Health systems in low resource settings operate under a growing burden of health needs. The utilization of resources in an innovative, efficient and integrated way is becoming more important than ever to accomplish the goal of achieving UHC, contributing to health equity and improving access to quality essential health-care services. Despite rapid advances in technology, design and social innovation, these do not always translate into sustained or improved health outcomes.
Since the launch of the SDGs in 2015, researchers and policy-makers around the world have been trying to find strategies to achieve high-quality, accessible and culturally appropriate health interventions. However, there are still more than 400 million people globally that lack access to essential health-care, mainly in low and middle-income countries. Resource availability is not enough; we must think beyond this towards health systems innovation.
Although innovations have been positioned as essential to overcoming health inequity, they must be informed by the local context, and involve the full participation of those receiving it; otherwise, indiscriminate use of technology may reinforce social inequities. They must be designed for and coordinated with the community, considering their perceived needs to ensure acceptance, effectiveness and sustainability.
To bridge theory and practice we have developed a framework that is simultaneously context-specific (and patient centered) and internationally relevant/comparable. It brings together academic literature, field work and case studies. It starts from the assumption that only with the support and motivation of community members can we achieve a sustainable change by recognizing their social and cultural norms while maximizing the efficient use of local resources. It connects three fundamental dimensions: a people-centered and integrated health system, the local health systems constraints and barriers, and adequate, available and accessible innovations. By tackling each dimension and maintaining the communities at the center we are bridging the gap between evidence and implementation, and thus contributing to sustainable health systems towards UHC.
This is a first step in the development of a decision-support system that bridges academic and practical, local and global, as well as public and private spheres to optimize health service provision. With an exponential increase in health innovation, there is a need to coordinate actions from researchers, entrepreneurs, policy-makers and the private sector to interface global innovation with the cultural, social and economic variability between contexts.
