TIPs on Implementation Research for Decision Makers in Low- and Middle-Income Countries
What are TIPs?
Health interventions in low- and middle-income countries (LMICs) often do not fully achieve their intended results. Implementation Research (IR) provides tools that health decision makers can use to:
- understand what is and is not working in health delivery,
- uncover and adapt to the contextual factors affecting implementation success, and
- test and demonstrate approaches that ensure people receive the health interventions they need.
TIPs are 2-4 page briefs laying out the most important concepts for planning and conducting IR. The TIPs contained in this series guide health decision makers to use IR approaches to inform decision-making, program management, and service delivery, and scaling-up health interventions. These TIPs were designed to:
- appeal to health decision makers in LMICs
- adapt to a variety of country contexts, audiences, and health interventions
- clearly communicate evidence
- convey practical, concise, non-technical, and action-oriented ‘how to’ language, complemented by case study examples
- facilitate access to key additional resources, including complimentary IR resources
Who are the TIPs for?
These TIPs provide a helpful resource for anyone working in health and development, but they have been designed specifically for decision makers working at various levels of a country health system, including at national, provincial, district, sub-district, and facility levels.
Decision makers include:
- health policymakers
- program managers
Why were the TIPs developed?
IR is an important tool or approach for addressing intractable or emerging challenges to ensuring access to and uptake of health services. IR uses an adaptive learning process and real-time inclusive planning to understand and close the gap between what we know can work and what is happening (the “know-do” gap). IR can help ensure health interventions achieve their full potential by:
- identifying challenges to delivering and scaling effective health interventions,
- promoting regular review and uptake of data to inform decision-making and adapt practices as they are being identified, and
- fostering collaboration and ownership among stakeholders to improve health outcomes.
In 2014, a coalition of partners launched a statement on IR that spoke of the need for partnerships between policymakers, program managers and other practitioners, and researchers to advance a joint vision of saving lives and improving health. This collaboration aims to address the challenges of equitable implementation, sustainable programs, and scale-up through wider use of IR embedded in real-time policymaking, program management, and health service practice.
In 2018, the Implementation Research and Delivery Science (IRDS) Coalition, a nascent group of LMIC health leaders,* committed to IR use, saw a growing need for a flexible, quick implementation research guide to support and accelerate primary health care and public health practitioners and decision makers in LMICs. As such, these TIPs were developed to provide tailored support for health decision makers to help them overcome implementation challenges and achieve their objectives.
*The IRDS Coalition includes USAID, Global Financing Facility, World Bank, UNICEF, Alliance for Health Policy and Systems Research, and Doris Duke Charitable Foundation. The TIPs were developed in collaboration with this Coalition with input from in-depth interviews from LMIC stakeholders.
How are TIPs different from existing tools?
Guides and tools to conduct IR exist but typically focus on research methodology and analysis, and often lack practical easy-to-use guidance for decision makers in their normal work environments. Health decision makers are not always experienced in research but by collaborating with researchers they can drive IR and use evidence to improve quality, effectiveness, efficiency, and equitable scale-up of proven health interventions. The TIPs focus on decision makers’ needs to solve implementation challenges and identify best practices, using context-specific research findings.
Support for the development of 10 TIPs on Implementation Research (IR) for decision makers in low- and middle-income countries (LMICs) was made possible by the support of the American People through the United States Agency for International Development (USAID) under the terms of the Coordinating Implementation Research to Communicate Learning and Evidence (CIRCLE) contract AID-OAA-M-16-00006. The views expressed here are those of the workshop presenters/contributors author(s) and do not represent official statements of USAID, the U.S. Government or other affiliated institutions.
- Kanmiki EW, Akazili J, Bawah AA, Phillips JF, Awoonor-Williams JK, Asuming PO, Oduro AR, Aikins M. Cost of implementing a community-based primary health care strengthening program: The case of the Ghana Essential Health Interventions Program in northern Ghana. PLoS ONE 2019; 14(2): e0211956.
- UNICEF. Implementation research for immunization. Summary Report of Global Activities supported by Gavi, the Vaccine Alliance 2015-2018. July 2018.
- Foege WH, Millar JD, Lane JM. Selective epidemiologic control in smallpox eradication. AmJEpi, 1971;94(4):311-315.
- Leroy JL, Habicht JP, Pelto G, Bertozzi SM. Current Priorities in Health Research Funding and Lack of Impact on the Number of Child Deaths per Year. Am Journal of Public Health, 2007;97(2):219-223.