{"title":"Systematic literature review of the barriers and facilitators of frugal innovation for surgical care in low-income and middle-income countries","authors":"Cyan Brittany Brown, L. McDermott","doi":"10.1136/bmjinnov-2022-001066","DOIUrl":null,"url":null,"abstract":"Objective Globally, 5 billion people lack access to safe surgery and annually, only 6% of surgeries occur in low-income countries. Surgical frugal innovations can reduce cost and optimise the function for the context; however, there is limited evidence about what enables success. Design A systematic literature review (SLR) was performed to understand the barriers and facilitators of frugal innovation for surgical care in low-income and middle-income countries (LMICs). Data sources Web of Science, PubMed, Embase at Ovid, Google Scholar and EThOs were searched. Eligibility criteria for selecting studies Inclusion criteria were original research in English containing a frugal surgical innovation. Research must be focused on LMICs. Studies were excluded if the content was not focused on LMICs or did not pertain to barriers and facilitators. 26 studies from 2006 to 2021 were included. The GRADE tool was used to assess overall review quality. Results Results were analysed using the modified consolidated framework for implementation research. The lack of formal evidence regarding frugal innovation in LMICs was the most reported barrier. The adaptability of frugal innovations to the context was the most reported facilitator. The limitations of this study were that most frugal innovations are not included in formal literature and that only English studies were included. Conclusion Frugal surgical innovations that are highly adaptable to the local context hold significant potential to scale and positively affect healthcare access and outcomes. Furthermore, supporting formal research about frugal innovations is important when aiming to innovate for health equity.","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Innovations","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/bmjinnov-2022-001066","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 1
Abstract
Objective Globally, 5 billion people lack access to safe surgery and annually, only 6% of surgeries occur in low-income countries. Surgical frugal innovations can reduce cost and optimise the function for the context; however, there is limited evidence about what enables success. Design A systematic literature review (SLR) was performed to understand the barriers and facilitators of frugal innovation for surgical care in low-income and middle-income countries (LMICs). Data sources Web of Science, PubMed, Embase at Ovid, Google Scholar and EThOs were searched. Eligibility criteria for selecting studies Inclusion criteria were original research in English containing a frugal surgical innovation. Research must be focused on LMICs. Studies were excluded if the content was not focused on LMICs or did not pertain to barriers and facilitators. 26 studies from 2006 to 2021 were included. The GRADE tool was used to assess overall review quality. Results Results were analysed using the modified consolidated framework for implementation research. The lack of formal evidence regarding frugal innovation in LMICs was the most reported barrier. The adaptability of frugal innovations to the context was the most reported facilitator. The limitations of this study were that most frugal innovations are not included in formal literature and that only English studies were included. Conclusion Frugal surgical innovations that are highly adaptable to the local context hold significant potential to scale and positively affect healthcare access and outcomes. Furthermore, supporting formal research about frugal innovations is important when aiming to innovate for health equity.
全球有50亿人无法获得安全手术,每年只有6%的手术发生在低收入国家。手术节约型创新可以降低成本,优化功能;然而,关于成功的因素的证据有限。设计进行了系统的文献综述(SLR),以了解中低收入国家(LMICs)外科护理节俭创新的障碍和促进因素。检索了Web of Science、PubMed、Embase at Ovid、Google Scholar和EThOs等数据源。入选标准为英文原创研究,包含一项节俭的外科创新。研究必须集中在中低收入国家。如果研究的内容不侧重于中低收入国家或不涉及障碍和促进因素,则排除研究。纳入了2006年至2021年的26项研究。GRADE工具用于评估总体评价质量。结果采用改进的综合框架对结果进行分析,进行实施研究。缺乏关于中低收入国家节俭创新的正式证据是报道最多的障碍。节约型创新对环境的适应性是被报道最多的促进因素。本研究的局限性在于大多数节约型创新没有被包括在正式文献中,而且只包括了英语研究。结论高度适应当地环境的节俭外科创新具有巨大的规模潜力,并对医疗服务的可及性和结果产生积极影响。此外,支持关于节约型创新的正式研究在旨在为卫生公平而创新时很重要。
期刊介绍:
Healthcare is undergoing a revolution and novel medical technologies are being developed to treat patients in better and faster ways. Mobile revolution has put a handheld computer in pockets of billions and we are ushering in an era of mHealth. In developed and developing world alike healthcare costs are a concern and frugal innovations are being promoted for bringing down the costs of healthcare. BMJ Innovations aims to promote innovative research which creates new, cost-effective medical devices, technologies, processes and systems that improve patient care, with particular focus on the needs of patients, physicians, and the health care industry as a whole and act as a platform to catalyse and seed more innovations. Submissions to BMJ Innovations will be considered from all clinical areas of medicine along with business and process innovations that make healthcare accessible and affordable. Submissions from groups of investigators engaged in international collaborations are especially encouraged. The broad areas of innovations that this journal aims to chronicle include but are not limited to: Medical devices, mHealth and wearable health technologies, Assistive technologies, Diagnostics, Health IT, systems and process innovation.