Reversing the trend: a scoping review of health innovation transfer or exchange from low- and middle-income countries to high-income countries

Abstract

The transfer of innovations from low and middle-income countries (LMICs) to high-income countries (HICs) has received little attention, leaving gaps in the understanding of the process, its benefits and the factors influencing it. This scoping review, part of a National Institutes of Health (NIH) project and the focus for a 2022 NIH-sponsored workshop on Global Health Reciprocal Innovation, sought to identify publications describing health innovations that were researched, developed and implemented in LMICs and adapted to address similar health challenges in HICs. A protocol was writtena prioriand registered on Open Science Framework. Four databases were searched for articles published in English from 2000 to 2022 and described health innovations developed in LMICs and were transferred to HICs. Using Covidence, two reviewers initially screened the title and abstract and then the full text; discrepancies were resolved through discussion. Two reviewers collected the data from each article using Covidence and Microsoft Excel; discrepancies were resolved by a separate third reviewer. 7191 records were retrieved and screened of which 12 studies were included. Various frameworks and methodologies were employed in these studies, with a particular emphasis on adaptation and adoption of innovations. The review uncovered different paradigms of LMIC to HIC innovation transfer and exchange, including unidirectional transfers from LMICs to HICs as well as bidirectional or multidirectional mutually beneficial exchanges. The use of both qualitative and quantitative data collection methods was common across all the included articles. Facilitators for innovation transfers included stakeholder engagement, relevance of local context, simplicity, and sufficient funding, promotion and branding. Barriers to transfers were mostly the opposite of the facilitators. Our results highlighted the underexplored field of LMIC to HIC innovation transfer and exchange and lay the foundation for future research studies.

Global health reciprocal innovation: ethical, legal and regulatory considerations

“…[24][25][26] Since GHRI has been proposed recently, it has only been used in a relatively small number of research studies. 27 While more of such studies would be welcome, GHRI does not aim to transform the global health research enterprise as a whole. Instead, GHRI has been suggested as an approach for expanding the development of new solutions to shared health challenges in LMICs and HICs that emphasises collaboration and shared learning between investigators in both settings.…”

The case for global health reciprocal innovation

“…Research outcomes for implementation research may include adaptation, acceptability and feasibility. 5 …”

“…In fact, some of the examples presented of reciprocal innovation evolved organically and serendipitously during the process of researching and implementing LMIC evidence-based interventions and were transferred to a different setting, resulting in novel and effective approaches to meet the needs of the new location. [3][4][5] The information and examples provided in the Supplement will hopefully inform researchers and funders of the opportunity to more systematically encourage and harness a GHRI approach to research. Because GHRI is an emerging concept in global health research, there are few programmes and publications that describe or incorporate the approach.…”

“…8 Other Supplement papers describe barriers and facilitators for implementing a GHRI approach, which highlight the complexities inherent in exchanging health innovations between different sociocultural and structural contexts. [4][5][6][7] Some papers include lessons learnt to guide the future use of a GHRI approach. 4 6 7 Rid et al explore ethical, legal and regulatory considerations involved in implementing GHRI, including GHRI's ethical commitment to equitable research partnerships as well as a concern that GHRI studies could displace funding for studies whose results have more immediate or significant benefits for populations in LMICs.…”

“…Research outcomes for implementation research may include adaptation, acceptability and feasibility. 5 A CALL TO ACTION The GHRI approach can elevate our global capacity to better address seemingly intractable health concerns. LMICs have offered solutions such as better harnessing community health clinics 3 and community health workers for rural populations 12 ; repairing hernias with mosquito net mesh as an alternative to commercial mesh; inducing neonatal therapeutic hypothermia with phase change material mattresses as an alternative to incubator devices; and treating severe burns with tilapia fish skin, 2 among numerous others.…”