MSF Innovation Principles

Innovation has been central to MSF’s medical work and culture since the organisation’s inception nearly 50 years ago. As the organisation has grown and become more complex in recent years, more effort has been made to ‘professionalise’ MSF’s innovation work; people and units with specific innovation mandates and expertise are now part of the ecosystem, as is a thriving innovation network (known as the Innovation Club).

In 2018, at the MSF Hong Kong AGM, a session focused on innovation resulted in interesting discussions around trust (or lack of) between medical/operational staff and the new(ish) innovation capacities. Concerns were raised that innovation work had sometimes happened without a proper appreciation of field realities and context and without an understanding of the end users (or those who could be considered the eventual beneficiaries). Whilst there were (and surely are still) cases where this was the case, counter arguments were made citing the MSF Innovation Club’s (a coming together of various innovation teams across the movement) focus on collaboration, problem analysis and user centredness. The conversation was constructive and it was agreed that a set of shared innovation ‘principles’ might go some way to closing this gap in trust. But, how to start?

We were not the first organisation to feel the need for a set of such principles, so our first move was to scout relevant publications and initiatives from NGOs and similar institutions. We discovered that many sets of principles were similar between organisations - particularly those with a humanitarian purpose - even if the wording would naturally vary. We distilled them into categories considered both representative of the sourced definitions and relevant to the work of MSF. We ran a quick test with members of the Innovation Club from a variety of roles to check comprehension and make sure there were no glaring omissions and adjusted the list.

The figure below presents the final list of distilled categories in full - as they were before the process of elimination. They are listed below alongside a brief description which was also attached to the principles when they were presented in the survey (fig 1.). Click the image to see the next slide:

Then followed a much wider consultation of people working within the organisation in different areas and constellations. In an open survey, MSF staff were asked to rank the principles in descending order of perceived importance. This meant that we could both eliminate the ones deemed to be less important (we wanted a final list of no more than ten). 

We also asked participants to comment on the principles and asked for permission to use the data they submitted. For each participant, their role within MSF and whether they operated from HQ or the field was recorded. 

At the end of the activity, 89 staff had responded from across MSF roles and locations. The figure below shows the principles presented in descending order of importance, with the five principles least prioritised excluded  (figure 2). Interestingly, the prioritisation was very similar across field and HQ profiles, with only one difference in the top ten (highlighted in bold). 

In terms of the comments submitted with the priorities, we happily noted that most were positive and welcomed the initiative. There were also plenty of suggestions, but considering the diversity of the respondents, it could have been a cause for concern had this not been the case! 

Multiple respondents identified collaboration as a missing element within the list, which is certainly something to reflect on.

Some field respondents indicated that they might have liked to see more process-oriented activities highlighted: for instance data protection and testing. There was also some questioning of feasibility (for example, “design for scale”), where some principles might be hard to implement in all cases and on all levels. 

Some respondents identified overlaps / friction between principles. For example, is it possible to strive for impact whilst being comfortable with failure? There were also some thoughts from both groups as to whether some items should have either been split or consolidated but on a whole the response was positive. 

Many could interpret a lack of homogeneity in responses that the list failed to be a catch-all (or even a catch-most) of what innovation means to the organisation. But using a more positive frame with which to interpret the submissions, they also shed light on the very diverse work that is carried out, just as it should be. Importantly, we should stress that each group excluded the same five principles, which lessens the need to delve into the comments as to justifications for the difference.  

Respondent Details

The group of responders were quite diverse, and comprised various levels of staff across HQ and the field. We collected a total of 89 responses, which were registered from positions ranging from field medical staff to HQ officers. Diversity was definitely key here: it suggests that values appear to hold throughout the many branches and levels of the organisation. 

Across the MSF movement we have developed strong innovation expertise, but it is clear we have some way to go when it comes to fully realising our innovation principles. In the coming years we are working to double down on integrating this innovative mindset further into our work, working closely with field teams, and clearly communicating innovation insights and best practices. To stay up to date on all things MSF innovation make sure to sign up to our bi-monthly newsletter below: