Focus Area: Implementation Research

The Alliance for Health Policy and Systems Research (AHPSR) partnered with the World Health Organization (WHO) Department of Maternal, Newborn, Child and Adolescent Health (MCA) to prepare a supplement to Acta Paediatrica to present results from selected implementation research studies that tested and documented the delivery of proven maternal, newborn and child health (MNCH) interventions in different countries and contexts. This editorial provides background information on how these studies were selected by WHO and an overview of the different studies in the context of the thinking on implementation research at the time they were developed.

Despite large investments to prevent mother-to-child-transmission (PMTCT), pediatric HIV elimination goals are not on track in many countries. The Systems Analysis and Improvement Approach (SAIA) study was a cluster-randomized trial to test whether a package of systems engineering tools could strengthen PMTCT programs. The authors sought to (1) define core and adaptable components of the SAIA intervention, and (2) explain the heterogeneity in SAIA’s success between facilities.

The authors address the challenges of specifying and reporting implementation strategies encountered by researchers who design, conduct, and report research on implementation strategies. They propose guidelines for naming, defining, and operationalizing implementation strategies in terms of seven dimensions: actor, the action, action targets, temporality, dose, implementation outcomes addressed, and theoretical justification.

This article addresses the challenges of preparing grant applications that succeed in the emerging field of dissemination and implementation. We summarize ten ingredients that are important in implementation research grants. For each, we provide examples of how preliminary data, background literature, and narrative detail in the application can strengthen the application.

This paper proposes a heuristic, working ‘‘taxonomy’’ of eight conceptually distinct implementation outcomes—acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability - along with their nominal definitions.

The purpose of this paper is to propose a multi-level, four phase model of the implementation process (i.e., Exploration, Adoption/Preparation, Implementation, Sustainment), derived from extant literature, and apply it to public sector services. The authors highlight features of the model likely to be particularly important in each phase, while considering the outer and inner contexts (i.e., levels) of public sector service systems.

This paper examines the characteristics of implementation research (IR) efforts in low-income and middle-income countries (LMICs) by describing how key IR principles and concepts have been used in published health research in LMICs between 1998 and 2016, with focus on how to better apply these principles and concepts to support large-scale impact of health interventions in LMICs.

The Boresha Afya project supports integrated primary health care in three geographical areas in Tanzania. USAID is conducting a Developmental Evaluation (DE) of the Boresha Afya project to support learning, innovation, and adaptive management efforts among implementing partners and Government of Tanzania stakeholders.