Objective Globally, 5 billion people lack access to safe surgery and annually, only 6% of surgeries occur in low-income countries. Surgical frugal innovations can reduce cost and optimise the function for the context; however, there is limited evidence about what enables success. Design A systematic literature review (SLR) was performed to understand the barriers and facilitators of frugal innovation for surgical care in low-income and middle-income countries (LMICs). Data sources Web of Science, PubMed, Embase at Ovid, Google Scholar and EThOs were searched. Eligibility criteria for selecting studies Inclusion criteria were original research in English containing a frugal surgical innovation. Research must be focused on LMICs. Studies were excluded if the content was not focused on LMICs or did not pertain to barriers and facilitators. 26 studies from 2006 to 2021 were included. The GRADE tool was used to assess overall review quality. Results Results were analysed using the modified consolidated framework for implementation research. The lack of formal evidence regarding frugal innovation in LMICs was the most reported barrier. The adaptability of frugal innovations to the context was the most reported facilitator. The limitations of this study were that most frugal innovations are not included in formal literature and that only English studies were included. Conclusion Frugal surgical innovations that are highly adaptable to the local context hold significant potential to scale and positively affect healthcare access and outcomes. Furthermore, supporting formal research about frugal innovations is important when aiming to innovate for health equity. Data is available in the OSF data repository and can be accessed here: [https://osf.io/t75na/?view_only=8959863c020f41778f0b2734e914c651][1]. [1]: https://osf.io/t75na/?view_only=8959863c020f41778f0b2734e914c651.

中文翻译：

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对低收入和中等收入国家外科护理节俭创新的障碍和促进因素的系统文献综述

目标 全球有 50 亿人无法获得安全手术，每年只有 6% 的手术发生在低收入国家。外科手术节俭的创新可以降低成本并针对环境优化功能；然而，关于成功的因素的证据有限。设计进行了系统文献综述（SLR），以了解低收入和中等收入国家（LMIC）外科护理节俭创新的障碍和促进因素。数据来源 Web of Science、PubMed、Embase at Ovid、Google Scholar 和 EThOs 进行了搜索。选择研究的资格标准纳入标准是包含节俭外科创新的英文原创研究。研究必须集中于中低收入国家。如果内容不关注中低收入国家或不涉及障碍和促进因素，则研究将被排除。纳入了 2006 年至 2021 年的 26 项研究。GRADE 工具用于评估总体评审质量。结果 使用修改后的实施研究综合框架对结果进行了分析。缺乏关于中低收入国家节俭创新的正式证据是报道最多的障碍。节俭创新对环境的适应性是报道最多的促进因素。这项研究的局限性在于，大多数节俭创新并未包含在正式文献中，并且仅包含英语研究。结论 高度适应当地情况的节俭外科创新具有巨大的扩展潜力，并对医疗保健的获取和结果产生积极影响。此外，在旨在实现健康公平的创新时，支持有关节俭创新的正式研究也很重要。数据可在 OSF 数据存储库中获取，可在此处访问：[https://osf.io/t75na/?view_only=8959863c020f41778f0b2734e914c651][1]。[1]：https://osf.io/t75na/?view_only=8959863c020f41778f0b2734e914c651。