Frugal Innovations and Health System Resilience. The Conceptualization, Policy Support and Forms of Frugality During Covid-19 in South India

Harilal Madhavan () and Jean-Paul Gaudilliere
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Harilal Madhavan: CHRIST University
Jean-Paul Gaudilliere: Inserm & EHESS

Chapter 7 in Capitalism, Innovations, and Health after Covid-19, 2026, pp 243-278 from Springer

Abstract: Abstract This chapter discusses the conceptualization of frugal innovations in the healthcare sector and offers empirical evidences of frugality and its success in the context of Covid-19 pandemic in India. It attempts to elaborate on the following arguments: (i) The concept of frugal innovations goes beyond simple cost-effectiveness argument for business models in developing societies, it offers multiple forms of affordable, adaptive and sustainable possibilities as evidenced during the pandemic. (ii) The spatiotemporal context is important, but the success and effectiveness of frugality also depends on the social, political and cultural fabric of innovations (innovation ecosystem) (iii) Frugal innovations are part of a regional innovation system in health that provide for local solutions, which can’t simply be standardized and reproduced in different contexts or for other healthcare systems. The chapter presents three types of frugal innovations from south of India, especially in the state of Kerala during the Covid-19 time to explain the relevance of this alternative, which confines not to health sector alone but applies to allied sectors too: (i) community mutual aid systems and decentralized delivery (‘break the chain’ campaign, community kitchen); (ii) use of low-cost alternative medical systems (rapid deployment in ‘Ayur Raksha’ clinics, repurposed Ayurveda preventive medicines and formation of a repository of traditional medical innovations in the Covid-19 treatment); (iii) complementary livelihood innovations (‘chekkutty dolls’ and women self-help groups that manufactured masks). In the context of Kerala, one can trace the reasons why these frugal innovations could be developed and easily adopted to an innovation culture that the state has nurtured through a decentralized governance and people’s participation; a strong co-existence of biomedical and indigenous health system; the mobilization of community women groups and neighbourhood entrepreneurship in association with a strategy for the common pooling of resources.

Date: 2026
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DOI: 10.1007/978-3-032-24479-6_7

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