Resource constrained innovation in a technology intensive sector: Frugal medical devices from manufacturing firms in South Africa

Most medical devices are designed by western firms from efficient innovation systems with a focus on their home markets. A disproportionately high percentage of imported medical devices in low resource settings become nonfunctional. Despite interest from global health and innovation studies, little is known about firms in emerging markets appreciative of challenges in their home environments. Using empirical evidence from innovative manufacturing firms in South Africa, this study investigates frugal orientation and mechanisms to innovate under resource constraints, in a technology intensive sector typically under the purview of western firms. Systematic analysis of six devices by adapting a global health lens reveals that while some innovations specifically address health challenges of low resource, others are more affordable technological innovations with universal relevance and some frugal elements. Resource constrained innovation strategies involved building advanced internal manufacturing capabilities to overcome institutional voids while forging multiple knowledge collaborations to complement inhouse capabilities. This drives frugality around design, engineering and manufacturing processes. Innovation delivery strategies are complementary to these processes. The evidence suggests fundamentally new products were designed in collaborative bottom up processes. The role of the state and global non-profits in harnessing frugal innovations for public health was found to be critical.