**3. Good health and well being**

UN SDG 3 focuses on Good Health and Well Being and includes several subgoals/ targets. Among these are reducing maternal mortality rates, infant and child mortality rates, and reducing the incidence of preventable, non-communicable diseases. In most LMIC's the health care system is a public system which is typically under-resourced both in terms of facilities and qualified medical staff. Patients in these countries are

#### **Figure 8.**

*Pay-as-you-go electricity access system concept [22].*

often willing to pay for private health services that offer higher quality service than the public health system without the long wait times associated with the public systems.

One approach to offering higher quality of service is through telemedicine programs. These systems may be developed using low-cost communications technology and open-source software. We have implemented such a system in Nicaragua using basic feature phones using 2G connectivity and the open-source software, Rapid SMS, available through UNICEF [23]. An important element of this program was to adequately train the front-line health care workers who generally have limited education and health care training in rural communities in LMICs. In the program we developed, we trained the community health workers (CHWs) both in basic nursing skills as well as in technology. They learned not only to measure basic vital signs, such as temperature, pulse rate, respiration rate, blood pressure, etc. but also to text this information in a coded format using their cell phones to a server. The data was entered into a database on the server as a patient health record. A volunteer doctor reviewed data that was flagged to be out of a normal range and, if necessary, the patient was referred for further clinical investigation. This process could catch manageable diseases, such as diabetes and hypertension, that may be asymptomatic. This could reduce the incidence of premature deaths related to non-communicable diseases.

Also, in the training program, the CHWs were trained in how to deal with issues arising from pregnancy such as eclampsia and pre-eclampsia. We found that the CHWs were better able to handle emergency situations with pregnant women following our training programs and having access to cell phones. They were more informed of the signs of these distresses in pregnant mothers and could use the cell phones to seek professional guidance when dealing with the situation. As a result of our program, several mothers' and infants' health outcomes have been drastically improved.

Of course, during the period of severe Covid restrictions, where people were not allowed to leave their homes, telemedicine consultations grew rapidly in developed countries also. Telemedicine between consultant doctors in cities in developed countries and clinics in developing countries has also been growing as an emerging paradigm to provide a higher quality of health care in LMIC's.

#### *Innovation and Entrepreneurship to Address the UN Sustainable Development Goals DOI: http://dx.doi.org/10.5772/intechopen.110150*

Another entrepreneurial model that the author has witnessed in Managua, Nicaragua, are health kiosks located in shopping centers in the city. Representatives of a for-profit company collect patients' vital signs for free. This information is then shared with pharmaceutical companies that can then suggest appropriate medication that can address health problems uncovered by these health screenings. The pharmaceutical companies therefore provide the support to allow these screenings to be offered for free to the general public while also increasing the market for their products.

A sustainable business model was developed by Prof. Khanjan Mehta for providing medical information in rural communities in Kenya [24]. He discovered that people in the rural communities were interested enough in finding out their medical information (e.g. blood pressure) that they were willing to pay for it. By arranging for one or two nurses to serve a particular catchment area, these vital sign measurement services could be run in a sustainable way [24].

The Aravind Eye clinic in India was established to provide cataract surgeries in remote communities in South India. Using innovations in low-cost replacement lens technology and large volumes of procedures through mobile clinics going out to the field, the Aravind Eye clinic has been able to provide cataract surgeries at low cost and high quality. The surgeons conducting the operations typically perform hundreds of surgeries per day. They have optimized their operations so that patients are rotated through various stages of the operation, including pre-op preparation, surgery, and post-op recovery in a very efficient and streamlined way. This allows the operations to be performed at low cost, high volume leading to low charges for patients. In the case of very poor people who cannot pay even the low fees, their operations are offered at subsidized prices (even free) depending on the patients' financial means [25]. A picture of a nurse examining the eyes of a patient in the Aravind Eye Care system is shown in **Figure 9**.

Business models for primary health care delivery in LMIC's was presented in a paper by Lokman and Chahine [27]. In this paper, the authors studied nine social enterprises delivering primary health care in LMICs in a sustainable, profitable way. They found some common patterns in the business models of these social enterprises as follows. They were all able to purchase medicines in bulk at low cost; they offered flat rate

**Figure 9.** *Doctor examining a patient in the Aravind Eye Care System [26].*

pricing for patients but cross-subsidizing for services; they offered high quality health care; and they generated revenue from alternative streams such as selling their in-house IT systems, subscription packages, telemedicine services, franchising, and mobile units.

#### **4. Clean water and sanitation**

UN SDG 6 is focused on ensuring availability and sustainable management of water and sanitation for all [23]. Between 2015 and 2020, the percentage of the world's population having access to safely managed drinking water increased from 70–74%. Similarly, the percentage of the world's population having access to safely managed sanitation rose from 47–54% [28]. To obtain universal coverage of these two types of services by the year 2030, the rate of expansion to these services would need to increase four-fold.

Water and sanitation utilities have been improving services to their customers over the last two decades. Such utilities have the expertise and capabilities to effectively manage the development of these systems and to attract commercial financing [29]. There are several examples of water and sanitation successes as presented in [29]. In Brazil, for example, the establishment of world class utilities has resulted in an increase in sanitation services from 73–87% in the last 20 years.

The World Bank has developed an initiative titled "Water Global Practice's Utilities of the Future" that "supports the establishment of efficient, reliable, transparent, responsive and inclusive utilities." By putting in place stronger incentives for improved policies and governance of utilities, the goal of this initiative is to "help utilities transition towards a sustainable business model that enables them to build resilient water supply and sanitation services for all" [29].

Gravity-fed water distribution systems are becoming popular in village communities in developing countries. These systems take clean water from above the animal grazing line and pipes it down to communities. These systems provide water to villagers free of contamination from animals grazing at lower levels. These systems are typically built by community members under the guidance of a water committee. This committee also needs to be organized to collect funds to be used for making repairs to the systems in the event of damage to the systems. This type of program may be considered as a social enterprise.

### **5. Zero Hunger**

UN SDG 2 is to end hunger, achieve food security and improved nutrition, and promote sustainable agriculture. Large agricultural corporations are turning to more automated systems for farming particularly incorporating sensors and software systems into the agricultural enterprise. This so-called *precision agriculture* is a "farming management strategy based on observing, measuring, and responding to temporal and spatial variability to improve agricultural production sustainability" [30]. The use of this technology can improve land productivity while using fewer resources. Higher productivity can lead to improved crop yield and livestock yield from a particular parcel of land. However, while this technology can benefit large farming corporations, bringing down the cost of the technology for use on small holder farms is still being researched.

Most of the world's poor rely on agriculture for their livelihoods. A significant issue that small holder farmers face is lack of water for irrigating their farms.

*Innovation and Entrepreneurship to Address the UN Sustainable Development Goals DOI: http://dx.doi.org/10.5772/intechopen.110150*

**Figure 10.** *Deployed drip irrigation system on a farm in India [34].*

Depending on rainfall to water their farms can lead to food insecurity, particularly with climate change adjusting regional rainfall patterns. Being able to irrigate small holder farms can offer farmers increased crop yield, with potentially increasing the number of crop cycles from only one per year to several crop cycles per year and therefore higher income to the families. A technology that offers such an opportunity is treadle pumps. Several versions of this technology have been commercialized but one of the most popular is the Super Money Maker pump [31]. This pump comprises two pedals that a farmer can stand on and alternately move up and down. The up and down motion results in water being pumped in each cycle of the motion. Such systems have been deployed in many different African countries. Over 350,000 of these pumps have been sold and have resulted in 13 million people being fed and \$230 million in new farm profits and wages being produced [32].

Another technology to irrigate and fertilize farms at low cost are drip irrigation systems. In this approach, water and nutrients can be delivered precisely to crops through a series of pipelines. The pumping system may be solar powered so that these systems may be used in remote, small farms which do not have access to grid electricity. This type of system again allows for crop irrigation without reliance on rainfall and can result in multiple crop cycles in a year from a piece of land. An example of a company manufacturing and selling such drip irrigation systems is Netafim, a company headquartered in Israel but with subsidiaries all over the world. The company is operating in 110 countries with 17 manufacturing plants worldwide. They have sold systems to over 2 million farmers [33]. A picture of a deployed Netafim drip irrigation system in India is shown in **Figure 10**.

### **6. Quality education**

UN SDG 4 is focused on providing quality education to all. In low resource settings, providing access to quality educational materials can be a challenge. Several companies have developed entrepreneurial solutions to this challenge.

#### *Entrepreneurship – New Insights*

World Possible is a non-profit corporation based in the US that has developed an open-source hardware-based system with educational content that can be used in locations where the internet is not accessible. Based on the open-source Raspberry Pi microcomputer, the remote area community hotspot for education and learning (RACHEL) device stores educational content on the Raspberry Pi server and distributes it by Wi-Fi to a classroom of students in a school setting [35]. The RACHEL-Plus 4.0 sells for \$500 and includes 500GB of data storage as standard. The educational materials are available in several languages including English, Spanish and French. The standard educational content includes Wikipedia, Kolibri, several mathematics packages, Great Books of the World, Moodle class management software, TED talks, KA Lite, and many more [36]. The Rachel system has been distributed throughout the world. We have also developed our own Rachel-type system by configuring and setting up a Raspberry Pi microcomputer for use in a school computer laboratory in Guatemala [37].

A communications company, Brck, based in Nairobi, Kenya is bringing free connectivity to communities without access to the Internet. They have developed a rugged WiFi router with 8 hours of battery life and an embedded SIM card for 3G Internet access [38]. Interfacing this unit to a Raspberry Pi microcomputer along with the development of ruggedized and customized tablet PCs led to the formation of

#### **Figure 11.**

*Tablet PCs plus server laptop computer and router donated by the Telefonica Foundation to the Colegio Liceo in San Cristobal Island in the Galapagos Islands.*

the Kio Educational kit [39]. Many of these kits have been distributed to schools in rural communities in Kenya and Uganda, improving the quality of education in these schools.

Other companies have also developed low-cost tablet PCs that are aimed at the educational market. One such company, Datawind, developed one of the first such tablet PCs initially for the Indian market. The company chose to develop a tablet PC with lower features than tablet PCs developed for the developed countries markets. The screens had to be custom made since there were none on the market that met the company's low-cost requirements. The Datawind tablet PC sells for about Rs. 3000 (about \$36) in India and is widely available in schools [40]. In 2015, Datawind accounted for 24% of the 4.4 million Tablet PC sales in India, most of them sold to the Indian government for use in schools [41].

Similar tablet PCs have been deployed in schools globally. For example, in Nicaragua, the Zamora Thuran Foundation supplied the Datawind tablet PCs under the name Mochila Digital to schools. Similarly, the Telefonica Foundation has provided similar tablet PCs to schools in the Galapagos Islands. A picture of the tablet PCs, server computer and the wireless router in their carrying case donated to the Colegio Liceo school in San Cristobal Island in the Galapagos archipelago is shown in **Figure 11**.

The Telefonica foundation has also developed a complete educational program together with educational resources called ProFuturo [42]. This program has been delivered to several schools in the Galapagos Islands. This project again represents a hybrid business model where a large telecommunications company, Telefonica, is using the revenues from its primary business to fund interventions in LMIC schools to improve the quality of education offered in these schools.

#### **7. Discussion**

In this chapter, various technology and business innovation models have been considered to address UN SDGs 2, 4, 6, 7 and 8. Some common approaches emerge in the innovations developed to date. The first is hybrid business models where services to wealthier customers are used to subsidize services for poorer clients. The Aravind Eye Care example and the GVE-group solar electric systems are examples of this type of hybrid business approach. A second common theme is that quality of service and attention to customer satisfaction are very important considerations to ensure that the customer is willing to outlay money for the private services rather than relying on public services. Again, the Aravind Eye Care center offers a good example in the health care sector while the sustainable tourism work by Global Himalayan Expeditions offers another excellent example. Third, innovations to improve efficiencies in the delivery of services is common to many of the enterprise approaches described in this book chapter. Fourth, the volume and scale of the enterprise can be used to reduce costs and thereby make the business competitive against other development approaches. The examples of the solar lanterns from d.light and Sun King as well as the tablet PCs from Data Wind are good examples of these business models. Finally, the use of technology to improve services and to support additional means of revenue generation is a common theme seen in the successful enterprises addressing the UN SDGs. In this case, pay-as-you-go models for electricity provision, the lowcost water pumping systems, and the use of open-source hardware and software tools to improve the quality of education are examples of technological innovations.

Areas for further work in this field are to apply these common innovations in technology and business models to other UN SDGs and to deploy these innovations more broadly to scale enterprises to advance progress in meeting the UN SDGs.

#### **8. Conclusions**

The UN Sustainable Development Goals outline goals in various development sectors to be achieved by the year 2030. Different mechanisms may be used to address these challenges including public services provided through governments, programs supported through donor aid funded and charitable organizations, or through private enterprise solutions.

In this book chapter we have illustrated various business models that have been used to address several of the UN SDGs. The advantages of entrepreneurial solutions are that they are not reliant on donations or public funds. They are often built out more efficiently than public services and require consideration of financial sustainability in planning the business model right from the outset. Entrepreneurs also must consider growth and scaling of their enterprises to achieve their overall company objectives.

The UN SDGs are scheduled to be met by the year 2030. While significant progress has been made in addressing some of the goals to date, there is still a lot of work to be done to achieve the goals. Entrepreneurial approaches if adequately financed and scaled have the potential to achieve these goals. It is important that the entrepreneurs working to meet these goals are provided the support needed to succeed in their important enterprises.

#### **Acknowledgements**

The author gratefully acknowledges the contributions of his students to the educational outreach programs in the various countries (primarily in Nicaragua, Ecuador and Guatemala) in which he has worked. In particular, he would like to thank Javier Urquizo, Viviana Villavicencio, Nathaly Sanchez, Diego Villacreses, John Beyer, Scarleth Vasconcelos, and Melvin Mendoza. He is also grateful to Mr. Edward Tohom of Catholic Relief Services. Finally, he would like to thank professors at various universities with whom he has partnered including Professors Ruth McDermott-Levy, Dr. Betty Keech and Dr. Betty Mariani of Villanova University's, M. Louise Fitzpatrick College of Nursing, Prof. Jim Klingler of the Villanova School of Business and Prof. Maria Virginia Moncada, retired from Universidad Nacional de Ingenieria (UNI), Drs. Cecilia Paredes, Cesar Martin, and Angel Ramirez as well as Prof. Jimmy Cordova of ESPOL and Prof. Elfego Ovalle of Landivar University in Quetzaltenango, Guatemala.

He is also grateful for financial support to Villanova University, Venture Well and Halloran Philanthropies for supporting his work.

This work received funding from Villanova University's Falvey Memorial Library Scholarship Open Access Reserve (SOAR) fund.

### **Conflict of interest**

The author declares no conflict of interest.

*Innovation and Entrepreneurship to Address the UN Sustainable Development Goals DOI: http://dx.doi.org/10.5772/intechopen.110150*
