Improvement studies for equitable and evidence-based innovation: an overview of the 'IM-SEEN' model.
Continuous improvement
Equity
Universal Health Coverage
Journal
International journal for equity in health
ISSN: 1475-9276
Titre abrégé: Int J Equity Health
Pays: England
ID NLM: 101147692
Informations de publication
Date de publication:
17 Jun 2023
17 Jun 2023
Historique:
received:
16
09
2022
accepted:
11
05
2023
medline:
19
6
2023
pubmed:
18
6
2023
entrez:
17
6
2023
Statut:
epublish
Résumé
Health 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. Our 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. There 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.
Sections du résumé
BACKGROUND
BACKGROUND
Health 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 TEXT
METHODS
Our 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.
CONCLUSION
CONCLUSIONS
There 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.
Identifiants
pubmed: 37330480
doi: 10.1186/s12939-023-01915-5
pii: 10.1186/s12939-023-01915-5
pmc: PMC10276912
doi:
Types de publication
Letter
Langues
eng
Sous-ensembles de citation
IM
Pagination
116Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/R010161/1
Pays : United Kingdom
Informations de copyright
© 2023. The Author(s).
Références
Ann Intern Med. 1998 Apr 15;128(8):651-6
pubmed: 9537939
Lancet Glob Health. 2021 Apr;9(4):e489-e551
pubmed: 33607016
BJOG. 2018 Dec;125(13):1716
pubmed: 29916205
Lancet Digit Health. 2021 Jul;3(7):e414-e424
pubmed: 34167763
Int J Equity Health. 2022 Nov 5;21(1):155
pubmed: 36335332
Lancet. 1971 Feb 27;1(7696):405-12
pubmed: 4100731
Rev Panam Salud Publica. 2020 Oct 15;44:e110
pubmed: 33088291
JAMA Ophthalmol. 2015 Aug;133(8):930-7
pubmed: 26022921
Front Public Health. 2022 Jul 22;10:873192
pubmed: 35937227
Trials. 2020 Feb 7;21(1):150
pubmed: 32033614
Int J Environ Res Public Health. 2019 Oct 12;16(20):
pubmed: 31614715
Trials. 2022 Aug 15;23(1):656
pubmed: 35971156
EClinicalMedicine. 2020 Oct 17;28:100594
pubmed: 33294811
Trials. 2018 Jan 11;19(1):29
pubmed: 29325575
Wellcome Open Res. 2022 May 4;7:144
pubmed: 37485295
BMJ Qual Saf. 2014 Apr;23(4):290-8
pubmed: 24025320
Lancet. 2005 Mar 19-25;365(9464):1099-104
pubmed: 15781105
JMIR Mhealth Uhealth. 2020 Jun 19;8(6):e16345
pubmed: 32558656
Asia Pac J Ophthalmol (Phila). 2022 Jan-Feb 01;11(1):59-65
pubmed: 35114685
Lancet Glob Health. 2018 Aug;6(8):e924-e932
pubmed: 30012273
BMJ. 1998 Jan 17;316(7126):201
pubmed: 9468688
Health Res Policy Syst. 2021 Jun 25;19(1):97
pubmed: 34172066
Health Policy. 2018 Apr;122(4):412-421
pubmed: 29482948
BJGP Open. 2023 Jul 20;:
pubmed: 37474255
BMJ Qual Saf. 2016 Mar;25(3):147-52
pubmed: 26700542
BMJ. 2021 Feb 15;372:m4752
pubmed: 33593813
Vaccine. 2018 Oct 22;36(44):6497-6505
pubmed: 29174106