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Advancing Implementation Science

Advancing Implementation Science

While remarkable advances have been made over the past few decades in medical science and discovery of medicines, vaccines and diagnostic tools, bottlenecks have emerged as implementation processes and approaches have failed to meet demand. These bottlenecks result from the significant gap between developing evidence based interventions and efficiently implementing those interventions at scale. On average, it takes 17 years to turn 14% of original research into public health practices, policies and programs. This shows that there is a significant delay between learning effective solutions, strategies, and interventions through research and implementing them through health policies, programs, and practice. This failure means that interventions fail to reach their potential. While this gap occurs across the globe, populations with the greatest healthcare needs and inequalities are disproportionately affected by this “know-do gap”. Implementation research and delivery science promotes integration of research findings and evidence into healthcare policy, programs and practice. It’s a method for better understanding how to efficiently and effectively get proven interventions to populations of need to improve health and well-being.[1] It is a collaborative and iterative process which engages a range of stakeholders to achieve sustainable uptake, adoption and implementation of evidence-based interventions that meet local needs. If the United Nations’ Millennium Development Goals (MDGs) are to be reached, these “know-do” gaps must be closed and more effective approaches to implementation and scale-up must be identified or developed. Implementation research and delivery science provides the tools to close these gaps and meet global health goals. The USAID-funded TRAction Project is working to promote research and innovation through local ownership and leveraged partnerships in order to scale up equitable and sustainable efforts to “do what works.” By linking evidence based practices with context specific settings we hope to increase the utilization and eventual scale-up of evidence based programs. [1] Adapted from the NIH Fogarty International Center definition on Implementation Science.

Advancing Implementation Science

Future application and scale-up of evidence-based practices

Implementation research and delivery science (IRDS) is a process to both understand “what’ works and “how” to get what works to the populations that need it to improve health outcomes. The process has been called by many names (e.g. - implementation research, implementation science), is closely related to other approaches (e.g. - operations research), and is an integral component of health systems research. The term IRDS has recently been coined to capture both the research and delivery aspects of the process, highlighting the challenges of actually implementing and scaling up evidence based approaches to improve health care.

Collaboration for IRDS

IRDS Working Group Engagement

TRAction Project is actively engaged with the Collaboration for Implementation Research and Delivery Science (IRDS), which is a working group comprised of the Alliance for Health Policy and Systems Research (AHPSR) within the World Health Organization, the World Bank, and the United States Agency for International Development (USAID). TRAction Project and Johns Hopkins University serve as the secretariat and support the group.

The collaboration was formed in response to a need for a new approach for implementation research and delivery science (IRDS) to effectively implement and scale up policies, programs and interventions that can save lives and improve health. The Collaboration on IRDS acknowledges that while research has shown that there are many effective methods for reducing health disparities around the world, up-to-date guidance on how to implement new and proven health interventions at scale and across different contexts is not widely available. The collaboration chose the term “implementation research and delivery science” to emphasis both the research and delivery components of getting evidence into practice.

Since its inception, the working group members and high level organizations that comprise the collaboration (WHO, World Bank, and USAID) have elevated discussions around implementation science, have created a shared vision for a broader and more effective use of IRDS, and have demonstrated its commitment towards strengthening the IRDS field to advance global health goals.

Consultative Meetings

Working session during a consultative meeting
Changing the Paradigms of IRDS

In an effort to further discussion and advance the use of implementation and delivery science TRAction Project contributed to a series of consultative meetings.  These meetings were organized by United States Agency for International Development (USAID); the Alliance for Health Policy and Systems Research (WHO) and the World Bank.  Participants included partners from TRAction, public and private sector professionals and stakeholders.

Statement on Advancing IRDS

Advancing IRDS: A Call to Action

Implementation Research and Delivery Science (IRDS) is increasingly recognized as a growing field that is critical to improving health at local, national, and global levels. Simply identifying and evaluating interventions to assess efficacy is not enough to address major national and global targets and milestones beyond the Millennium Development Goals. At the Third Global Symposium on Health Systems Research in Cape Town in October 2014 over 2,000 health researchers, policy-makers, program implementers and funders met to share ideas and debate ways to improve the performance of health systems through research. Among their recommendations is a statement to promote implementation research and delivery science as a collaborative venture between researchers, implementers, policy-makers, and civil society.

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