Health Research Program
Sara Sulzbach, Senior Implementation Research Adviser, Office of Maternal and Child Health and Nutrition, Bureau for Global Health, USAID

In light of the current Covid-19 global pandemic, the 6th Global Symposium on Health Systems Research (HSR2020) will be held virtually this year.  While we are disappointed to miss the opportunity to re-engage in-person with our many friends and colleagues, we are eager to share how the Health Research Program’s work aligns with this year’s theme: Re-imagining health systems for better health and social justice. Our work includes a study about emergency healthcare referral systems in Ghana that are being adapted in rural areas, learning more about how country leadership and stewardship can improve child health in east Africa, and lessons about how maternal and child health services responded to the Zika pandemic in five Latin American countries. Through these studies we support and promote an implementation research approach to accelerate the research utilization process and facilitate the introduction, uptake, and scale-up of new or adapted health interventions to prevent child and maternal deaths. 

The Health Research Program is supporting the work behind four presentations at the upcoming HSR2020 conference, an event expected to bring together over 2,000 policy-makers, practitioners, and researchers from more than 100 countries. During the symposium (November 8-12, 2020), registered participants will be able to virtually view the Health Research Program’s three posters and interact online with the lead authors.  

If you are planning to attend the HSR2020 virtual conference, please be sure to check out these sessions that feature Health Research Program-supported work. We hope to see you there!

Thursday, November 12, 2020 @ 1:05-1:50pm GST, UTC+4

Lessons on the effects of the Zika outbreak on MCH services: Learning from the past to prepare for the future (Cudjoe Bennett, USAID, and Ana Franca-Koh, Social Solutions International/CIRCLE Project) Poster Session under “Engaging Social, Economic and Environmental Forces” theme.

The CIRCLE Project assessed the extent to which the Zika outbreak affected Maternal and Child Health (MCH) service delivery and the resilience of the health system in five affected countries: Colombia, El Salvador, Honduras, Guatemala, and the Dominican Republic. A mixed methods approach was used to better understand the resilience of each country’s health system to deliver MCH services in response to the outbreak. The case studies assessed aspects of resilience that need to be in place to allow health systems in both the public and private sectors, to adequately respond to emergencies while maintaining core MCH services. The lessons learned and recommendations from this learning assessment are a useful reference for governments, implementers, and donors to prepare for and respond to future health outbreaks.  

Thursday, November 12, 2020 @ 1:05-1:50pm GST, UTC+4

Beyond referral:  Integrating primary health and definitive emergency care systems learning in rural Ghana (Rachel T. Moresky, Columbia University Mailman School of Public Health/sidHARTe Program; Mohammed Ali, Catholic Relief Services, Ayaga A. Bawah University of Ghana/Regional Institute of Population Studies; Koku Awoonor-Williams, Ghana Health Service)  

Poster Session under “Engaging Technological Data and Social Innovations” theme.

Implementation research for guiding the enactment of universal primary health care (PHC) has a long history in Ghana over the last two decades. The Community-Based Health Planning and Services (CHPS) program, as the key PHC strategy, has historically been focused on community ownership with oversight through the Ghana Health Service (GHS).  However, one challenge faced in rural Ghana is integrating these robust primary care systems with informed, coordinated referral and transportation systems to connect sub-district primary health care to definitive emergency care.  The Acute Care and Emergency Referral Systems (ACERS) program is designed to address this primary health care and emergency referral gap to improve maternal and newborn outcomes using an embedded system learning approach. ACERS seeks to enhance GHS’s existing strategies for 1. increasing community demand for emergency obstetric and neonatal care (EmONC), 2. strengthening informed referral, and 3. improving high quality, timely and definitive EmONC. By evaluating both contextual and structural factors, we hope to develop an ecological approach to service delivery learning, data use, and policy through the Ghana Health Service delivery platform through implementation research frameworks.


The role of country leadership and stakeholder networks in child health progress 2000-2015: Country perspectives from Mozambique, Tanzania, and Uganda (Malia Boggs, USAID, and Rebekah King, Social Solutions International/CIRCLE Project, and Mary Taylor, Social Solutions International/CIRCLE Project)

This poster is not part of a specific poster session, but presenters will be available to answer questions about their poster during the daily working sessions.

The objective of this mixed method study was to understand the effectiveness of leadership, organizational networks, and political commitment on child health progress in Mozambique, Tanzania, and Uganda. The study results provide rich information on the drivers of child health, the current state of country leadership and stakeholder networks, ideas for improving country child health outcomes, and recommendations for global support. Through deliberate stakeholder engagement activities, informal champions were identified to help advocate for use of study findings in Tanzania, Mozambique, and Uganda.  As countries work towards achieving the SDGs, these findings will inform future investments, policy, and programmatic decisions and enhance stakeholder collaboration.

After the initial conference, HSR2020 planners will arrange for a series of fortnightly parallel sessions to promote and facilitate exchange and community building around the symposium sub-themes.  This second phase will take place between November 25, 2020 – March 2021, and will feature an oral presentation of the formative work done in preparation of the 10 TIPs on Implementation Research for Decision Makers in Low and Middle-income Countries: a series of briefs designed to provide clear guidance for local health decision makers on how and when to conduct implementation research.




Wednesday, January 13, 2021 @ 5:00-6:15 GST

Stakeholder voices: Strengthening national-level stewardship of implementation research in low- and middle- income countries (Sara Sulzbach, USAID, and Monica Fox, Social Solutions International/CIRCLE Project) 

Phase 2, Oral Presentation.

USAID is developing a set of tools designed to strengthen policy makers’ and health managers’ leadership and participation in the design and use of implementation research (IR) to strengthen MNCH program implementation. Other IR guidance documents have typically been written for researchers, focusing mainly on research methodology and analysis rather than practical and easily accessible guidance.  This presentation will focus on a series of interviews conducted with key stakeholders to inform the development of materials and ensure that we develop resources that are responsive to country-level needs. The materials being developed TIPs on Implementation Research for Decision Makers in Low- and Middle-Income Countries are available now at