Health Research Program
Project Summary:

The Coordinating Implementation Research to Communicate Learning and Evidence (CIRCLE) project provides technical, logistical, and administrative support to the USAID Health Research Program. The goal of the project is to coordinate and support activities related to implementation research to improve health outcomes and increase survival of newborns, children, and women.

Woman staring at baby
Photo credit: MCHIP

Implementation research is an iterative process in which stakeholder engagement informs applied research and the introduction of new or refined approaches and interventions, leading to sustained scale at the country level and collaborative learning at the global level. CIRCLE supports the Health Research Program to advance implementation research through: strategic planning, stakeholder engagement, communication and collaborative learning, expert mobilization and consultation, knowledge management, and research translation. CIRCLE also supports USAID Missions and other health offices implement studies using an implementation research approach.

CIRCLE is led by Social Solutions International, Inc., a woman-owned, full-service consulting firm dedicated to improving the health and well-being of underserved populations worldwide. Social Solutions specializes in providing high quality research, evaluation, and technical assistance on global health and development.


CIRCLE supports the content and maintenance of the website, including the development of blogs on priority maternal and child health and nutrition (MCHN) topics; implementation research resources and the MCH Matters quarterly newsletter that shares latest information and research to inform MCHN programs, practices, and policies.

Stakeholder Engagement

CIRCLE supports the Health Research Program implement three Communities of Practice (PSBI, Care-Seeking & Referral, and Urban Health in sub-Saharan Africa) which includes webinars, technical assistance and south-to-south exchanges; convening stakeholders for co-design of implementation research projects, collaborative learning, and research planning and implementation.  


Tanzania Developmental Evaluation 

In coordination with USAID Tanzania, implementing partners, and the Government of Tanzania, the CIRCLE project is conducting a Developmental Evaluation (DE) to support the USAID Tanzania Boresha Afya project. The Boresha Afya project supports the implementation of integrated primary healthcare platforms in three zones: Lake/Western Zone, North/Central Zone, and Southern Zone. This is a large-scale, highly dynamic program, but evidence on implementation and effectiveness of integrated health platforms is limited. DE is well-suited to meet this gap by utilizing an iterative, adaptive management and learning focused approach to program evaluation.The DE utilizes embedded evaluators that collaborate with Boresha Afya implementing partners to study implementation outcomes and generate-real time evidence and learnings. The DE supports  implementing partners and the Government of Tanzania to adapt and innovate the Boresha Afya project to improve efficiency, utilization, and scalability of integrated services. 

For more information about the Tanzania DE, click here.

Nigeria 2019 Verbal and Social Autopsy

The Nigeria 2019 Verbal and Social Autopsy (VASA) was a mixed methods study, implemented by the National Population Commission, in collaboration with the Federal Ministry of Health, with technical support from CIRCLE. The 2019 VASA aimed to provide national and zonal level estimates of the major causes of under-five mortality in Nigeria and insights into the social determinants of death among children to enable policy makers to make evidence-based decisions and programs. CIRCLE’s technical assistance, overseen by the multi-stakeholder VASA technical committee in Nigeria, included: facilitating stakeholder engagement; development of protocol and tools; implementation of the electronic data collection system, qualitative data collection; data analysis and report writing; and preparation for dissemination and utilization of findings. 

For more information about the 2019 VASA, click here.

Zika Outbreak Learning Assessment

The CIRCLE project conducted the Zika learning assessment to understand the effects of the Zika outbreak on maternal and child health service delivery and the adaptability of national health systems in five Latin America and Caribbean countries: Colombia, El Salvador, Guatemala, Honduras and the Dominican Republic. Utilizing a mixed-methods approach, the assessment focused on primary qualitative data collection comprised of country-specific case studies. The results of this assessment provide a better understanding of how health systems are structured, their response to unexpected outbreaks, and identification of strengths and weaknesses. The lessons learned, recommendations, and key cross-cutting findings in the assessment are a useful reference for donors, governments, and implementers that aim to improve the responses of health systems and their adaptability to future emergencies. 

For more information about the Zika Learning Assessment, click here

Child Health Country Perspectives Study 

The CIRCLE project conducted a mixed methods study to document country level perspectives on leadership and stakeholder networks in child health in Mozambique, Tanzania, and Uganda. The objectives of the Child Health Country Perspectives Study were to: understand how leadership, organizational networks, and political commitment affected progress in child health; identify constraints and enablers of national progress; and determine how these and other contributors to change might advance child health in the study countries. The study utilized desk review and secondary data analysis, qualitative interviews, organizational network analysis and stakeholder consultations. Study results will be shared widely to inform future investments, policy, and programmatic decisions for child health and enhance collaboration among stakeholders in the study countries. 

For more information about the Child Health Study, click here.

Expert Consultation

Through mobilizing experts, CIRCLE supports the development of knowledge products (e.g. HAP brief, LMIC Urban Air Pollution Solutions) and provides technical assistance on implementation research and other priority areas.

Photo credit: USAID

The CIRCLE Project is led by Elizabeth Macgregor-Skinner, Project Director.  For more information about CIRCLE, please contact the team at To learn more about how CIRCLE can support  USAID Missions, please contact Neal Brandes or Sara Sulzbach at