We believe that entrepreneurship is the best approach to deploy a technology-based product in sustainable manner at scale. One of the crucial components of entrepreneurship is the identification and elaboration of a suitable business for your product. Thus, it is important to understand revenue generation processes for any prospective product in LMIC markets, in order to ensure sustainable commercial viability. Most medical technology innovations require significant financial investments to convert them from a prototype and industrialize them into a marketable product. Thus, a robust business model is also paramount for convincing and obtaining investors. We adopted the widely used business model canvas for traditional businesses originally described by Osterwalder and Pigneur. This tool provides a systematic method to determine the mechanism(s) by which a new venture will generate income, as well as assist in developing the value proposition to contribute to sales and marketing activities. However, since we also aim to achieve social impact with the innovation, we modified this canvas to reflect impact and sustainability aspects over and above financial performance, giving rise to what we refer to as the Sustainable Business Model Canvas.
We propose adding what we term the “Strategy” layer at the top of the canvas for representing the vision and strategy of the team. This will help the team to determine a common vision about issues such as their principle on profit: do they maximize profit or impact? If profit is made, will it be reinvested or will it be distributed to the shareholders and what proportion? The Strategy layer also allows the definition of the impact we are seeking with the new innovation, as well as the identification of the potential beneficiaries. The beneficiary (e.g. patient) of a technology may not be the same as the customer (the one who pays for it) e.g. health ministry, private health care organization or health insurance. The proposed Sustainable Business Model Canvas makes this distinction clearly discernible. The second “Operations” layer below is the traditional business model canvas. This is where we define operational activities as well as customer strategy and segments. On the left hand side, the purpose is to define who will do what in generating the value proposition, which is the product itself along with other services sold to a specific customer segment. The right hand side defines the relations with the customer segments, i.e. how they are reached, and what kind of interaction is planned with them (aftersales services etc.). This is the revenue generating part. Finally the “Performance” layer displays a triple bottom line involving financial, environmental and social dimensions. This layer prompts us to consider striking the right balance between economic viability and impact, between profitability and affordability, between potential social costs (i.e. collateral negative side-effects of the technology on society) and benefits, between potentially generating environmental damage and improving the lives of the poorest. This exercise also forces us to reflect and clearly express our underlying drivers for the project. It is thus a very important and useful task towards creating clarity and alignment in the team concerning individual aspirations and personal philosophies.