BMJ Innovations最新文献

{"title":"Emulating value-chains of fast-moving consumer goods to improve uptake of co-packaged ORS and zinc for childhood diarrhoea: evaluation of the ColaLife trial","authors":"R. Ramchandani, Simon Berry, Jane Berry, S. Tembo, R. Black","doi":"10.1136/bmjinnov-2021-000914","DOIUrl":"https://doi.org/10.1136/bmjinnov-2021-000914","url":null,"abstract":"Introduction Oral rehydration salts (ORS) and zinc comprise the globally recommended treatment for diarrhoea in children aged <5 years. However, limited access contributes to low uptake of this treatment and subsequently high rates of morbidity and mortality among this age group in low-income and middle-income countries. We adopted approaches used for private-sector value-chains of fast-moving consumer-goods, involving the simultaneous stimulation of supply and demand. These approaches were applied to the introduction of an innovative co-packaged diarrhoea-treatment kit (ORSZ co-pack) to increase ORS and zinc coverage at the community level in Zambia. Methods We tested our approach using an observational pre–post test study design in two intervention districts in rural Zambia (Kalomo and Katete), each with a matched comparator (Monze and Petauke, respectively). We assessed the effect on coverage, of ORS and zinc as well as ORS alone, by conducting household surveys of a total of 2458 and 2477 caregivers of children aged <5 years at baseline and endline, respectively, across the four districts. We also assessed whether the source of ORS (public or private sector) changed following the intervention. Results Both intervention districts experienced significant increases in coverage of ORS and zinc from <1% at baseline to 46.9% and 46.3% in Kalomo and Katete, respectively. Uptake in the comparator districts remained low at 1.7% and 0.6% in Monze and Petauke, respectively. For the secondary outcome examining ORS coverage (with or without zinc), the intervention was associated with a significant increase in Kalomo versus Monze, but not in Katete versus Petauke. There was a clear shift from the public to the private sector, and specifically to the use of the ORSZ co-pack. Conclusion Implementation of a value-chain creation approach for an innovative, over-the-counter, co-packaged diarrhoea-treatment kit can significantly improve the coverage of ORS and zinc.","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"29 1","pages":"169 - 182"},"PeriodicalIF":2.0,"publicationDate":"2022-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84296975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Innovation in Health: research, public policy and agency capacity in the Colombian Zika Kids programme","authors":"Marcela Daza, Martha Milena Bautista-Gómez, Laura Sofia Zuluaga, M. Mercado-Reyes","doi":"10.1136/bmjinnov-2021-000894","DOIUrl":"https://doi.org/10.1136/bmjinnov-2021-000894","url":null,"abstract":"Daza M, et al. BMJ Innov 2022;0:1–6. doi:10.1136/bmjinnov-2021-000894 Grupo de investigación en Salud Materna y Perinatal, Instituto Nacional de Salud, Bogota, Colombia Unidad de Investigación Social en Salud, Centro Internacional de Entrenamiento e Investigaciones Medicas, Cali, Valle del Cauca, Colombia Universidad Icesi, Cali, Colombia Dirección de Investigación en Salud Pública, Instituto Nacional de Salud, Bogotá, Colombia","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"9 1","pages":"143 - 148"},"PeriodicalIF":2.0,"publicationDate":"2022-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88385903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using medical education as a tool to train doctors as social innovators","authors":"N. Khan, A. Rogers, C. Melville, R. Shankar, W. Gilliar, P. Byrne, Alex Serafimov, S. Sira Mahalingappa, Simran Sehdev, A. Sri, S. Dave","doi":"10.1136/bmjinnov-2021-000910","DOIUrl":"https://doi.org/10.1136/bmjinnov-2021-000910","url":null,"abstract":"Introduction Current medical education prepares doctors to diagnose, assess and treat individual patients yet lacks the expectation to be responsible for the care of the wider community. Learning the skills to recognise and redress the social determinants of health are increasingly being recognised as an essential part of medical education. Objectives The goal of this research was (1) to investigate how medical education can be leveraged to reduce health inequalities through the role and practice of doctors and (2) to elucidate how key innovations in medical education are a necessity that can support doctors as ‘change agents.’ Methods Two international multidisciplinary roundtable focus groups with 23 healthcare leaders from various backgrounds were facilitated. The discussions were audiorecorded, transcribed and then thematically analysed with the qualitative analysis software QDA Miner. Results Eight themes emerged: (1) Social innovation training in medical education; (2) Linking community working with social innovation; (3) Future curricula development; (4) Settings, context, environment and leaving the classroom; (5) Developing links with third sector organisations and community, including low-income and middle-income countries; (6) Including learners’ perspectives and lived experience; (7) Medical roles are political and need political support and (8) The need to address power imbalances and impact of discrimination. Conclusions Medical education needs to fundamentally widen its focus from the individual doctor–patient relationship to the doctor–community relationship. Doctors’ training needs to help them become social innovators who can balance interventions with prevention, promote good health on a community and societal scale and tailor their treatments to the individuals’ contexts.","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"1 1","pages":"190 - 198"},"PeriodicalIF":2.0,"publicationDate":"2022-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82107675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Audio innovation and songs to spur change in global health: evidence from a national crowdsourcing open call for youth social innovation in Malaysia","authors":"R. Tan, R. Mpofu, Pradheep Kay, Darien Sebastian, Djordje Novakovic, Ying-Ru Jacqueline Lo, Joseph D. Tucker","doi":"10.1136/bmjinnov-2021-000905","DOIUrl":"https://doi.org/10.1136/bmjinnov-2021-000905","url":null,"abstract":"Introduction Audio innovations remain an important medium to drive innovation in health, especially in low-resource settings. This article explores the role of audio innovation to spur change in the context of a crowdsourcing open call for youth (18–30 years old) in Malaysia. Methods A crowdsourcing open call for youth in Malaysia was organised from March to June 2021 using standards from the WHO-TDR. The open call was called ‘Imagine the World Anew’ and submission categories included youth-led messaging, youth social innovation and youth strategic planning. We analyse open call submissions and provide a more detailed analysis of an audio submission. Results A total 43 entries were submitted to the open call and 6 were selected for grand prizes. One of the two grand prizes in the youth messaging category was a song developed by a youth team. The song was called ‘Rise Up’ and was developed by Malaysian youth to demonstrate how youth have been critical agents for change during the COVID-19 pandemic. The audio format allowed the youth to directly speak to other Malaysian youth, leverage existing audio channels and democratise messaging during COVID-19. Building on the experience from this crowdsourcing open call, we also describe key considerations for open calls to incorporate audio innovations in low-resource settings. Conclusion Audio innovations like songs can mobilise youth and other members of the public and amplify their voices. Audio messages may enhance dissemination of health messages in diverse low-income and middle-income country settings.","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"140 1","pages":"199 - 206"},"PeriodicalIF":2.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78372305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reporta Health: a mobile social innovation for crowdsourcing data on illegal health facilities in Nigeria","authors":"O. Makinde, Utibe S Ebong, Nchelem Kokomma Ichegbo, M. Omotosho","doi":"10.1136/bmjinnov-2021-000878","DOIUrl":"https://doi.org/10.1136/bmjinnov-2021-000878","url":null,"abstract":"© Author(s) (or their employer(s)) 2022. Reuse permitted under CC BYNC. No commercial reuse. See rights and permissions. Published by BMJ. INTRODUCTION The WHO advocates for countries to develop Master Facility Lists (MFL) to provide authoritative lists of legal health facilities in each country. Nigeria has developed its MFL and established a Health Facility Registry (HFR) to actively manage this list. Despite this effort, there are still several unregistered or illegally operating health facilities across the country. Between January and June 2019, not fewer than four state governments identified and shut several illegally operating health facilities within their territories. The problem of illegal health facilities remains a pressing issue due to their relatively large number and limited resources to track them. Only 13.4% (2565 out of 20 642) of the patent and proprietary medicine vendor shops surveyed in an earlier study were registered with the regulatory agency. The risks are that many of these illegal health facilities may be providing suboptimal services to their clients such as inappropriate use of antibiotics, abuse of drugs and suboptimal quality of care. Nigeria is a vast country with limited human and financial resources to police for illegal health facilities. Providing an opportunity for the general population to report unregistered health facilities around them could help in prompt detection of these illegal health facilities. When the public are also able to verify duly registered health facilities, they are more likely to access services there. However, engaging the public to report illegal health facilities has been fraught with challenges. The current practice by a regulator requires complainants to visit the regulator (situated in the state capital) and complete a form. In doing so, the complainant must provide his or her name and contact information. A senior regulatory officer recounted (during an engagement session) that moles within the regulator often reveal to proprietors of illegal health facilities how they obtained information on their health facilities, leaving the member of the public who volunteered such information at risk of being targeted. Thus, the need to protect whistleblowers calls for innovative approaches and a policy shift. Social innovations leveraging mobile phones provide an opportunity to crowdsource and anonymise reporting of illegal health facilities. To this end, we developed a crowdsourcing mobile app—Reporta WHAT ARE THE NEW FINDINGS?","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"48 1","pages":"137 - 142"},"PeriodicalIF":2.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87923558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons learnt from applying a human-centred design process to develop one of the largest mobile health communication programmes in the world","authors":"S. Chamberlain, Priyanka Dutt, R. Mitra, A. Godfrey, A. Lefevre, K. Scott, Soma Katiyar, Jai Mendiratta, Shefali Chaturvedi","doi":"10.1136/bmjinnov-2021-000841","DOIUrl":"https://doi.org/10.1136/bmjinnov-2021-000841","url":null,"abstract":"‘Design with the user’ is a guiding principle for creating digital solutions to solve systemic developmental challenges. According to this principle, digital solutions are more likely to be effective if the intended users are involved in the design process, thereby rooting design thinking in a human-centric approach that seeks to understand their characteristics, needs and challenges. However, few examples exist for human-centred design (HCD) processes being successfully applied in low-and-middle-income countries to create digital health interventions that achieve both scale and sustainability. This paper describes the application of a five-stage HCD process to develop a suite of mobile solutions to improve reproductive, maternal, neonatal and child health in Bihar, India, and discusses lessons learnt. Two of the solutions were later adopted by the government and scaled to 10 million subscribers and more than 300 000 front-line health workers (FLHWs) in 13 states. The socio-ecological model, which considers the interplay between individual, interpersonal, organisational, community and public policy factors, provides a conceptual framework for understanding key learnings from the HCD process. At the organisational level, we found that demand generation was constrained by deficiencies in the public health system, while at the community level, gender norms were a barrier to changing health practices. At the interpersonal level, mobile health solutions for mothers also had to address fathers, because they controlled women’s access to mobile phones. At the individual level, FLHWs had limited time to build their skills and needed more flexible, home-based learning opportunities; most FLHWs had access to mobile phones, but devices were overwhelmingly basic and digital skills limited; voice technology was required to maximise reach among low literate women and an authoritative yet empathetic narrator was required to humanise the digital experience, lend credibility and create engagement.","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"50 1","pages":"240 - 246"},"PeriodicalIF":2.0,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77685037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical analysis of the effect the new Medical Device Regulation will have on the relevant stakeholder","authors":"Tehzeem Ahmed, J. Zafar, F. Sharif, H. Zafar","doi":"10.1136/bmjinnov-2021-000855","DOIUrl":"https://doi.org/10.1136/bmjinnov-2021-000855","url":null,"abstract":"The regulatory framework around medical devices in the European Union has always focused on upholding patient safety. However, over the years, certain scandals have come to light in which patient safety has been compromised considerably. As a consequence, the overwhelming opprobrium was the cause for a radical change. The new Medical Device Regulation (MDR) has now been introduced (but yet to be fully implemented) to primarily combat the issues that have arisen as a result of these scandals. The MDR has been subject to significant commentary, particularly the effect it will have on relevant stakeholders. The stakeholders in the context of the MDR are the manufacturers, distributors, authorised representatives and importers. There is a general consensus among various professionals that the new requirements are far more onerous than the obligations contained in the previous regulatory framework. Moreover, there has been a lengthy delay in the date of application for the MDR. In particular, the approval of the notified bodies is raising a great concern. This paper will provide a critical analysis of the new requirements that stakeholders must comply with and, in addition, will review the postponement of the MDR.","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"15 9 1","pages":"285 - 290"},"PeriodicalIF":2.0,"publicationDate":"2022-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79615156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Appropriation of Knowledge and its contributions to the prevention of cutaneous leishmaniasis in rural contexts","authors":"Kathleen Agudelo Paipilla, D. Castro-Arroyave, Laura Guzmán Grajales, M. Echavarría","doi":"10.1136/bmjinnov-2021-000899","DOIUrl":"https://doi.org/10.1136/bmjinnov-2021-000899","url":null,"abstract":"© Author(s) (or their employer(s)) 2022. Reuse permitted under CC BYNC. No commercial reuse. See rights and permissions. Published by BMJ. BACKGROUND Cutaneous leishmaniasis (CL) is a neglected infectious endemic disease that is transmitted through the bite of a vector insect (sandfly) of the Lutzomyia genus, 2 typical of rural geographical territories, 4 and causes disfiguring skin ulcers and disabilities. It is estimated that CL affects between 600 000 and 1 000 000 people a year around the world, mainly in the America s, the Mediterranean basin, the Middle East and Central Asia. Eighteen of the 21 countries that make up the Latin American (LA) region are considered endemic areas for this neglected tropical disease. Colombia is one of the countries that reports the majority of global cases with 6161 in 2020 and has the second highest number of cases in the Americas, after Brazil. 6 This disease is associated with poor socioeconomic conditions, low coverage of access to basic sanitation services and difficulties in accessing health services. Despite the various efforts of public health systems and leishmaniasis surveillance and control programmes, the implemented strategies are still challenged with being timely, efficient and sustainable. Additionally, barriers caused by geographical conditions and sociocultural aspects such as unawareness about the subject persist. 9 This scenario highlights the importance of proposing situated initiatives, based on the communities in favour of strengthening Social Appropriation of Knowledge (SAK) processes for the prevention and control of the disease.","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"6 1","pages":"234 - 239"},"PeriodicalIF":2.0,"publicationDate":"2022-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82522989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert panel: an innovative approach to evaluating government policy commitments in health and social care","authors":"A. J. Lacey, Florence L. Young, S. Peckham, J. Dacre","doi":"10.1136/bmjinnov-2021-000913","DOIUrl":"https://doi.org/10.1136/bmjinnov-2021-000913","url":null,"abstract":"","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"75 1","pages":"296 - 300"},"PeriodicalIF":2.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86012501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence and opioid use: a narrative review","authors":"S. Gadhia, G. Richards, Tracey Marriott, J. Rose","doi":"10.1136/bmjinnov-2022-000972","DOIUrl":"https://doi.org/10.1136/bmjinnov-2022-000972","url":null,"abstract":"Background Opioids are strong pain medications that can be essential for acute pain. However, opioids are also commonly used for chronic conditions and illicitly where there are well-recognised concerns about the balance of their benefits and harms. Technologies using artificial intelligence (AI) are being developed to examine and optimise the use of opioids. Yet, this research has not been synthesised to determine the types of AI models being developed and the application of these models. Methods We aimed to synthesise studies exploring the use of AI in people taking opioids. We searched three databases: the Cochrane Database of Systematic Reviews, Embase and Medline on 4 January 2021. Studies were included if they were published after 2010, conducted in a real-life community setting involving humans and used AI to understand opioid use. Data on the types and applications of AI models were extracted and descriptively analysed. Results Eighty-one articles were included in our review, representing over 5.3 million participants and 14.6 million social media posts. Most (93%) studies were conducted in the USA. The types of AI technologies included natural language processing (46%) and a range of machine learning algorithms, the most common being random forest algorithms (36%). AI was predominately applied for the surveillance and monitoring of opioids (46%), followed by risk prediction (42%), pain management (10%) and patient support (2%). Few of the AI models were ready for adoption, with most (62%) being in preliminary stages. Conclusions Many AI models are being developed and applied to understand opioid use. However, there is a need for these AI technologies to be externally validated and robustly evaluated to determine whether they can improve the use and safety of opioids.","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"10 1","pages":"78 - 96"},"PeriodicalIF":2.0,"publicationDate":"2022-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84576902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}