Barriers to Innovation in Public Health: A Scoping Review

OBJECTIVES: This study aims to investigate the obstacles to innovation in public health.

METHODS: We conducted a scoping review of studies on barriers to public health innovation, adhering to the guidelines of the JBI Scoping Review Methodology Group. Our search encompassed original articles, without any time or language constraints. We searched PubMed, Scopus, and WoS to compile research from diverse sources. To streamline the process, we utilized an Excel workbook to create a comprehensive data extraction form, encompassing general study information and a list of definitions, concepts, and term analyses. The included articles underwent qualitative content analysis, employing a deductive and descriptive approach to categorize the data based on predefined categories.

RESULTS: We found 8,924 records and screened 151 records for full-text eligibility. 26 studies were included in the qualitative synthesis. Ten major barriers to innovation in public health were identified: i) Provider-centered health care models, in which many consumers of health care are passive; ii) Lack of leadership of clinicians in care centers and administrative leadership of actors in the health system; iii) Inadequate health system intelligence. iv) Restrictive business models and perverse financing and remuneration systems; v) Restrictive regulatory practice; vi) Threat of legal litigation, vii) Territorial behavior of potentially affected technical groups and professions; viii) Inherently flawed health systems by design; ix) Distributed governance system for public health services; and x) Rigid hierarchies in health care.

CONCLUSIONS: There are several important barriers to incorporating innovation in public health, even though this is a field with potential for effective use. Most of them have to do with issues outside the public health sector and even the broader health sector. These barriers should be systematically addressed in the health policy-making process to achieve a greater impact on the population's health status, quality of care, and cost of care.