Introducing global health

Summary of Week 1 (Part 1) of Essentials of Global Health (Coursera – Yale School of Public Health)

Global health considers the health of populations in a global context, placing priority on improving health and achieving equity in health for all people. This course focuses on the health of poor people in poor countries, issues in public health that transcend national boundaries, and critical public health issues that require global cooperation.

Key perspectives on global health

Determinants of health can be thought of as risk factors and social determinants. A risk factor refers to any attribute, characteristic or exposure of an individual that increases the likelihood of developing a disease or injury while social determinants refer to the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. They can range from individual characteristics to governance, policies and interventions.

Therefore it is important to think broadly. 5 key questions to ask when thinking through a problem to solution are:

  1. What is the problem?
  2. Who is affected?
  3. Why do they get it? Risk factors and social determinants.
  4. Why should we care? Health, social and economic consequences.
  5. What can be done?

The global health context and who plays

Many SDGs targets relate directly and indirectly to health. There are a wide range of different kinds of organisations involved in different kinds of activities:

  • Individuals, communities, and governments
  • UN agencies
  • Multilateral and bilateral development organisations
  • International partnerships
  • Foundations
  • National research and health oversight organisations
  • Universities
  • Consulting firms
  • Product development partnerships
  • Pharmaceutical firms
  • Non-governmental organisations

3S Methodology: Scalability

Summary of Week 4 of Technology Evaluation for Global Development(edX – MITx)

CITE defines scalability as a firm’s capability to expand and meet customer demand, taking into account its supply chain configuration, costs, constraints, context and risks. Scalability is important because it creates a supply of goods, provides returns to investors, and grows the economy. Evaluation findings can provide insights into novel ideas for processes and business models.


The unit of analysis is the product distinguished by the brand and/or model, while the scalability unit of analysis are the processes which span all the parties involved in fulfilling a customer’s request (the supply chain). The supply chain can be characterised as follows:

  • Parties: Supplies, manufacturers, distributors, retailers, and consumers. Brand owners are typically manufacturers, but can be retailers and sometimes distributors.
  • Stages: Procurement (e.g. sourcing, procurement management), production (facilities, production planning), distribution (e.g. inventory echelon, warehouse management, transportation management), sales (sales channels, manufacturer representative, commercial, mission, distributor, broker), and after sales (warranty duration and type)
  • Flows: Material flow, financial flow and information flow

The scalability criteria for evaluating supply chains are:

  • Affordability (including landed cost, retail price, total cost of ownership, financing)
  • Accessibility (i.e. customer reach)
  • Availability (i.e. throughput capacity and inventory)
  • After sales service


Talent development

Summary of Week 5 of Human Capital Strategy for Social Enterprises (Novoed – Acumen / Hitachi Foundation)

It can pay off to establish a culture of learning and development early on because it will sow the seeds of a company’s future success, even survival. If implemented effectively, a learning and development program can optimise the performance of the team and prepare the ‘next generation’ of leaders for the organisation, reinforce values and culture, and increase employee engagement.

The reading recommended the 70-20-10 framework of talent development, where 70% comprises experiential learning or on-the-job experiences, 20% informal training and coaching, and 10% formal training. The good news is that early-stage, resource-constrained organisations often have plenty ‘stretch assignments’ to choose from

70-20-10 framework

Only 10%  is spent on formal training. According to Molly Alexander, Head of Talent Development at Acumen, formal training is not a magical fix for talent development needs. The real key to success is setting up a culture where new skills are embedded into everyday routines.

Key areas for employee skill development in the social enterprise sector are:

  • Core competencies which are the skills that define how people get things done.
  • Technical skills necessary for employees to develop in service of ultimately tackling more sophisticated challenges within their functional area
  • Understanding of the sector and organisation in order to see the big picture.


Pluralistic ignorance and measuring norms

Summary of Week 4 of Social Norms, Social Change I (Coursera – University of Pennsylvania & UNICEF)

Pluralistic ignorance

Pluralistic ignorance occurs when many people privately condemn a behaviour but wrongly believe that their peers endorse it. This can occur because the behaviour or its consequences are visible but people do not voice their disagreement, leading to a lack of transparent communication. In such cases, updating normative expectations can help to change behaviour.

A different but related situation is when people misperceive the frequency of a behaviour (e.g. prevalance of corruption or drinking). Correcting misperceptions can change descriptive norms but not social norms.

Measuring norms

To measure norms, you must check empirical expectations, normative expectations and whether there is a conditional preference.

Behaviour can be measured through monitors or self-reports. Personal normative beliefs can be measured through surveys, and it is important to distinguish between prudential and non-prudential beliefs.

If empirical and normative expectations are mutually consistent, it is PROBABLE that there is a norm, but it could also signal a moral rule. Therefore it is necessary to check whether preferences are conditional. This is done by varying empirical and normative expectations and checking whether behaviour changes, through direct hypotheticals or vignettes.

You can also measure how stable a norm is by assessing which expectation has more weight. For example, when empirical and normative expectations diverge, empirical expectations usually dominate.


Thus, through systematic measure, you can diagnose whether a behaviour is a custom, moral rule or true social norm, and whether the social norm has causal relevance.



Water treatment options

Summary of Week 2 of Introduction to Household Water Treatment and Safe Storage (Coursera – École Polytechnique Fédérale de Lausanne)

Water safety

In water treatment (and in life), the question is what level of risk is acceptable. WHO defines safe drinking water as water that presents no significant risk to health over a lifetime of consumption.

The water safety framework comprises health-based targets, water safety plans and verification. Health-based targets include performance measures in terms of log reduction values.

It is important to note that measuring water quality is not the same as water safety because water quality varies in space and time, and no E.coli does not mean no contamination. Multiple treatment barriers should be put in place to remove contaminants.

Health-based targets include performance measures in terms of log reduction values. Water quality measurement does not mean water safety because water quality is variable in space and time, and no E.coli does not mean no contamination

Water treatment options: Sedimentation and filtration

A household-level treatment process typically comprises sedimentation, filtration, disinfection and safe storage.

  • Sedimentation removes turbidity (suspended particles in water), and some pathogens. Turbidity itself has no health risks, but has impacts on subsequent treatment steps. Mechanisms include gravity settling, and coagulation and flocculation.
  • Membrane filtration works on size exclusion, electrostatic effects and biological activity.
  • Ceramic filters work on physical and electrostatic removal. It is common to brush silver onto filters, which contributes to bacteria reduction and prevents biofilm growth and clogging.
  • Biosand filtration also uses size exclusion, electrostatic effects and biological activity.

3S Methodology: Suitability

Summary of Week 3 of Technology Evaluation for Global Development(edX – MITx)

CITE considers technology evaluation through the lenses of suitability (how well a product performs), scalability (how well a product reaches a customer) and sustainability (how a user and a product interact over time).

Developing a set of evaluation metrics

Metrics guides decision-making and focuses the evaluation effort. Good metrics are measurable, relevant, apply broadly across the product family, understandable, and reliable. It is recommended to have 7-12 metrics.

Lab or field?


Lab tests are usually more precise and repeatable, and more objective. The lecture recommends using lab tests when fine discrimination among alternatives are needed, and using field tests is unbiased estimates of actual performance in a particular setting are needed.


Low-cost sensors, such as thermometers, can provide valuable information. Sensors are beneficial because of its persistence and long duration of observation, allowing for high sampling frequencies. Ethical considerations include privacy and possible harm to the user. The user might also alter their behaviour if they are aware of the presence of the sensor. Note that sensors may not always be appropriate depending on the circumstances.

Conditional preferences and social norms

Summary of Week 3 of Social Norms, Social Change I (Coursera – University of Pennsylvania & UNICEF)

Conditional preferences

Preference is a disposition to act in a certain way. It is different to liking or endorsing something.

Conditional preferences means that a choice is dependent on empirical expectations (descriptive norms) or both empirical and normative expectations i.e. if different expectations lead to different behaviour, then people have conditional expectations. It is important to note that consistency between social expectations and behaviour does not mean that the behaviour is influenced by expectation.

Whether people have conditional preferences influences the intervention that is designed. If people have conditional preferences, the intervention should focus on changing social expectations.

Social norms

A social norm is a rule of behaviour such that people prefer to conform to the norm conditional on empirical and normative expectations. Under social norms, there are usually informal social sanctions that motivate compliance. Hence the presence of sanctions indicate that there are normative expectations. However, some people might comply without sanctions if they believe that other people’s normative expectations are legitimate.

(If empirical expectations were sufficient to motivate compliance, this would be a descriptive norm. )

Motivations for behaviour differ from community to community. Bicchieri provides a useful visual summary for diagnosing whether a behaviour is a custom/rule, descriptive norm or social norm.


Source: Bicchieri in Social Norms, Social Change I