility is declining in parallel – as appears to be the case in the US currently. In addition, an over-emphasis on relative measures may encourage individuals to focus on psychological drivers which many may consider harmful, such as a propensity to evaluate one’s own success in terms of power and status over others, rather than evolving mindsets towards a model of shared prosperity in which the focus remains on ‘all boats rising’.

Analytical Implications:  Inter-generational vs. Intra-generational mobility

In contrast to the more complex nuances on relative vs absolute measures, the implications of inter-generational vs inter-generational analyses may be more intuitive.

Inter-generational mobility

Inter-generational analyses tell a stronger story of how a country, as a whole, has fared over time, by showing how one age cohort has progressed as a whole, relative to the parents (or grandparents) of those in that cohort at an equivalent age. For this reason, most large-scale studies of economic mobility in the US point to an inter-generational measure. This measure has provided many of our most powerful insights on how far the US is living up to its ideals and whether prevailing narratives of economic opportunity are borne out in reality, across different regions, counties, and neighborhoods.

However, inter-generational measures also run the risk of being seen as overly academic and detached from the immediate concerns of individuals. While knowledge of how individuals are faring economically relative to their parents is invaluable, it is also removed from the immediate needs and priorities most people are focused on, namely: how can I continue to improve my (or my household’s) economic status?

This leads many stakeholders involved in direct efforts to spur economic mobility in the present to dismiss inter-generational analyses, as they may not provide practical insights to apply. Others appreciate their value, but question how far inter-generational analyses can help them to build evidence around the causal link of certain variables to economic mobility. To-date, inter-generational analyses have offered powerful discoveries as to the variables that may correlate with economic mobility, and the ways in which these variables appear more or less prominently across localities (in the US), but analyses of causation remain under study.

Intra-generational mobility

Intra-generational analyses are naturally most effective at conveying the evolution of individuals through their various life stages, and for pinpointing specific age brackets or events that tend to correlate with a change in absolute or relative economic status (e.g. acquiring a new qualification, marriage, parenthood, new mentors/networks, or health crises). These analyses are powerful in identifying trends based on specific variables, which can then help to inform promising program interventions or policy choices going forwards.

As such, many organizations directly servicing individuals, such as those seeking to alleviate poverty or tap into an under-utilized lever of economic opportunity, may do well to track their impact according to the intra-generational economic mobility of those they support. Similarly, most of us logically think about our own economic mobility in these terms, as we aim to experience upward mobility over the course of our lifetimes.

Notwithstanding these benefits, this measure is also the most narrow and future-oriented, by design. Its practical utility and resonance are clear, but it says little about the true current state of economic mobility.

Synthesis of potential measures of economic mobility: pros and cons

In sum: the varying measures of economic mobility can be used to obtain different insights, and to inform and disseminate differing social agendas. Stakeholders should be sure to be clear about the measure they are referring to, thoughtful as to their choice of measure and its pertinence to their agenda, and regularly triangulating the insights provided by all four measures in order to maintain the strongest possible understanding of economic mobility in their geography of interest.

The post Which Measure Of Economic Mobility Fits Your Organization? appeared first on Camber Collective.

The authors wish to thank Patrick Russel and Natacha Mugeni for their contributions to this article.

Public healthcare spending has doubled in sub-Saharan Africa over the last two decades, with the per capita going from $100 in 2000 to $205 in 2018^[1]. But, despite this progress, access to primary care remains a challenge for many people. In remote areas, it’s still difficult and costly to access a doctor, a nurse, or the appropriate treatment. Six out of ten people^[2] are not covered by Universal health coverage schemes, and for those covered, the out-of-pocket expense is significant and can be as high as 76% in Nigeria^[3]. Moreover, going to the hospital is associated with bad personal experiences for many people discouraged from seeking preventative care. The challenge is even daunting when we factor in the population growth on the continent. By 2050, the continent’s population is projected to double to 2.5 billion people, with one in four people in the world living in Africa. The healthcare sector needs a massive increase in productivity to address this challenge, and we cannot see it happening without bringing in new innovative approaches and leveraging digital technologies.

Provide better health through digital

With the recent uptake in smartphone and internet usage, there is an opportunity to take a different approach to quality and cost-effective primary health. Digital health services could transform people’s experience with healthcare. Even in rural areas, internet uptake has increased to 60% in some countries such as Senegal and Zimbabwe^[4]. Seeking a doctor consultation could be as simple as pulling out a phone to book a virtual appointment. The patient could order her medication through an e-commerce health platform doing last-mile delivery in rural areas. This scenario is already a reality in Kenya, but most people in sub-Saharan Africa are not yet benefiting from this opportunity. Given population growth projection for the next decades, this opportunity is one that stands to grow exponentially.

The good news is that Africa is only at the onset of its digital health journey, and we are seeing the rapid growth of highly scalable innovations that have the potential to disrupt global health. Startups like Kasha and Totohealth are bringing concrete and fast-to-market digital health and self-care solutions for women with novel business models that benefit both patients and providers in urban and last-mile environments. Focusing on the customer experience helps these businesses to improve patients’ interaction with primary health and enhances spaces such as self-care. Other players such as Crib MD are building on-demand preventive care platforms. Beyond primary care, BIMA seizes the opportunity to safeguard people from economic shocks by providing cost-effective health insurance.

Unfortunately, too few of these solutions are available at scale and customers without access to smartphones are not often prioritized. Entrepreneurs face multiple challenges to bring their products to the masses and reach those still using a basic mobile phone. It is important that whilst we acknowledge the power of digital health care and the benefits it provides, we do not forget those who do not have easy and affordable access to digital solutions. We believe there are complementary opportunities between these private initiatives and the public health systems to build affordable, cost-effective, and sustainable primary care services to the hard-to-reach.

Seizing the digital health opportunity

Our experience suggests that building platforms that bring together startups, public health systems, and regulators will enable countries to take advantage of the digital health opportunity fully. Similar approaches have yielded benefits in other countries. For example, Doctolib, a French startup offering online doctor-appointment services, has increased access to providers with a user-friendly experience, an area in which the public health offering was lagging. During the Covid-19 pandemic, public bodies, startups, and regulators collaborated closely to make PCR-tests and vaccine appointments widely available, leading to other innovations such as ChronoDose or ViteMaDose^[5], built as soon as the vaccines were available.

Empathize with patients

Getting a deep understanding of patient needs and behaviors is the best place to start for all ecosystem actors, that way platforms are built with a customer first approach. Patients need a space to share their pains and aspirations, which are necessary to build sustainable digital health products and services. Additionally, each country is different, and understanding people’s cultural norms, behaviors, and specific digital profiles will increase digital health adoption and utilization.

Create space for entrepreneurs to grow

Enabling the new digital health startups to emerge should be a priority for countries. It starts with standard innovation building blocks such as dedicated support, mentoring programs, coupled with eased access to financing to demonstrate product-market fit. For digital health, it also requires evolving the regulatory framework to enable use cases such as remote consultations and task shifting while protecting patients’ data and privacy.

Experiment boldly within the public health systems

Too few health systems are digitalized today, data is not collected, and most investments provide basic needs. While this remains critical, bringing technology could bring massive operational efficiencies within the current healthcare systems and improve patients’ experience. But it requires a bold vision to bring the technology within the public health system. Starting with patient-facing services could be an excellent place to begin building a digital and data-driven culture within public health agencies. The future of public healthcare relies on engaging new models alongside the traditional public health models and leading with successful public-private partnerships or success.

Share and collaborate

Public health systems have an established distribution system across countries, and startups have innovation and the ability to deliver market-ready products with a novel business model as well provide traceability back to the provider. Learning platforms where people will learn from each other through local organizations are critical. These platforms will help entrepreneurs understand the challenges in the healthcare systems while exposing public health bodies to the innovation mindset that startups bring. Finally, collecting and sharing data through open data platforms will be critical to foster concrete solutions that will ultimately benefit the patients wherever they are.

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[1] Current health expenditure per capita, PPP (current international $) – Sub-Saharan Africa, European Union | Data (worldbank.org)

[2] UHC service coverage index – Sub-Saharan Africa | Data (worldbank.org)

[3] Out-of-pocket expenditure (% of current health expenditure) – Sub-Saharan Africa | Data (worldbank.org)

[4] DHS Survey : Usage of internet, ownership of a mobile phone

[5] Vite Ma Dose : trouvez un créneau de vaccination COVID-19 (covidtracker.fr)

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The recent release of the Scorecard for Shared Prosperity, a new framework developed by Civic Commons to evaluate the Greater Seattle region’s economic well-being, ushers in a new way to consider what it means for a region to be prosperous. Traditional measures of prosperity are based solely on economic growth, with Seattle often at the top of lists that celebrate GDP and wealth creation. While our economy has created benefits for many people, driven primarily by a record stock market and increasing housing prices, a significant portion of people have been excluded from participation in this growth.  

While economic growth alone is insufficient to evaluate regional prosperity, the Scorecard for Shared Prosperity appropriately recognizes that our region’s economic growth is a critical ingredient for all of us to do better. However, growth that further enriches the wealthiest while excluding those on the margins is unsustainable and undemocratic. Growth that serves to enrich all individuals, households and communities is necessary and critical and serves as the basis for shared prosperity.

The Scorecard for Shared Prosperity is not simply a data project. It uses data to change the narrative around two separate but interconnected realities that people in our region face. The first is that while pace of growth in our region is extraordinarily high, that growth has not been sufficiently reinvested to allow individuals, households, and communities in our region thrive.   The Scorecard for Shared Prosperity puts forward a new framework and associated indicators to evaluate how individuals, households, and communities are thriving, supported by both a strong economy and healthy democracy.  We won’t truly achieve shared prosperity in our region until each element of the framework indicates health and progress.

The second reality that the Scorecard for Shared Prosperity highlights is the pervasive disparities experienced by people of color in our region. Wherever possible, data is disaggregated by race to show the significance of these disparities, and to track their change over time. These disparities are driven by many factors. Discriminatory behaviors and individual biases play a role and must be addressed. Far more impactful, however, are systems of racism, enacted through policy, that have excluded many people of color from prosperity over time. The legacy of redlining, exclusionary hiring and lending policies, and a criminal justice system that incarcerates people of color at far higher rates relative to the rest of the population, are examples of these systemic causes that lead to the disparities we see highlighted on the Scorecard for Shared Prosperity.

The two realities highlighted by the Scorecard for Shared Prosperity are unique yet interconnected. Strategies to address one of these realities without considering the other are insufficient and sub-optimized. For example, The Business Roundtable’s recent “Statement of Purpose of a Corporation” outlines a new model of capitalism that elevates the needs of a broad set of stakeholder groups to be equal to the needs of its shareholders. The Roundtable should be applauded for evolving and supporting a model that is much more aligned with the framework of shared prosperity. However, recognizing the reality of racial disparities in their efforts, and developing approaches that seek to address those disparities while at the same time more effectively supporting individuals, households, and communities will lead to even better outcomes for our region.   By reimagining systems and institutions to include rather than exclude, eliminating barriers to participation and power, and recognizing the value of culturally rich communities that are afforded the opportunity to thrive in our region, we can move toward a reality of shared prosperity. We all can do better if we are all doing better.

My hope is the Scorecard for Shared Prosperity will spur a new conversation and a new frame to guide decision making. As a business owner, I need to evaluate my decisions and investments based not only on revenue and margin, but also on how they allow individuals, households and communities to thrive in our region, and on how they allow people to participate in our essential civic processes. I need to find new ways to collaborate with partners in the public and non-profit sectors in pursuit of these outcomes, bringing my unique expertise and allowing them to bring their unique expertise to the issues at hand. And I need to support all communities in our region to achieve self-determination and effectively wield power and influence. I hope everyone in the Greater Seattle region will join me in this conversation as we reimagine what prosperity truly means for every one of us.

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