Innovation Strategies and Health System Guiding Principles to Address Equity and Sustainability in Responsible Innovation in Health; Comment on “What Health System Challenges Should Responsible Innovation in Health Address? Insights From an International Scoping Review”

Document Type : Commentary

Author

1 Department of Health Services Management, Faculty of Health Sciences, University of Malta, Msida, Malta

2 Health Services Management Centre, School of Social Policy, College of Social Sciences, University of Birmingham, Birmingham, UK

Abstract

The insights from an international scoping review provided by Lehoux et al challenge health policy-makers, entrepreneurs/innovators and users of healthcare, worldwide, to be aware of equity and sustainability challenges at system-level when appraising responsible innovation in health (RIH) – purposefully designed to better support health systems.The authors manage to extract no less than 1391 health system challenges with those mostly cited pertaining to service delivery, human resources, leadership and governance. Countries were classified according to the Human Development Index (HDI), while the authors decided not to classify according to the types of health systems justifying this on the basis that the articles reviewed studied a specific setting within a broader national or regional health system. The article presents highly powerful and discerning viewpoints, indeed providing numerous standpoints, yet in a comprehensive manner, thereby putting structure to a somewhat highly complex and multidimensional subject. This commentary brings forth several considerations that are perceived on reading this article. First, although innovation strategies are important for the dynamicity of health systems, one should discuss whether or not RIH can adequately address equity and sustainability on a global scale. Secondly, RIH across countries should also be debated in the context of the principles garnered by the type of health system, thereby identifying whether or not the prevailing political goals support equity and sustainability, and whether or not policy-makers are adequately supported to translate system-level demand signals into innovation development opportunities. As key messages, the commentary reiterates the emphasis made by the authors of the need for international policy-oriented fora as learning vehicles on RIH that also address system-level challenges, albeit the need to acknowledge cultural differences. In addition, the public has not only the right for transparency on how equity and sustainability challenges are addressed in innovation decisions, but also the responsibilities to contribute to overcome these challenges.

Keywords

Main Subjects


  1. Lehoux P, Roncarolo F, Silva HP, Boivin A, Denis JL, Hébert R. What health system challenges should responsible innovation in health address? Insights from an international scoping review. Int J Health Policy Manag. 2019;8(2):63-75. doi:10.15171/ijhpm.2018.110
  2. Braveman P, Gruskin S. Defining equity in health. J Epidemiol Community Health. 2003;57(4):254-258. doi:10.1136/jech.57.4.254
  3. Fischer M. Fit for the Future? A new approach in the debate about what makes healthcare systems really sustainable. Sustainability. 2015;7(1):294-312.
  4. van Olmen J, Criel B, Van Damme W, et al. Analysing health systems to make them stronger. Antwerp, Belgium: ITGPress; 2010.
  5. Silva HP, Lehoux P, Miller FA, Denis JL. Introducing responsible innovation in health: a policy-oriented framework. Health Res Policy Syst. 2018;16:90. doi:10.1186/s12961-018-0362-5
  6. Wyber R, Vaillancourt S, Perry W, Mannava P, Folaranmi T, Celi LA. Big data in global health: improving health in low-and middle-income countries. Bull World Health Organ. 2015;93:203-208.
  7. Quamruzzaman A. Infrastructure Provisioning and Health Service Utilization in Africa: Does Governance Explain the Gap? Sociol Dev. 2017;3(1):47-69.
  8. Buttigieg SC, Grima S, Camilleri C. Commentary: Comparison of historical medical spending patterns among the BRICS and G7. Front Pharmacol. 2016;7:213. doi:10.3389/fphar.2016.00213
  9. Witty A. New strategies for innovation in global health: a pharmaceutical industry perspective. Health Aff (Millwood). 2011;30(1):118-126. doi:10.1377/hlthaff.2010.0933
  10. Rüegg SR, Nielsen LR, Buttigieg SC, et al. A systems approach to evaluate One Health initiatives. Front Vet Sci. 2018;5:23. doi:10.3389/fvets.2018.00023
  11. Grigorovich A, Fang ML, Sixsmith J, Kontos P. Defining and evaluating transdisciplinary research: implications for aging and technology. Disabil Rehabil Assist Technol. 2018:1-11. 10.1080/17483107.2018.1496361
  12. Young-Wolff KC, Kotz K, McCaw B. Transforming the health care response to intimate partner violence: Addressing “wicked problems.” Jama. 2016;315(23):2517-2518. doi:10.1001/jama.2016.4837
  13. Detsky AS, Garber AM. Uber’s message for health care. N Engl J Med. 2016;374(9):806-809.
  14. Buttigieg SC, Von Eiff W, Farrugia P, Von Eiff MC. Process optimization in the emergency department by the use of point-of-care-testing (Poct) in Life-Threatening Conditions: Comparative Best Practice Examples from Germany and Malta. Adv Health Care Manag. 2015;17:195-219. doi:10.1108/S1474-823120140000017012
  15. Buttigieg SC, Gauci D. Health care innovation across health systems. In:    Gurtner S, Soyez K, eds. Challenges and Opportunities in Health Care Management. Springer; 2015:47-59.
  16. Berwick DM. Lessons from developing nations on improving health care. BMJ. 2004;328(7448):1124-1129.
Volume 8, Issue 9
September 2019
Pages 570-572
  • Receive Date: 22 April 2019
  • Revise Date: 09 June 2019
  • Accept Date: 09 June 2019
  • First Publish Date: 01 September 2019