# Employee-Driven Innovation as an Approach to Health System Strengthening in LMICs: Comment on "Employee-Driven Innovation in Health Organizations: Insights From a Scoping Review"

## TL;DR

This paper discusses how healthcare workers in low- and middle-income countries can drive innovation to improve health systems.

## Contribution

It provides examples and insights on employee-driven innovation in LMICs, addressing gaps in existing literature.

## Key findings

- Employee-driven innovation improves efficiency and quality of care in LMIC health systems.
- EDI fosters positive organizational cultures in these settings.
- Barriers and enablers of EDI in LMICs are identified and discussed.

## Abstract

Cadeddu and colleagues’ scoping review, Employee-Driven Innovation in Health Organizations, provides a valuable reframing of healthcare workers’ roles beyond service delivery and positions them as key contributors to organizational and systems innovation. Key gaps identified in the literature through their scoping review include limited evidence from low- and middle-income countries (LMICs) and an incomplete understanding of how top-down or hybrid employee-driven innovation (EDI) processes can effectively enable bottom-up innovation. This commentary provides possible reasons for the limited published evidence from LMICs and, uses the framework by Caddedu et al, to address the knowledge gaps by presenting examples of EDI processes from LMICs, as well as discussing the barriers and enablers of EDI in these settings. Examples from LMICs demonstrate that EDI not only drives solutions to enhance the efficiency and quality of care but also plays a pivotal role in fostering positive organizational cultures within health systems.