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Implementation research: new imperatives and opportunities in global health.

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TLDR
The case studies reveal the complex adaptive nature of health systems, emphasise the importance of understanding context, and highlight the role of multidisciplinary, rigorous, and adaptive processes that allow for course correction to ensure interventions have an impact.
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This article is published in The Lancet.The article was published on 2018-11-17 and is currently open access. It has received 268 citations till now. The article focuses on the topics: Implementation research & Health policy.

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Gender equality in science, medicine, and global health: where are we at and why does it matter?

TL;DR: This Review presents a high-level synthesis of global gender data, summarise progress towards gender equality in science, medicine, and global health, review the evidence for why gender Equality in these fields matters in terms of health and social outcomes, and reflect on strategies to promote change.
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Malaria eradication within a generation: ambitious, achievable, and necessary

TL;DR: Authors: Richard G. A. Feachem, Ingrid Chen*, Omar Akbari‡, Amelia Bertozzi-Villa, Samir Bhatt, Fred Binka, Maciej Boni, Caroline Buckee, Joseph Dieleman, Arjen Dondorp, Neelam Sekhri FeAChem, Scott Filler, Peter Gething, Roly Gosling, Annie Haakenstad.
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Knowledge translation in health: how implementation science could contribute more

TL;DR: It is crucially important to establish substantial programmes of research on implementation and improvement in healthcare, and better recognize the societal and practical benefits of research.
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Improving Health Service Delivery in Developing Countries: From Evidence to Action

TL;DR: This book pulls together available evidence concerning strategies to improve health services delivery in low- and middle-income countries (LMICs), using current methods to assemble a knowledge base and analyze the findings.
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Framework for the development and evaluation of complex interventions:gap analysis, workshop and consultation-informed update

TL;DR: The second edition of the MRC framework on complex intervention research was published in 2006 as discussed by the authors, focusing on the importance of context and the value of understanding interventions as events in systems that produce effects through interactions with features of the contexts in which they are implemented.
References
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Journal ArticleDOI

Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

TL;DR: The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories.
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Maternal and child undernutrition and overweight in low-income and middle-income countries

TL;DR: It is estimated that undernutrition in the aggregate--including fetal growth restriction, stunting, wasting, and deficiencies of vitamin A and zinc along with suboptimum breastfeeding--is a cause of 3·1 million child deaths annually or 45% of all child deaths in 2011.

Implementation research: a synthesis of the literature.

TL;DR: The authors call for applied research to better understand service delivery processes and contextual factors to improve the efficiency and effectiveness of program implementation at local state and national levels.
Journal ArticleDOI

Improving the reporting of pragmatic trials: an extension of the CONSORT statement.

TL;DR: Eight CONSORT checklist items for reporting of pragmatic trials are recommended, including the background, participants, interventions, outcomes, sample size, blinding, participant flow, and generalisability of the findings.
Journal ArticleDOI

Welcome to Implementation Science

TL;DR: This online journal will provide a unique platform for this type of research and will publish a broad range of articles – study protocols, debate, theoretical and conceptual articles, rigorous evaluations of the process of change, and articles on methodology and rigorously developed tools – that will enhance the development and refinement of implementation research.
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Frequently Asked Questions (13)
Q1. What are the contributions in this paper?

Drawing on an expert review process, this paper presents purposively selected case studies to illustrate the essential characteristics of implementation research and its application in low and middleincome countries ( LMICs ). 

These endeavours involve a range of research methods, shaped according to the questions addressed and further iterative processes linking research, reflection and action. 67 This highlights the need for further dialogue between journals and authors on how to report the implementation process and learning from implementation research and the broader field of Health Policy and Systems research. 

Examplesof bundles of interventions include linking human resources strategies (e.g. attendance monitoringand appraisal) with strategies addressing wider health systems problems, such as by building competence and ensuring medical supplies are available. 

The awareness of onchocerciasis and its socio-economic impacts on the population was a motivating factor for community adherence totreatment. 

6. Implementation research involves some key trade-offs to consider: (i) rigor versus usefulness of the research; (ii) fidelity versus adaptation of an implementation component; (iii) embedded versus externally objective approaches; (iv) seeking generalizable knowledge versus context-specific problem-solving; (v) incentives versus disincentives for researchers and implementing agencies. 

These include the Consolidated Framework for Implementation Research,13 the National (US) Implementation Research Network’s Active Implementation Frameworks (Usable interventions, Implementation stages, Implementation drivers, Implementation teams, and Improvement cycles),14 a synthesis of frameworks on implementation processes,15 and an analysis of models according to a socioecological framework to help identify and select relevant frameworks. 

The case of the development and use of a national Balanced Scorecard (BSC) onbasic services in Afghanistan demonstrates how implementation research can be used toimmediately influence policy, as well as the limitations and potential consequences of the closelinks of research and policy. 

The case studies also demonstrate how implementation research involves partnerships acrossthe research and implementation cycles with co-production and concurrent use of knowledge. 

Between 1994 and 2000, country stakeholders went through an interactive and engaging processto pilot, experiment, replicate and scale up a programme that mobilized local volunteers, resources and cultural institutions to support community based primary care. 

67 Thishighlights the need for further dialogue between journals and authors on how to report theimplementation process and learning from implementation research and the broader field ofHealth Policy and Systems research. 

While hospitalization remainsthe WHO standard of care, a coordinated set of studies in Africa, Bangladesh and Pakistanestablished a new evidence base of implementation strategies for outpatient management, where necessary, which have been included in new WHO guidance. 

Implementation research that informs policyGhana: The Community Health and Planning Services (CHPS) is the lowest level at which publichealth services are delivered in Ghana. 

This included research on different ways to deliver vaccines, such as thebifurcated needle invented in 1965 that enabled quick and efficient immunization of large numbersof people. 

Trending Questions (1)
What Is Implementation Research?: Rationale, Concepts, and Practices?

The paper provides a comprehensive overview of implementation research, which is defined as the creation and application of knowledge to improve the implementation of health policies, programs, and practices.