A spotlight on IDinsight Director: Leah Mwai

Leah Mwai is a seasoned global health specialist and research and innovation expert with over 15 years of experience working in Sub-Saharan Africa. Leah holds a PhD in clinical medicine and global health from the University of Oxford, UK and post-graduate qualifications in strategy and innovation from Oxford Saïd Business School. Prior to IDinsight, Leah was the lead advisor of a cross-sectoral research and innovation program portfolio at the UK’s Foreign Commonwealth and Development Office (FCDO). At Canada’s International Development Research Centre (IDRC), Leah served as Senior Program Officer and oversaw the design and implementation of a large multi-donor initiative aimed at scaling high-impact maternal and child health interventions in several countries in West, East, and Southern Africa. 

Q: Tell us a little about yourself.

I am a scientist who is preoccupied with questions about scaling impact, translating and integrating insights from data and evidence to improve well-being and livelihoods. I am very curious. My entire childhood was steeped in experiences in the natural world, with lots of observation and experimentation. I have been asking questions for as long as I can remember. I am eclectic, and particularly enjoy spanning traditional disciplinary and sectoral boundaries, and applying collaborative, innovative, and holistic scientific approaches to maximize practical benefits for individuals and communities. The scope of my career has evolved over time, starting in the clinical and biomedical setting (as a frontline healthcare practitioner and biomedical researcher in clinical pharmacology, therapeutics, and translational medicine), later transitioning to implementation science, scientific funding,  portfolio design, and management in health and other cross-cutting areas (including research and innovation, climate, education and training, and capacity and ecosystem strengthening).

Q: How do you explain what you do to your friends and family? 

This has evolved somewhat. At the beginning of my career as a health practitioner and clinical pharmacology and therapeutics researcher, I would say I worked to ensure people receive the correct diagnoses, as well as safe and effective doses of medicines and treatments, and the necessary support to manage or prevent illness. With the broadened scope of my work, I explain that I also help to diagnose and treat ‘system issues.’ In so doing I support decision-makers (be it policymakers, funders, program implementers, practitioners, communities, or individuals) to use data and evidence to diagnose and solve societal problems, maximize their social impact, and build the capacities and capabilities that foster the sustainability of their efforts and investments.

Q: What inspired you to dedicate your career to research in global health?

As a young healthcare practitioner in Kenya, I quickly realized that many of the challenges I needed to overcome to be effective and impactful in my work often transcended the institutional, geographical, disciplinary, and political boundaries in which I was constrained. Global health was the most immediate and practical framework and opportunity I could access to approach these issues more holistically. Especially learning how to identify, design, and test the right interventions, and to effectively measure, document, and track their effectiveness. I was particularly inspired by the versatility of the field and the fact that I had access to a family, mentors, and colleagues who encouraged and nurtured my curiosity and interest in exploring complex questions and diversifying my work and career path.

Q: Feedback loops between policymakers and communities are paramount for effective service delivery, especially in the health sector. As an innovations expert, what creative solutions exist that can make the feedback process smoother and faster for healthcare policymakers in Africa?

Feedback processes that are dynamic and scalable, that enable continuous and real-time data collection and analysis, and tailored decision-making can help to optimize patients’ engagement and satisfaction with the quality of services. Mobile and digital technological solutions, if thoughtfully designed and integrated, offer immense possibilities in this regard.

MomConnect, an initiative of the South African Department of Health, is an example of a solution that leverages the widespread availability of mobile phone technology to improve the demand and the quality of supply of maternal health services, through a digital feedback platform. By providing information and empowering women to send feedback either as compliments and /or complaints through their mobile phones to the relevant health providers, managers, and policymakers, the platform facilitates the timely identification and resolution of issues such as optimal drug supplies and improved standards of care at all levels of the health care system. 

To maximize the potential of mobile and digital solutions, policymakers should ensure that the technology does not inadvertently introduce or perpetuate existing inequities, and prioritize actions that build trust and incentivize positive user engagement and participation.

Q: As an advocate for continuous learning, development, and capacity building, how can academic institutions and research organizations work with governments to facilitate knowledge transfer?

Learning tends to be most successful when there are sustained long-term relationships of trust, which provide opportunities to align on interests and common goals and co-create the strategies and processes that facilitate uptake and use. 

IDinsight’s learning partnerships model comes to mind as an illustration in this regard. These collaborative, long-term in-depth engagements allow IDinsight teams and their clients to better identify and articulate opportunities for sustained impact by gaining a mutual understanding of the contextual demand for the improved use of evidence on the one hand –– and the operational constraints on the other. Providing each key stakeholder the opportunity to co-create the terms of engagement helps to foster mutual trust, commitment, and buy-in, and to maximize conditions for institutionalization, uptake, and use.  The iterative nature of these engagements helps to ensure that solutions are adequately tailored to the needs of each client and that partners have the flexibility to pivot or shift approaches or address new questions as they arise using a diverse methodological toolkit.

Q: What steps can philanthropists and development funders take to more closely align their program decisions with beneficiary priorities? 

Given that the majority of beneficiary issues and priorities are often rooted in systemic structural inequality and power asymmetries, philanthropists and funders should be willing to introspect about their role in this. They should learn from those they seek to help, and reimagine relationships that make them more equal partners and  ‘co-disruptors’ with beneficiaries, not merely ‘donors’.  In this regard, they should make their overall granting and decision-making processes more transparent, fair and accessible, and raise their ambitions to ensure they share and redistribute (not reinforce) entrenched power in order to achieve the level of transformation espoused in their mandates. Being more intentional in support of flexible and adaptive programming approaches can engender genuine local ownership by shifting the role of beneficiaries as passive recipients to co-creators, co-owners, and co-decision-makers in their own development processes.

The situation on the ground is far from the ideal in the vast majority of contexts, but perhaps the San Code of Research Ethics can offer inspiration and a helpful framework that development practitioners can consider for re-imagining more equitable and transparent partnerships and decision-making processes. The code documents how The San community (a classic example of a vulnerable population) and its partners progressively co-created research processes and systems that recognize The San community’s value system and promote genuine collaboration and sharing of benefits. The code development process outlined an alternative collaboration and accountability approach that prioritized communication and consultation at all stages, allowed genuine local leadership, governance, and institutional capabilities to emerge, and shifted ownership to the San community.

Given the importance of this question and scantiness of real-world examples on what works and why, funders can help to strengthen the evidence base by allocating sufficient resources for consistent rigorous learning and engagement, and use their positions and influence to bring others to the conversation and spearhead improved standards of practice.  IDinsight’s Dignity Initiative is supporting learning and improvement on this.

Q: What attracted you to IDinsight?

IDinsight’s reputation and deep commitment to conducting demand-driven, rigorous, and cutting-edge research that has social value and impact, and particularly how these values resonated effortlessly across each and every current and former member of the team that I spoke to. The passion and enthusiasm was contagious and I knew that I not only wanted to contribute to the compelling work but also to be part of such a genuine value and mission-driven culture.

Q: What is one of your most memorable life experiences?

Growing up with my paternal grandmother. She was a wonderful and engaging storyteller, a walking encyclopedia on cultural topics, and had an interest and a wealth of knowledge on practical traditional herbal remedies, healing, and scientific practices. Towards the end of her life, she became ill and I was one of her primary caregivers. I realize that my interactions with her must have influenced my character, interests, and personal choices to a great extent, especially my particular interest in a career in healthcare and therapeutics and my sustained curiosity to understand how holistic transdisciplinary scientific approaches can help to better examine, link, simplify, and contextualize different types of (including local) knowledge so that they can be more meaningful and applicable for individuals and communities.

Q: What do you enjoy doing outside of work?

I am a voracious reader. I love sunshine and nature and spend a lot of time outdoors wherever these can be found! I enjoy community and cultural activities (particularly when they involve stimulating conversation and storytelling), and every so often I set time aside to engage on issues I care about, or to simply connect with family or friends. I enjoy writing but I don’t write as much as I would like to – it’s definitely something I would like to do more.