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”

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 topdown 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.