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Medical devices
Systematic literature review of the barriers and facilitators of frugal innovation for surgical care in low-income and middle-income countries
  1. Cyan Brittany Brown1,2,
  2. Lisa McDermott3
  1. 1Stanford Biodesign, Stanford University, Palo Alto, CA, USA
  2. 2Faculty of Life and Medical Sciences, School of Population Health & Environmental Sciences, King's College London, London, UK
  3. 3Public Health in the School of Population Health & Environmental Sciences, King's College London, London, UK
  1. Correspondence to Dr Cyan Brittany Brown, Stanford Biodesign, Stanford University, Palo Alto, California, USA; c.brown{at}atlanticfellows.org

Abstract

Objective Globally, 5 billion people lack access to safe surgery and annually, only 6% of surgeries occur in low-income countries. Surgical frugal innovations can reduce cost and optimise the function for the context; however, there is limited evidence about what enables success.

Design A systematic literature review (SLR) was performed to understand the barriers and facilitators of frugal innovation for surgical care in low-income and middle-income countries (LMICs).

Data sources Web of Science, PubMed, Embase at Ovid, Google Scholar and EThOs were searched.

Eligibility criteria for selecting studies Inclusion criteria were original research in English containing a frugal surgical innovation. Research must be focused on LMICs. Studies were excluded if the content was not focused on LMICs or did not pertain to barriers and facilitators. 26 studies from 2006 to 2021 were included. The GRADE tool was used to assess overall review quality.

Results Results were analysed using the modified consolidated framework for implementation research. The lack of formal evidence regarding frugal innovation in LMICs was the most reported barrier. The adaptability of frugal innovations to the context was the most reported facilitator. The limitations of this study were that most frugal innovations are not included in formal literature and that only English studies were included.

Conclusion Frugal surgical innovations that are highly adaptable to the local context hold significant potential to scale and positively affect healthcare access and outcomes. Furthermore, supporting formal research about frugal innovations is important when aiming to innovate for health equity.

  • Global Health
  • Surgical Procedures, Operative
  • Public Health

Data availability statement

Data is available in the OSF data repository and can be accessed here: https://osf.io/t75na/?view_only=8959863c020f41778f0b2734e914c651.

http://dx.doi.org/10.1136/bmjinnov-2022-001066

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    Data availability statement

    Data is available in the OSF data repository and can be accessed here: https://osf.io/t75na/?view_only=8959863c020f41778f0b2734e914c651.

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    Footnotes

    • Contributors CBB planned, conducted and reported on the work in the paper. CBB is the gaurantor of this paper. LM helped to conceptualise the paper and assisted with the interpretation and analysis of the data.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.