Tracey Koehlmoos: Implementation research evidence uptake and use for policy making

Tracey KoehlmoosFor the last two years I have worked on a project about implementation research with more than 120 colleagues from across the globe: India, Chile, Mexico, Switzerland, Brazil, Canada, Uganda and more.  The book, which was published by the World Health Organization (WHO) and the lesser known TDR  is called Implementation research for the control of diseases of poverty.

I know that many people are not familiar with TDR, which is the Special Programme for Research and Training in Tropical Diseases. It is a global programme of scientific collaboration that helps coordinate, support, and influence global efforts to combat a portfolio of major diseases of the poor and disadvantaged. TDR was established in 1975  and is based at and executed by the WHO, and is sponsored by the United Nations Children’s Fund (UNICEF), the United Nations Development Programme (UNDP), the World Bank, and WHO.

The work was started by Jane Kengeya-Kayondo and Ivane Bochorishvili, with technical support by Shenglan Tang and Soumya Swaminathan. This team provided critical input and overall leadership to the project while Miguel Angel Gonzalez Block (Centre for Health Systems Research of Mexico’s National Institute of Public Health) acted as technical coordinator for the report. As always, I felt lucky to be included and to have the chance to learn from global colleagues and to share what I have been doing and learning in South Asia. Support for the project also came from the Wellcome Trust and the European Union. I acknowledge their contribution with gratitude and hope that the collaborations, ideas, and products will have a life that exceeds the investment.

Miguel Angel placed me on a team led by Ulysses Panisset that included my fellow systematic reviewer Tomás Pantoja among others. Our section, which became Chapter 11 in the final work, was meant to focus on uses of implementation research in the decision making cycle of developing countries. We tried to capture the benefits of knowledge translation for implementation research and to clarify the synergies between the two areas. The team highlighted the challenges and opportunities at the operational and systems levels in terms of using implementation research and then looked at ways in which capacity for implementation research could be strengthened.

Our team, in support of the book, considered that a major obstacle to the progress of the Millennium Development Goals has been the inability of health systems in many low- and middle-income countries to effectively implement evidence-informed interventions. We discussed the relationships between implementation research and knowledge translation and identifies the role of implementation research in the design and execution of evidence-informed policy.  Further, we were able to identify and detail specific examples of the use of implementation research in national level programmes by looking at the scale up of zinc for the treatment of childhood diarrhoea in Bangladesh (the SUZY Project) and the scaling up of malaria treatment in Burkina Faso.

We provided a number of tested strategies to support the transfer of implementation research results into policy-making to help meet the standards that are increasingly expected from evidence informed policy making practices; however, we will have to wait and measure if there is a knowledge translation benefit of this work.

The team and I have a paper based on our work for the chapter that will be published shortly in one of my favorite open access journals: Health Research Policy and Systems (a.k.a. HARPS). Hopefully, the paper will get the broader circulation it will take to help move these ideas into practice.

Tracey Koehlmoos is programme head for health and family planning systems at ICDDR,B and adjunct professor at the James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.