Improvement studies for equitable and evidence-based innovation: an overview of the ‘IM-SEEN’ model (original) (raw)
Related papers
2020
Introduction Equity in the access and use of health services is critical if countries are to make progress towards universal health coverage and address the systematic exclusion of the most vulnerable groups. The purpose of this study was to assess if the Co-ordinated Approach To Community Health programme implemented by Sightsavers was successful in reaching the poorest population and people living with disabilities in Kasungu district, Malawi. Outreach camps were organized to provide a range of integrated eye care services. Methods Between April and September 2017, data on socio-economic status, household characteristics and functional disability were collected from patients attending at eye camps in Kasungu district, Malawi. Results were compared to Demographic Health Surveys and Integrated Household Surveys data. Using asset-based questions on household characteristics (EquityTool© and Simple Poverty Scorecard©) and the Washington Group Short Set of Questions, individuals were c...
Towards equity effectiveness in health interventions
2011
Health interventions are a significant challenge for health systems, in terms of both feasibility and costs. Public health specialists are interested in the efficacy of interventions, as well as in learning how, in a given health and social systems context, the given efficacy of an intervention will translate into community effectiveness. This means establishing the actual cure rate of a given disease under real-life conditions. Focusing on the average effects of interventions in health may miss important differences within populations, for example between different social groups. Consequently, measuring the effectiveness of interventions and policies in terms of social equity means assessing their equity effectiveness. From 2001 to 2008, a group of researchers addressed the issue of equity effectiveness in the contexts of HIV/AIDS and the provision of drinking water in Côte d’Ivoire, environmental sanitation in Vietnam, and health and demographic surveillance of mobile pastoralists...
International Journal of Environmental Research and Public Health, 2020
Reaching vulnerable populations through programmatic eye health interventions requires a focus on not only the intervention strategies, but the adaptability of the program design process itself. Knowing who is left behind and why solutions that will be effective on the ground at the time of implementation are not necessarily generated. There is a need for eye health programmatic design processes that can trial interventions and allow for continuous knowledge translation along the way. In rural Nepal, women are impacted by multiple and interconnected determinants of health, as well as unique barriers to accessing information and services, requiring targeted programming strategies. This article describes a programmatic design and knowledge translation process that aims to increase women's uptake of eye health services in rural Nepal. The article outlines key learnings of this knowledge translation process, and how this may contribute to addressing gender equity in eye health.
BMC Health Services Research, 2013
Background: Ensuring access to timely and appropriate primary healthcare for people living in poverty is an issue facing all countries, even those with universal healthcare systems. The transformation of healthcare practices and organization could be improved by involving key stakeholders from the community and the healthcare system in the development of research interventions. The aim of this project is to stimulate changes in healthcare organizations and practices by encouraging collaboration between care teams and people living in poverty. Our objectives are twofold: 1) to identify actions required to promote the adoption of professional practices oriented toward social competence in primary care teams; and 2) to examine factors that would encourage the inclusion of people living in poverty in the process of developing social competence in healthcare organizations. Methods/design: This study will use a participatory action research design applied in healthcare organizations. Participatory research is an increasingly recognized approach that is helpful for involving the people for whom the research results are intended. Our research team consists of 19 non-academic researchers, 11 academic researchers and six partners. A steering committee composed of academic researchers and stakeholders will have a decisionmaking role at each step, including knowledge dissemination and recommendations for new interventions. In this project we will adopt a multiphase approach and will use a variety of methods, including photovoice, group discussions and interviews. Discussion: The proposed study will be one of only a few using participatory research in primary care to foster changes aimed at enhancing quality and access to care for people living in poverty. To our knowledge this will be the first study to use photovoice in healthcare organizations to promote new interventions. Our project includes partners who are targeted for practice changes and improvements in delivering primary care to persons living in poverty. By involving knowledge users, including service recipients, our study is more likely to produce a transformation of professional practices and encourage healthcare organizations to take into account the needs of persons living in poverty.
innovations to advance global health equity Open Access
2013
The notion of "reverse innovation"-that some insights from low-income countries might offer transferable lessons for wealthier contexts-is increasingly common in the global health and business strategy literature. Yet the perspectives of researchers and policymakers in settings where these innovations are developed have been largely absent from the discussion to date. In this Commentary, we present examples of programmatic, technological, and research-based innovations from Rwanda, and offer reflections on how the global health community might leverage innovative partnerships for shared learning and improved health outcomes in all countries.
International journal for equity in health, 2016
Improving access to primary healthcare (PHC) for vulnerable populations is important for achieving health equity, yet this remains challenging. Evidence of effective interventions is rather limited and fragmented. We need to identify innovative ways to improve access to PHC for vulnerable populations, and to clarify which elements of health systems, organisations or services (supply-side dimensions of access) and abilities of patients or populations (demand-side dimensions of access) need to be strengthened to achieve transformative change. The work reported here was conducted as part of IMPACT (Innovative Models Promoting Access-to-Care Transformation), a 5-year Canadian-Australian research program aiming to identify, implement and trial best practice interventions to improve access to PHC for vulnerable populations. We undertook an environmental scan as a broad screening approach to identify the breadth of current innovations from the field. We distributed a brief online survey to...
Wellcome open research, 2022
Background: Attendance rates for eye clinics are low across low-and middle-income countries (LMICs) and exhibit marked sociodemographic (SD) inequalities. We aimed to quantify the association between a range of SD domains and attendance rates from vision screening in programmes launching in Botswana, Kenya and Nepal. Methods: We will develop a set of sociodemographic questions and introduce them into routine community-based eye screening programmes in Kenya, Botswana and Nepal, targeting children aged 5-18 years and adults. Our study design is a rolling survey, embedded within the Peek screening programme. The sociodemographic questions will be asked of 10% of all those presenting to be screened, and 100% of those identified with an eye problem. We will also collect data on whether people referred to ophthalmic clinic for treatment or further assessment attended, and we will use logistic regression to report odds ratios for this outcome attendance) for each
Building capacity for health equity analysis in the WHO South-East Asia Region
WHO South-East Asia Journal of Public Health
Leaving no one behind" is at the heart of the agenda of the Sustainable Development Goals, requiring that health systems be vigilant to how interventions can be accessed equitably by all, including population subgroups that face exclusion. In the World Health Organization (WHO) SouthEast Asia Region, inequalities can be found across and within countries but there has been a growing commitment to examining and starting to tackle them. Over the past decade in particular, WHO has been developing an armamentarium of tools to enable analysis of health inequalities and action on health equity. Tools include the Health Equity Assessment Toolkit in built-in database and upload database editions, as well as the Innov8 tool for reorientation of national health programmes. Countries across the region have engaged meaningfully in the development and application of these tools, in many cases aligning them with, or including them as part of, ongoing efforts to examine inequities in population subgroups domestically. This paper reflects on these experiences in Bangladesh, India, Indonesia, Nepal, Sri Lanka and Thailand, where efforts have ranged from workshops to programme reorientation; the creation of assemblies and conferences; and collation of evidence through collaborative research, reviews/synthesis and conferences. This promising start must be maintained and expanded, with greater emphasis on building capacity for interpretation and use of evidence on inequalities in policy-making. This may be further enhanced by the use of innovative mixed methodologies and interdisciplinary approaches to refine and contextualize evidence, with a concomitant shift in attention, developing solutions to redress inequities and anchor health reform within communities. There are many lessons to be learnt in this region, as well as mounting political and popular will for change.