Abstract
Achieving universal health care coverage requires the adoption of primary health care policies and delivery strategies that are evidence based. Although this has been confronted by manifold challenges, particularly in the health systems of sub-Saharan Africa, there are promising approaches for accomplishing this objective. Salient among these is embedding implementation research (i.e., the study of methods to promote the systematic uptake of evidence-based interventions (EBIs) into routine practice) into policy making and implementation processes. Since 2007, the African Health Initiative of the Doris Duke Charitable Foundation supported partnerships that strengthened primary health systems and policy implementation in 7 countries in sub- Saharan Africa using the embedded implementation research as a core strategy. This programmatic review and analysis aims to identify the core features and processes that characterized how the partnerships operationalized the embedded implementation research approach and understand the factors that helped and constrained partnerships' effective use of this approach. For this, we drew upon findings from a desk review that consisted of 30 examples of embedded implementation research conducted by 3 African Health Initiative partnerships between 2016 and 2021 in Ethiopia, Ghana, and Mozambique. In addition, we conducted and analyzed 13 in-depth interviews with embedded implementation research stakeholders of the 3 projects. Core features and processes of embedded implementation research were: (1) the leadership role of policy decision makers and implementation leaders; (2) positioning research with program implementation at multiple levels of health systems; (3) multidisciplinary and multisectoral partnerships; (4) focus on research capacity building; and (5) real-time feedback loops and knowledge translation. Factors influencing the effectiveness of the embedded implementation research experiences involved: (1) the implementation climate and leadership; (2) opportunities and capacities to circulate and absorb new information; and (3) stakeholders' baseline knowledge and embedded scientists' identification within their organizations.
| Original language | English (US) |
|---|---|
| Article number | e2200061 |
| Journal | Global Health Science and Practice |
| Volume | 10 |
| Issue number | 1 |
| DOIs | |
| State | Published - Sep 2022 |
Funding
Acknowledgments: We wish to acknowledge the support provided for this study by the Doris Duke Charitable Foundation and express our thanks to functionaries of the local health systems and Ministries of Health in Ethiopia, Ghana, and Mozambique and other project partners whose collaboration was key to the lessons reported in this paper. Funding: The publication cost of this article and the collection of data for it were funded by the African Health Initiative of the Doris Duke Charitable Foundation. The Mozambique embedded research work is additionally supported by the Eunice Kennedy Shriver National Institute of Child Health and Development of the National Institutes of Health under award R01HDHD092449; the National Institutes of Health had no role in the design of the study, the collection, analysis, and interpretation of the data, and in writing the manuscript.
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Health Policy
