Mapping and Synthesizing Health Innovations to Enhance Health System Efficiency in LMICs: Lessons and Implications for Ethiopia

Executive summary Introduction: Health systems in low- and lower–middle-income countries (LMICs) face persistent constraints, including limited financing, workforce shortages, and rising service demands. Improving efficiency is essential for achieving universal health coverage (UHC) and maximizing health outcomes. While a wide range of social, organizational, and technological innovations have been introduced to address inefficiencies, existing evidence remains fragmented and lacks systematic synthesis. This gap limits informed decision-making, particularly in reform-oriented settings such as Ethiopia. Objective: This scoping review aims to systematically map and synthesize evidence on health innovations that improve health system and service delivery efficiency in LMICs, and to generate policy-relevant insights to inform adaptation and scale-up in Ethiopia. Methods: The review will follow the Joanna Briggs Institute (JBI) methodology and adhere to PRISMA-ScR guidelines. A Population–Concept–Context (PCC) framework will guide inclusion, focusing on populations involved in health systems, innovations targeting efficiency, and LMIC settings from 2010 onward. A comprehensive search will be conducted across PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, and JBI Evidence Synthesis. Eligible studies will include empirical research on social and technological innovations. Data extraction will capture innovation characteristics, targeted efficiency dimensions, WHO health system building blocks, implementation context, and stage of development. Data will be synthesized using descriptive mapping and thematic analysis. Plan and Way Forward: This review represents Phase I of a two-phase study. Phase II will involve mapping efficiency-oriented innovations in Ethiopia through grey literature review and stakeholder consultations. By linking global evidence with national experience, the study will identify promising innovations, highlight evidence gaps, and inform strategies for adaptation, scale-up, and institutionalization to improve health system efficiency and performance in Ethiopia.