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Harnessing people's lived experience to strengthen health systems and support equitable musculoskeletal health care.

BACKGROUND: Despite the rising burden of musculoskeletal (MSK) problems (MSK conditions, MSK pain and MSK injury and trauma) in most countries, actions to improve (strengthen) systems for supporting MSK health are often low on the priority list. Delivering effective, person-centred and equitable MSK health care requires strengthening systems for health, for example through policy, financing, service delivery and workforce initiatives. A critical but often overlooked component is genuine integration of lived experience perspectives to co-create care and systems that are responsive to people's needs and contexts. KEY QUESTIONS FOR CLINICIANS, EDUCATORS AND POLICY MAKERS: How can co-creation approaches support effective, person-centred and equitable MSK health care? What principles can stakeholders adopt to build responsive health systems? KEY RESULTS: Lived experience perspectives are not systematically integrated in initiatives to strengthen health systems. Yet, integration is critical to creating equitable and person-centred health systems that provide care and support healthy populations. Co-creation principles and frameworks can guide processes to strengthen health systems, which must include historically marginalized groups and consider social and environmental contexts as they relate to health. KEY ACTIONS IN PRACTICE: Clinicians, educators and policy-makers play a critical role in creating equitable health systems and environments, and driving system reform with people who have lived experience. Genuine co-creation approaches capture diverse economic development (in particular, low-resource settings where health inequities are more prevalent), span the life course and diagnostic categories, are appropriate and/or adapted for the context and setting, and reflect evolving standards and opportunities for MSK health.

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