title: Innovation in income-poor environments.
abstract: BACKGROUND
  At the core of surgical development in any economic environment lies innovation. Innovation in high-income countries (HICs) often derives from research, whereas innovation in low- and middle-income countries (LMICs) may be spontaneous owing to a desperate drive to meet a local need. The local needs are substantial because of the unequal access to healthcare in LMICs.
  
  
  METHODS
  The experience of the author in working in LMICs through Operation Hernia, a medical charity, provides a backdrop for this review. Other published innovative devices and models are discussed.
  
  
  RESULTS
  Innovation in income-poor countries has provided cost-effective but efficient solutions to local health needs. Some innovations have been enhanced and adopted worldwide.
  
  
  CONCLUSIONS
  HICs can learn more from innovative strategies adopted in LMICs.
authors: Colorectal Unit, Derriford Hospital, Plymouth PL6 8DH, UK.
authors: F C
authors: FC
authors: Oppong
mesh_terms: D058107:Abdominal Wound Closure Techniques / Q000191:economics; D032022:Delegation, Professional; D003695:Delivery of Health Care / Q000191:economics; D003906:Developing Countries; D004638:Emergency Treatment / Q000191:economics / Q000379:methods; D004867:Equipment Design / Q000191:economics / Q000639:trends; D006801:Humans; D062069:Inventions / Q000191:economics / Q000639:trends*; D010092:Oximetry / Q000191:economics / Q000295:instrumentation; D013526:Surgical Mesh; D013514:Surgical Procedures, Operative / Q000191:economics / Q000639:trends*; D035703:Therapies, Investigational / Q000191:economics / Q000639:trends