Reverse innovation in global health

Zinsstag, Jakob; Pelikan, Kristina; Hammel, Tanja; Tischler, Julia; Flahault, Antoine; Utzinger, Jürg; Probst-Hensch, Nicole

doi:10.21037/jphe.2018.12.05

Cited by 11 publications

(10 citation statements)

References 16 publications

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“…For HICs, areas for further inquiry include how to address cultural factors within task-shifted interventions and whether and how to prioritize deeper community partnerships (Hoeft et al, 2018). Exploring these aspects of task-shifting efforts in HICs is one of the clearest opportunities for learning from successful efforts in LMICs (Zinsstag et al, 2019). The task-shifted intervention presented as the case example in this article, for instance, includes lay providers from the community with no role in the health system but who have other key roles within the community’s social fabric.…”

Section: What Do We Know? Empirically Supported Implementation Princi...mentioning

confidence: 99%

A Community-Embedded Implementation Model for Mental-Health Interventions: Reaching the Hardest to Reach

Ayuku

2022

Perspect Psychol Sci

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The mental-health-care treatment gap remains very large in low-resource communities, both within high-income countries and globally in low- and middle-income countries. Existing approaches for disseminating psychological interventions within health systems are not working well enough, and hard-to-reach, high-risk populations are often going unreached. Alternative implementation models are needed to expand access and to address the burden of mental-health disorders and risk factors at the family and community levels. In this article, we present empirically supported implementation strategies and propose an implementation model—the community-embedded model (CEM)—that integrates these approaches and situates them within social settings. Key elements of the model include (a) embedding in an existing, community-based social setting; (b) delivering prevention and treatment in tandem; (c) using multiproblem interventions; (d) delivering through lay providers within the social setting; and (e) facilitating relationships between community settings and external systems of care. We propose integrating these elements to maximize the benefits of each to improve clinical outcomes and sustainment of interventions. A case study illustrates the application of the CEM to the delivery of a family-based prevention and treatment intervention within the social setting of religious congregations in Kenya. The discussion highlights challenges and opportunities for applying the CEM across contexts and interventions.

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Section: What Do We Know? Empirically Supported Implementation Princi...mentioning

confidence: 99%

A Community-Embedded Implementation Model for Mental-Health Interventions: Reaching the Hardest to Reach

Ayuku

2022

Perspect Psychol Sci

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“…Seventeen (17) sources [ 2 3 4 8 11 12 13 22 30 31 32 33 34 35 36 37 38 ] were categorized by the authors as broadly describing the potential benefits of learning from low-income or low-resource settings; [ 12 ] the developing world, developing countries, or developing nations; [ 4 13 ] Africa; [ 2 ] or abroad [ 11 ]. The sources in this category do not provide details about specific interventions, but rather comment on the broader financing and equity justifications for global learning.…”

Section: Resultsmentioning

confidence: 99%

Global Learning for Health Equity: A Literature Review

Ogbolu

Dudding

Fiori

et al. 2022

Annals of Global Health

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Background:In high income countries struggling with escalating health care costs and persistent lack of equity, there is growing interest in searching for innovative solutions developed outside national borders, particularly in low-and middle-income countries (LMICs). Engaging with global ideas to apply them to local health equity challenges is becoming increasingly recognized as an approach to shift the health equity landscape in the United States (US) in a significant way. No single name or set of practices yet defines the process of identifying LMIC interventions for adaptation; implementing interventions in high-income countries (HIC) settings; or evaluating the implementation of such projects.Objectives: This paper presents a review of the literature describing the practice of adapting global ideas for use in the US, particularly in the area of health equity. Specifically, the authors sought to examine; (i) the literature that advocates for, or describes, adaption of health-related innovations from LMICs to HICs, both generally and for health equity specifically, and (ii) implementation practices, strategies, and evidence-based outcomes in this field, generally and in the area of health equity specifically. The authors also propose terminology and a definition to describe the practice. Methods:The literature search included two main concepts: global learning and health equity (using these and related terms). The search consisted of text-words and databasespecific terminology (e.g., MeSH, Emtree) using PubMed, Embase (Elsevier), CINAHL (Ebsco), and Scopus in March 2021. The authors also contacted relevant experts to identify grey literature. Identified sources were categorized according to theme to facilitate analysis. In addition, five key interviews with experts engaged with global ideas to promote health equity in the United States were conducted to develop additional data.

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“…One Health (OH) is such an approach; it addresses challenges at the interface between people, animals, plants, and their environments, and consequently requires transdisciplinary collaboration among multiple stakeholders from different sectors (2). A key element of the OH approach is the integration of knowledge across sectors, disciplines and stakeholders (3), and at global scale, health innovation can be seen as a result of successful knowledge integration across continental boundaries (4). However, it is not yet clear what form and degree of knowledge integration is needed to conduct successful OH initiatives.…”

Section: Introductionmentioning

confidence: 99%

System Thinking and Citizen Participation Is Still Missing in One Health Initiatives – Lessons From Fifteen Evaluations

Berezowski

Dürr

Falzon

et al. 2021

Front. Public Health

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Tackling complex public health challenges requires integrated approaches to health, such as One Health (OH). A key element of these approaches is the integration of knowledge across sectors, disciplines and stakeholders. It is not yet clear which elements of knowledge integration need endorsement to achieve best outcomes. This paper assesses 15 OH initiatives in 16 African, Asian and European countries to identify opportunities to improve knowledge integration and to investigate geographic influences on knowledge integration capacities. Two related evaluation tools, both relying on semi-quantitative questionnaires, were applied to two sets of case studies. In one tool, the questions relate to operations and infrastructure, while the other assigns questions to the three phases of “design,” “implementation,” and “evaluation” of the project life cycle. In both, the question scores are aggregated using medians. For analysis, extreme values were identified to highlight strengths and weaknesses. Seven initiatives were assessed by a single evaluator external to the initiative, and the other eight initiatives were jointly assessed by several internal and external evaluators. The knowledge integration capacity was greatest during the project implementation stage, and lowest during the evaluation stage. The main weaknesses pointing towards concrete potential for improvement were identified to be a lack of consideration of systemic characteristics, missing engagement of external stakeholders and poor bridging of knowledge, amplified by the absence of opportunities to learn and evolve in a collective process. Most users were unfamiliar with the systems approach to evaluation and found the use of the tools challenging, but they appreciated the new perspective and saw benefits in the ensuing reflections. We conclude that systems thinking and associated practises for OH require not only specific education in OH core competencies, but also methodological and institutional measures to endorse broad participation. To facilitate meta-analyses and generic improvement of integrated approaches to health we suggest including knowledge integration processes as elements to report according to the COHERE guidelines.

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Reverse innovation in global health

Cited by 11 publications

References 16 publications

A Community-Embedded Implementation Model for Mental-Health Interventions: Reaching the Hardest to Reach

A Community-Embedded Implementation Model for Mental-Health Interventions: Reaching the Hardest to Reach

Global Learning for Health Equity: A Literature Review

System Thinking and Citizen Participation Is Still Missing in One Health Initiatives – Lessons From Fifteen Evaluations

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