Improvement studies for equitable and evidence-based innovation: an overview of the ‘IM-SEEN’ model

International Journal for Equity in Health

Comment

Sarah Karanja¹  Michael Gichangi²  Hilary Rono³  Luke N. Allen⁴  Min Kim⁴  Matthew Burton⁴  David Macleod⁴  Jacqueline Ramke⁴  Ana Patricia Marques⁴  Sailesh Kumar Mishra⁵  Andrew Bastawrous⁶  Nigel Bolster⁶  Oathokwa Nkomazana⁷  Bakgaki Ratshaa⁷  Ari Ho-Foster⁷ 

[1]KEMRI, Nairobi, Kenya

[2]Kenyan Ministry of Health, Nairobi, Kenya

[3]Kitale Hospital and Peek Vision, Kitale, Kenya

[4]London School of Hygiene & Tropical Medicine (LSHTM), Keppel St, WC1E 7HT, London, UK

[5]Nepal Netra Jyoti Sangh, Kathmandu, Nepal

[6]Peek Vision and LSHTM, Berkhamsted, UK

[7]University of Botswana, Gaborone, Botswana

关键词: Equity;    Continuous improvement;    Universal Health Coverage;   

DOI  :  10.1186/s12939-023-01915-5

 received in 2022-09-16, accepted in 2023-05-11,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundHealth inequalities are ubiquitous, and as countries seek to expand service coverage, they are at risk of exacerbating existing inequalities unless they adopt equity-focused approaches to service delivery.Main textOur team has developed an equity-focused continuous improvement model that reconciles prioritisation of disadvantaged groups with the expansion of service coverage. Our new approach is based on the foundations of routinely collecting sociodemographic data; identifying left-behind groups; engaging with these service users to elicit barriers and potential solutions; and then rigorously testing these solutions with pragmatic, embedded trials. This paper presents the rationale for the model, a holistic overview of how the different elements fit together, and potential applications. Future work will present findings as the model is operationalised in eye-health programmes in Botswana, India, Kenya, and Nepal.ConclusionThere is a real paucity of approaches for operationalising equity. By bringing a series of steps together that force programme managers to focus on groups that are being left behind, we present a model that can be used in any service delivery setting to build equity into routine practice.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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