BMJ Innovations最新文献

{"title":"Building the social innovation for health ecosystem in Latin America: experiences and learning from SIHI-LAC","authors":"L. van Niekerk, M. I. Echavarria, J. Alger, D. Castro-Arroyave, Martha Milena Bautista-Gómez, Claudia Ivette Nieto Anderson, B. Beltran, L. Cuervo","doi":"10.1136/bmjinnov-2021-000898","DOIUrl":"https://doi.org/10.1136/bmjinnov-2021-000898","url":null,"abstract":"Social innovation for health has grown in relevance and momentum across Latin America.1-5 Yet, the potential of social innovation for health appears mostly untapped, with one reason for this being the limited investment to build strong ecosystems that can support social innovation initiatives.6-8","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"268 1","pages":"224 - 233"},"PeriodicalIF":2.0,"publicationDate":"2022-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77168910","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: concepts and practice","authors":"Joseph D. Tucker, L. Manderson, U. Amazigo, J. Alger, Elizabeth Chen, M. Labarda, E. Kpokiri, P. Dako-Gyeke, R. Peeling, L. Cuervo, B. Halpaap","doi":"10.1136/bmjinnov-2022-000982","DOIUrl":"https://doi.org/10.1136/bmjinnov-2022-000982","url":null,"abstract":"","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"21 1","pages":"133 - 136"},"PeriodicalIF":2.0,"publicationDate":"2022-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87526556","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":"Technological innovation in vascular access surgery: a reflection on two recent developments","authors":"A. Williamson","doi":"10.1136/bmjinnov-2021-000854","DOIUrl":"https://doi.org/10.1136/bmjinnov-2021-000854","url":null,"abstract":"© Author(s) (or their employer(s)) 2022. No commercial reuse. See rights and permissions. Published by BMJ. INTRODUCTION The discipline of vascular access surgery can be defined as the facilitation of dialysis through rapid and easy access to a patient’s bloodstream. 2 This is one of the most fundamental diagnostic and therapeutic principles in the care of renal failure patients; however, instruments to achieve this in a controlled manner were only developed midway through the 17th century. By the early 20th century, the earliest dialysis machines had been created; however, haemodialysis could not continue beyond a couple of dozen treatments per patient—there was an exhaustion of access as the blood vessels would be ligated (‘tiedoff ’) after each treatment to prevent excessive bleeding. Modern vascular access methods were born in the 1950s when the first central venous catheters (CVCs—catheter entering a central vein), arteriovenous grafts (AVG—a synthetic tube connecting an artery and a vein) and native arteriovenous fistulas (AVF—a surgically created communication between an artery and a vein) were used. Technological advancement in these early stages focused on vascular anastomosis techniques and arteriovenous shunting (directing arterial blood through the venous system) materials to overcome access failure and thrombosis, respectively. The need for innovation to overcome the shortcomings of previous technologies or practices is an ongoing process—this report describes the driving forces behind two recent developments in the field of vascular access and evaluates their advantages and disadvantages against alternate technologies and their current use in clinical practice: ► The Hemodialysis Reliable Outflow (HeRO) graft—a twocomponent graft aiming to overcome the problem of central venous stenosis (luminal narrowing of the central veins). ► Percutaneous endovascular fistula creation—imageguided fistula creation aiming to avoid complications associated with open surgically created AVFs.","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"84 1","pages":"291 - 295"},"PeriodicalIF":2.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75107336","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":"Youth researchers academy: a report on an innovative research training programme for young people in Zimbabwe","authors":"M. Tembo, C. Mackworth-Young, K. Kranzer, Chido Dziva-Chikwari, C. Mavodza, E. Dauya, Mufaro Makuni, Dakarai Chipare, Blessing Munyavi-Dehwe, Daniel Raradza, S. Bernays, R. Chingono, N. Dzavakwa, Rudo Nyamwanza, S. Francis, V. Simms, R. Ferrand","doi":"10.1136/bmjinnov-2021-000885","DOIUrl":"https://doi.org/10.1136/bmjinnov-2021-000885","url":null,"abstract":"Introduction Youth engagement has the potential to enhance the design, implementation and relevance of research. Without strategies to capacitate young people with research skills, youth engagement in research is often tokenistic and ineffective. In this paper, we detail the implementation and evaluation of an innovative research training programme for youth (aged 18–24 years) in Zimbabwe called the Youth Researchers Academy (YRA). Methods Quantitative programme data and qualitative interviews and focus group discussions assessed acceptability of the YRA, youth researcher and mentor experiences, and impact of the YRA over time. Results We received 60 applications in 2019 and 89 applications in 2021. Ongoing feedback led to changes in the second programme (including longer training and certification). Youth researcher experiences included being motivated by learning new skills and valuing the relationship with mentors and peer networks. Many described long-term impact, including facilitation of higher education, setting up of new businesses through the stipends received, and, for some, opportunities to work in research. Discussion Overall, the programme was acceptable, facilitated meaningful youth-led research and trained a cohort of empowered youth researchers. Young people were eager to learn and capable of both learning and implementing critical research skills in a professional working environment. Implementation challenges included limited freedom in the co-design of research projects and the additional burden of work for YRA mentors. Conclusion The YRA provides a template for other academics to support similar training to facilitate capacity building and meaningful youth engagement for research with and for youth.","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"22 1","pages":"183 - 189"},"PeriodicalIF":2.0,"publicationDate":"2022-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91006762","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":"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}