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. 2023 Jun 17;22(1):116.
doi: 10.1186/s12939-023-01915-5.

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

Luke N Allen  1 , Oathokwa Nkomazana  2 , Sailesh Kumar Mishra  3 , Michael Gichangi  4 , David Macleod  5 , Jacqueline Ramke  5 , Nigel Bolster  6 , Ana Patricia Marques  5 , Hilary Rono  7 , Matthew Burton  5 , Min Kim  5 , Bakgaki Ratshaa  2 , Sarah Karanja  8 , Ari Ho-Foster  2 , Andrew Bastawrous  6
Affiliations

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

Luke N Allen et al. Int J Equity Health. .

Abstract

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.

Keywords: Continuous improvement; Equity; Universal Health Coverage.

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Conflict of interest statement

AB and NB both work for Peek Vision.

Figures

Fig. 1
Fig. 1
The IM-SEEN approach to continually improving equitable outcomes
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