How to Change the World: Social Entrepreneurs and the Power of New Ideas by David Bornstein

So interesting how I picked up this book at the end of winter break and it continued the trail of ideas from where my social determinants of health class had left off. So many theories of behavior change recognize the role of the larger community but in the effort to avoid victim blaming, these theories fail to recognize some amazing individuals. So are these success stories inevitable and any number of people could connect the social resources or do they truly require a social entrepreneur?

Bornstein chronicles the organizational history of Ashoka Innovators for the Public and outlines this more individualistic theory of change.

The stories were really amazing, and for that you should read the book. But the real insight for me was the compilation of principles that defined successful change. The examination of commonalities between these change-agents. That's what was really cool to see.

Considering the gaps in social infastructure as potential markets is enlightening. "Firms arise where markets and one-on-one transactions don't conrdinate well enough" (175). Bornstein uses College Summit as an example, where the benefits of a college education are broadly distributed and the only way to bring them together is through a firm. The beneficiaries of that kid making it include the high school where she came from, the city that won't have to pay to assist her, the college that increases diversity, the company that hires her, the government that taxes her, and then all those indirect effects on peers, not to mention individual wealth and well-being. All those smaller amounts "add up to a return to society well in excess of the $1000 that changed her life but any single one of them wouldn't be enough to economically justify paying to changer her path" (175).

Mosaic meeting of multiple programs allowed some other principles to emerge.

1. Get youth in leadership role.

2. Enlist "barefoot" professionals. The real professionals are too expensive and too rare, so you must train ordinary citizens to reach underserved markets at scale.

3. Work to change legal frameworks to give as much advantage as possible. Lobby and be active in the media.

4. Help small producers capture greater profits. Just increasing profits pushes toward larger enterprises which tend to rely less on human labor and more on technology. This actually increases poverty and the shift of village to city. Instead of maximizing production, must seek to maximize producers and the best way to do that is to ensure that they get a decent profit, enough to motivate them to stay in their villages and towns and not move to a slum near a megalopolis.

5. Link economic development to environmental protection

6. unleash resources in the community you are serving

7. Link citizen, government, and business sectors for comprehensive solutions.

8. Institutionalize listening

9. pay attention to the exceptional

10. design real solutions for real people

11. focus on the human qualities of workers

Six qualities of successful social entrepreneurs. Willingness to;

1. self-correct
2. share credit
3. break free of established structures
4. cross disciplinary boundaries
5. work quietly (John Woolman)
6. strong ethical impetus (think mission driven)

Chapter 19 discusses the work of James Grant, a champion of the GOBI movement to within primary care, the core of selective primary care which epitomizes the conflict within medicine about how many of the social determinants of health should society allow healthcare to manage or shape. Ignoring this larger debate, Grant was able to focus his energy on child mortality and championed oral rehydration and child immunization to reduce mortality significantly. He even got a war to go on hold in order to vaccinate children in El Salvador, but even this action could be seen in the larger light of his unwillingness to focus on the larger causes of that war (his own country's militarism).

Bornstein concludes with the idea of blueprint copying as the most efficient way to transmit and implement knowledge. He criticizes social movements for using only idea diffusion that come detached from their implementation details, forcing adopters to go through the slow and painful process of working out the kinks before they can take advantage of good ideas.

And finally how do we make social entrepreneurialism as cool as profit-oriented entrepreneurialism? Both the citizen and business sectors market products and services to fill gaps. Both are operational that are inventive and productive when political and cultural environments are supportive. Both sectors exist to create value for society. If they are so similar, then competition should drive huge improvements, the same way that competition increased productivity so much when markets gained mobility through technology. But how do you assess various organizations and allocate capital correctly when success is not measured in dollars? Bornstein warns against using numerical metrics and asks instead for judgement, the way that the law applies judgement. I wonder why he distrusts such measures as DALYs or other measures meant to compare diverse services. His idea is to fund citizen sector research analysts to publish expert opinions.

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