Utilization of community engagement in social innovation health projects in low-and-middle income countries: A global sequential mixed methods analysis

Social innovation in health provides solutions to address healthcare delivery gaps using community engagement as a strategy. This study aimed to assess and understand the extent to which social innovation in health projects in LMICs use community engagement approaches in their processes, and how these shape and influence the outcomes of these health projects. We used a sequential mixed methods approach. Semi-structured interviews with social innovators were followed by an online survey among social innovation researchers and implementers. Interviews were recorded, transcribed and analyzed using NVivo 11, and themes informed development of the survey tool. The survey data were analyzed using STATA version-14 and descriptive statistics were presented. A total of 27 social innovators participated in semi-structured interviews, with 66.7% from Africa. The survey respondents had a mean age of 38.6 years (SD ± 11.5) and most of them were males 141 (51.5%). Community engagement in social innovation health projects was mostly utilized during problem identification 167 (62.1%), intervention identification and design 179 (66.5%), and delivery of interventions 213 (79.2%). Half of the social innovations 135 (52.1%) had very high level of community engagement, described as collaborative or shared leadership. There was differential participation of community stakeholders at different stages of the social innovation projects. Community engagement resulted into intervention acceptance, community ownership, and improved sustainability of interventions. Key sustainability strategies employed in social innovation health projects included capacity building, integration with existing health systems, partnerships, and financial interventions. More than half of the social innovation health projects used community engagement strategies across the various stages of their work. However, there is still need to create strong governance structures, co-create interventions with communities, and have shared responsibilities with the communities in order to attain the desirable high level of community engagement and substantiality in social innovation health projects in LMICs.