The healthcare sector is facing serious challenges. On the one hand, the population is ageing, resulting in a higher pressure on healthcare resources. On the other hand, less than half of the world’s global population is covered by essential healthcare services due to limiting resources. Frugal health innovations are developed to be affordable, accessible, and make effective use of limited resources. As such, frugal health innovations can help to decrease the resource-dependency in the healthcare sector, contributing to healthcare access to all. Yet, the adoption of frugal health innovations remains limited. Adding to this issue, the adoption is not studied from a theoretical perspective and empirical evidence on the reasons for (non-)adoption remains scarce. Understanding what affects the adoption from a theoretical perspective helps to identify underlying principles at hand, allowing to build a conceptual framework. Such a conceptual framework can guide frugal health innovation development for increased adoption probability and promote future theoretical studies on frugal health innovations. This research aims to understand what factors affect the adoption of frugal health innovations from a theoretical perspective, by asking the research question “What factors affect the adoption of frugal health innovations?”.

To guide the research, the first sub-research question “What theoretical framework is most appropriate to describe adoption of frugal health innovations?” was asked. Answering this question ensured a departing point for the theoretical understanding of frugal health innovation adoption. Secondary data from the literature was retrieved through a literature review, from which it followed that nine theoretical perspectives have been used to study the adoption of non-health-related frugal innovations. By comparing the theoretical perspectives against the context of frugal health innovations, it followed that the Unified Theory of Acceptance and Use of Technology 2 is the most appropriate theoretical perspective to study the adoption of frugal health innovations.

To further guide the research, the second sub-research question “What empirical evidence exists, that can give information on factors affecting the adoption of frugal health innovations?” was asked. Answering this sub-research question allowed to synthesize empirical evidence in the Unified Theory of Acceptance and Use of Technology 2 framework to arrive at a conceptual framework for the adoption of frugal health innovations. Secondary data from the literature was retrieved through a literature study, and the empirical evidence was put in the context of frugal health innovations. From this, it followed that the possibility to experiment with the innovation (Trialability), the innovation- fit with the customers’ lifestyle (Lifestyle Compatibility), the availability of required knowledge to use the innovation (Consumer Literacy), the trust toward the provider of the innovation (Trust), the technical performance of the innovation (Performance Expectancy), the ease-of-use of the innovation (Effort Expectancy), the degree of social pressure to use the innovation (Social Influence), the price of the innovation (Price Value), and the degree of resource- and infrastructural constraints impeding the use of the innovation (Facilitating Conditions) facilitate the intention to adopt frugal health innovations (Behavioural Intention). Interestingly, the synthesis revealed that Price Value, Facilitating Conditions, and Trust also act as a barrier in case they are not properly addressed by the frugal health innovation.

Ultimately, the conceptual framework was empirically validated in the context of frugal health innovations through semi-structured interviews with four frugal health innovation developers. Because developers were surveyed, in contrast to consumers by the studies from the literature review, the adoption, and not consumer-central behavioural intention to adopt, was studied. To increase the possibility of adoption, results suggest that trust between the developer and consumer should be established (Trust), the innovation should align with the preferences of the consumer (Lifestyle Compatibility), the innovation should be designed so that it is easy to use and install (Effort Expectancy), and the innovation should be priced appropriately to ensure affordability whilst maintaining a positive perceived price- quality relationship (Price Value). Further, results suggest that it is imperative to understand the context of the addressed health-related issues, as the performance of the frugal innovation must be superior to traditional health innovations if the latter shows poor performance or side effects, or can be inferior if they are used indicatively where the traditional innovation is used confirmatively (Performance Expectancy). Understanding the context is also of importance to determine whether the use of the frugal health innovation is not impeded by the lack of resources and/or infrastructure, or, appropriately addresses their absence, thereby providing a market opportunity (Facilitating Conditions). Additionally, results suggest that the severity of the health problem (Problem Severity) also affect the adoption, whilst only relevant in case frugal health innovations are sold to governmental organizations. All in all, this exploratory research provides a first conceptual framework to study the adoption of frugal health innovations and opens up the debate on what is required for their adoption. Developers are advised to tailor frugal health innovations according to the principles observed in this research study, as doing so likely enhances the probability of adoption. However, considering the lack of a consumer-perspective in this research study, a logical next step is to further gather empirical findings on frugal health innovation adoption using the developed conceptual framework, to ensure a more robust image of the factors affecting the adoption of frugal health innovations.