Author: Soumyadeep Bhaumik is a member of the Working Group on Evidence-Informed Policy & Practice, Healthcare Information for All. He is a medical doctor working in the field of evidence syntheses and program evaluation in India. Twitter : @DrSoumyadeepB
The importance of research evidence in global health is widely accepted and recognised since decades. However global health research has typically been limited to testing new drugs, diagnostics and innovations; programme implementation has been perceived to be a different ball game altogether. This however has changed in the last few years with the advent of a formal discipline of implementation research within the global health community. Implementation research in essence intends to understand the enablers and barriers for implementation of evidence based interventions in actual practice. This is important because contextual factors related to communities, providers, governance and support systems (training and technical assistance) have been found to affect as much as 50% of effectiveness of interventions.
Almost all global health funders, and lately even national funders in Low and Middle Income Countries (example in India) are funding implementation research with the view of knowing “why the intervention works, how, for whom and in which contexts”. Considering, the growing importance of this domain in global health, HIFA (Healthcare Information for All ) organised a thematic discussion on the topic of implementation research. This was as part of a series of online discussions implemented by the HIFA Working Group on Evidence-Informed Policy and Practice, supported by the Special Programme for Research and Training in Tropical Diseases (TDR) at WHO and The Lancet.
The HIFA virtual community consists of more than 16,000 members from 175 countries across the world and the discussion intended to not only increase the awareness about implementation research but also learn about it from those who have conducted and used such research for programme implementation. As the HIFA moderator initiated the discussion introducing the topic as well as the WHO TDR toolkit there was a spurt of interest from members across the spectrum with many seeking more information on it and expressing opinions on its utility. This included the need to elicit the research questions for such projects coming from healthcare workers as well as how it actually enables those involved to better understand the health systems and policy perspective.
What followed thereafter was interesting. Many global health practitioners had doubts on the terminology in relation to “implementation research” and its scope. HIFA members wanted to clarify how it was different from other kinds of research already integrated within global health programmes like quality improvement, operational research, knowledge translation and health-services research. The focus of the remaining discussion hovered around members supporting each other in understanding this and identifying resources, but the need for further understanding pervaded throughout the discussion.
This implies that while more funding on conduct of implementation research is welcome, there is also a need to fund activities relating to capacity building and understanding of this new discipline within the global health community itself.
One clear learning point is that such virtual platforms can quickly provide alternative information from a global perspective and across a wide section of stakeholders in a quick and inexpensive manner. The HIFA Working Group on Evidence-Informed Policy & Practice is taking forward this model by organising a thematic discussion to understand systematic reviews, with a special focus on issues in relation to low and middle income countries from 15th May 2017 for a period of six weeks at the HIFA virtual platform. Like the implementation research discussion - we hope the one on systematic reviews also provides new insights from the wider global health community.