Understanding the convergence of social enterprise, digital health, and citizen engagement for co-producing integrated Person-Centred health services: A critical review and theoretical framework.

INTRODUCTION: To achieve Universal Health Coverage and the United Nations' (UN) Sustainable Development Goals (SDGs) agenda for 2030, the World Health Organisation (WHO) recommended the use of social enterprise, digital technology, and citizen engagement in the delivery of Integrated People-Centred Health Services (IPCHS) as part of its strategic vision for 21st century primary care. METHODS: We conducted a hermeneutic review of frameworks, models and theories on social enterprise, digital health, citizen engagement and IPCHS. This involved multiple iterative cycles of (i) searching and acquisition, followed by (ii) critical analysis and interpretation of literature to assemble arguments and evidence for conceptual relationships until information saturation was reached. This process identified a set of constructs which we synthesised into a testable framework. RESULTS: Several interdisciplinary frameworks, models and theories explain how social enterprises could use digital technology, and citizen engagement to enable the technical and social integration required to facilitate people-centred primary care. Innovative approaches can be used to maintain financial sustainability while delivering IPCHS at lower cost to vulnerable and marginalised populations in both developed and developing countries. CONCLUSION: This framework provides a theoretical grounding to guide empirical inquiry into how social enterprises use digital technology to engage citizens in co-producing IPCHS.

Community health alliances as social enterprises that digitally engage citizens and integrate services: A case study in Southwestern Sydney (protocol).

South Western Sydney (SWS) is one of the fastest growing regions in the state of New South Wales (Australia). Much of the population live in local government areas (LGAs) with levels of disadvantage higher than the state average, with a predominance of non-communicable and chronic diseases that are typically associated with age-related and behavioural factors. This necessitates the management of social determinants of health through the integrated provision of primary and social care. The SWS Local Health District and Primary Health Network is exploring the potential of community health alliances (CHAs) as an innovative approach to support the provision of integrated health services. CHAs are a population health approach for addressing health challenges faced by people who share a common area of residence, sociocultural characteristic or health need, and are characterised by a shared mission, shared resource needs and acquiring/developing necessary organisational knowledge and skills. We explore how CHAs operate as social enterprises that utilise digital health and citizen engagement to deliver integrated people-centred health services (IPCHS) by conducting two case studies of CHAs operating in SWS: in Wollondilly and Fairfield LGAs. Using this approach, we aim to unpack the conceptual convergence that enables social enterprises to utilise digital health interventions and citizen engagement strategies to co-produce IPCHS with a view to developing theory and a framework for engaging digital citizens in integrated primary health care via social enterprise.

Development of a mobile groundwater desalination system for communities in rural India.

The consumption of saline groundwater has contributed to a growing incidence of renal diseases, particularly in coastal communities of India. Although reverse osmosis (RO) is routinely used to remove salt from groundwater, conventional RO systems (i.e. centralized systems using spiral wound RO elements) have limited utility in these communities due to high capital and maintenances costs, and lack of infrastructure to distribute the water. Consequently, there is a need to develop an appropriate solution for groundwater treatment based on small-scale, mobile and community-led systems. In this work, we designed a mobile desalination system to provide a simple platform for water treatment and delivery of goods to rural communities. The system employs tubular RO membranes packed in a single, low-profile vessel which fits below the cargo space. The low-profile enables minimal intrusion on the space available for the transportation of goods. Pressure is delivered by a belt driven clutch pump, powered by the engine. Water is treated locally by connecting the intake to the village well while the vehicle idles. A combined numerical and experimental approach was used to optimise the module/system design, resulting in ∼20% permeate flux enhancement. Experimental results revealed that the system can produce 16 L per square meter of membrane area per hour (LMH) at a salinity level of 80 ppm from a ∼2000 ppm groundwater when it is feed at 1 m3/h at 8 bars. This indicates that a vehicle equipped with 12 m2 of tubular RO membranes can deliver 1 m3 of drinkable water by using ∼0.9 L of diesel. Assuming eight such systems could be implemented in a community to fulfil the water demands for a village with 2000 residents, a social business study revealed that a payback time of 2.5 years is achievable, even if the sale price of the water is relatively low, USD 0.18 (Rs 12, which is half of the lowest market price) per 20 L, including providing a goods transportation service at price of USD 5.25 (Rs 350) per 100 km.

Global eHealth, Social Business and Citizen Engagement: A Natural Convergence?

This paper draws on the vision, mission and experience with the WHO Collaborating Centre on eHealth (WHOCC-eHealth) and Yunus Social Business Health Hub (YSBHH) based at UNSW Australia, and the Asia electronic Health Information Network (AeHIN). Global eHealth aims to provide equitable access to ICT and health care, particularly to the poor, vulnerable and disadvantaged. Social business aims to solve social and economic problem. Its best known product is microcredit financial services for the poor which are small loans that enable them to "produce something, sell something, earn something to develop self-reliance and a life of dignity". Citizen engagement and community participation is integral to both constructs within the context of global partnerships for Integrated People-Centred Health Services (IPCHS) and Sustainable Development Goals (SDGs). The eHealth dimension is consumer heath informatics, social media, mHealth and the Internet of Things. The convergence is multidimensional, mutually beneficial and requires good governance and leadership.