Josh Nesbit

Ashoka Fellow
San Francisco, United States
Fellow Since 2011
My work: creating coordinated rural healthcare systems thanks to smart and simple mobile phone-based solutions.


This profile was prepared when Josh Nesbit was elected to the Ashoka Fellowship in 2011.
The New Idea
While doing research on children’s access to HIV/AIDS medicine in rural Malawi, Josh—at the time, an aspiring doctor—was struck by two trends. On the one hand, he observed volunteer community health workers who could not respond effectively to a high demand for public health services due to distance, isolation, and a lack of communication infrastructure between the field and medical facilities. On the other hand, he observed the prevalence of mobile phones in even the most remote regions of the country. Putting two and two together, Josh realized that mobile phone-based communication had the potential to turn a fragmented rural healthcare quagmire into a coordinated health system where community health workers (CHWs) living and working in rural communities would be able to respond to patients’ needs rapidly and efficiently. More rural patients could receive better healthcare simply by improving communication among the players that already existed within the system.

Josh saw an opportunity to expand and improve healthcare to rural patients without relying on an influx of more doctors and nurses. Rather, he saw an opportunity to maximize the potential of existing human resources. Using affordable, scalable, and easy-to-use mobile technology, Josh is creating connected and coordinated health systems where locally-based community health workers can serve their communities with minimal dependence on distant medical facilities. In other words, he is building a system for “just-in-time” healthcare. Leveraging pervasive mobile phones and simple text messaging, Josh and his team are helping healthcare communities vastly improve communication and, consequently, the efficiency and efficacy of locally-based healthcare workers. Now, CHWs are able to use SMS to collect, convey, and receive important medical and logistical information without the need to travel back and forth between the point-of-care and the base hospital or clinic. In this way, decentralized, locally-led healthcare in remote regions is achieving its high potential. In short, Josh’s solution is building the infrastructure for the model of community health workers to function.
The Problem
The Strategy
The Person


Featured in The Rise of the Reluctant Innovator, by Ken Banks (2013)

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