London School of Hygiene and Tropical Medicine, London, UK.
School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
Infect Dis Poverty. 2021 Mar 8;10(1):26. doi: 10.1186/s40249-021-00794-8.
Social innovation has been applied increasingly to achieve social goals, including improved healthcare delivery, despite a lack of conceptual clarity and consensus on its definition. Beyond its tangible artefacts to address societal and structural needs, social innovation can best be understood as innovation in social relations, in power dynamics and in governance transformations, and may include institutional and systems transformations.
A scoping review was conducted of empirical studies published in the past 10 years, to identify how social innovation in healthcare has been applied, the enablers and barriers affecting its operation, and gaps in the current literature. A number of disciplinary databases were searched between April and June 2020, including Academic Source Complete, CIHAHL, Business Source Complete Psych INFO, PubMed and Global Health. A 10-year publication time frame was selected and articles limited to English text. Studies for final inclusion was based on a pre-defined criteria.
Of the 27 studies included in this review, the majority adopted a case research methodology. Half of these were from authors outside the health sector working in high-income countries (HIC). Social innovation was seen to provide creative solutions to address barriers associated with access and cost of care in both low- and middle-income countries and HIC settings in a variety of disease focus areas. Compared to studies in other disciplines, health researchers applied social innovation mainly from an instrumental and technocratic standpoint to foster greater patient and beneficiary participation in health programmes. No empirical evidence was presented on whether this process leads to empowerment, and social innovation was not presented as transformative. The studies provided practical insights on how implementing social innovation in health systems and practice can be enhanced.
Based on theoretical literature, social innovation has the potential to mobilise institutional and systems change, yet research in health has not yet fully explored this dimension. Thus far, social innovation has been applied to extend population and financial coverage, principles inherent in universal health coverage and central to SDG 3.8. However, limitations exist in conceptualising social innovation and applying its theoretical and multidisciplinary underpinnings in health research.
社会创新已被越来越多地应用于实现社会目标，包括改善医疗服务提供，尽管其定义缺乏概念上的清晰性和共识。除了满足社会和结构需求的有形手段外，社会创新最好被理解为社会关系、权力动态和治理转型方面的创新，并且可能包括制度和系统转型。
对过去 10 年发表的实证研究进行了范围综述，以确定医疗保健领域的社会创新是如何应用的，影响其运作的促进因素和障碍，以及当前文献中的空白。在 2020 年 4 月至 6 月期间，在包括 Academic Source Complete、CIHAHL、Business Source Complete Psych INFO、PubMed 和 Global Health 在内的多个学科数据库中进行了搜索。选择了 10 年的出版时间框架，并且仅限制文章为英文文本。最终纳入的研究基于预先确定的标准。
在本综述中纳入的 27 项研究中，大多数采用了案例研究方法。其中一半来自卫生部门以外的高收入国家（HIC）的作者。社会创新被认为为解决中低收入国家和 HIC 环境中医疗保健获取和成本相关障碍提供了创造性的解决方案，涉及各种疾病重点领域。与其他学科的研究相比，卫生研究人员主要从工具和技术官僚的角度应用社会创新，以促进更多的患者和受益人参与卫生方案。没有提出任何实证证据表明这一过程是否会导致赋权，也没有将社会创新视为变革性的。这些研究提供了有关如何增强卫生系统和实践中社会创新实施的实用见解。
基于理论文献，社会创新有可能动员机构和系统变革，而卫生领域的研究尚未充分探索这一方面。迄今为止，社会创新已被应用于扩大人口和财务覆盖范围，这是全民健康覆盖的固有原则，也是可持续发展目标 3.8 的核心。然而，在卫生研究中概念化社会创新及其理论和多学科基础方面存在局限性。
