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

Allen, LNORCID logo; Nkomazana, O; Mishra, SK; Gichangi, M; Macleod, DORCID logo; Ramke, JORCID logo; Bolster, N; Marques, APORCID logo; Rono, H; Burton, MORCID logo; +5 more...Kim, MORCID logo; Ratshaa, B; Karanja, S; Ho-Foster, A; Bastawrous, AORCID logo and (2023) Improvement studies for equitable and evidence-based innovation: an overview of the 'IM-SEEN' model. International journal for equity in health, 22 (1). 116-. ISSN 1475-9276 DOI: 10.1186/s12939-023-01915-5
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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: 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: 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.


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