November 13, 2020

Putting Women at the Center of “The Triple Aims”

The concept of the “Triple Aims” in healthcare first took hold more than a decade ago and has shaped delivery of services in a number of countries. These aims: improving the individual experience of care; improving the health of populations; and reducing the per capita costs of care for populations have driven important progress in the sector.

However, discussions at Innovations in Healthcare’s 2015 Annual Forum raised the possibility that health systems and services have important and largely invisible roles to play beyond achievement of the Triple Aims that can affect large-scale social and economic progress.

The idea of a different set of Triple Aims was discussed at last year’s Forum during a panel entitled, Empowering Women and Strengthening Health Systems: Moving toward the “Triple Win.”  Panelists representing international development, health enterprise innovation, policy, and research focused on three key opportunities: 1) empowering women working in the health sector through development of health-related enterprise affording them means for improving their overall wellbeing; 2) extending the reach and impact of health systems through women’s engagement in these enterprises; and, 3) reducing poverty and economic vulnerability through improved access to affordable health service--and through providing decent employment opportunities in the health sector to women (including compensating women for their current unpaid work).

The backdrop for this panel was a body of work culminating in February of 2015 in the Institute of Medicine’s global workshop report entitled Empowering Women and Strengthening Health Systems and Service through Investing in Nursing and Midwifery Enterprise. Two of my co-panelists Akiko Maeda (World Bank), and Krishna Udayakumar (Innovations in Healthcare), were also participants in an IOM workshop that informed this report.

At the heart of last year’s panel and the work leading up to it is the strong theme of innovation and health-related social enterprise.  Health systems worldwide depend on the work of women who often fill crucial roles in the healthcare system as nurses, midwives, and community health and outreach workers.  Innovative service delivery models that engage these female workers as owners, operators, and key stakeholders in health enterprise have significant potential for not only achieving what are now becoming the “traditional” Triple Aims for health care – but also expanding impact that can advance both health and human wellbeing. Nursing and midwifery enterprises play a crucial role in this arena. A recent article I co-wrote with my colleague Akiko Maeda at The World Bank, in the American Academy of Nursing’s journal, Nursing Outlook , summarizes the work in support of these efforts, and possibilities for the way forward.

Innovations in Healthcare, its innovators, partners, and members are already making important contributions to advancing these new Triple Aims, along with those proposed over a decade ago.  This year’s Annual Forum will provide a very important platform for further discussion of building out health systems with both the “traditional” triple aims and those broader aims relating to social and economic well-being.

At the heart of all of this work are the innovators – those who see innovation and improving lives as inextricably linked.  (It is no surprise that the cover photo of the IOM report shows the work of LifeNet International, one such Innovations in Healthcare innovator.)  As with last year’s Forum, this year’s agenda promises to provide the context for continuing progress!

You can meet Marla and other key members of our network at our upcoming Annual Forum, April 4th and 5th in Washington, D.C. For more information about this invitation-only event, contact Jenny Cook at