Implementing solutions: rethinking research evidence
With our most recent redesignation in 2020, the Collaborating Center’s top priority will be generating and applying the best evidence for supporting implementation in global women’s, children’s and adolescents’ health. Our focus in this regard will be the use of novel research methods to generate research evidence for effective implementation. Further, we will be using this evidence to build the in-country capacity needed for improving implementation research and implementation practice—and, ultimately, assuring that innovations are fully and effectively used in countries. A 2020 report by the Health Services Academy in Pakistan, published in Global Health Action (PDF), highlights the Center’s initial efforts to build in-country capacity for implementation. Going forward, the Center will build on this success to further develop and deploy capacity-building efforts in countries; in so doing, it will generate a new understanding of how best to improve support for implementation and apply that understanding toward continuous improvement in its capacity-building efforts. Working with WHO, UNICEF, and others, including in-country partners, the Center will lead the development and application of a model for implementation capacity-building that can be replicated by other programs to achieve worldwide influence and impact.
With the 2016 redesignation, we committed to a major expansion of the scientific and technical support we provide to WHO, the other multilateral agencies, and the other key stakeholders who work at the interface between implementation and implementation science. We described our conceptual approach to building the implementation capacity needed to succeed at this interface in our 2018 report in Obstetrics & Gynecology. Professor Peterson’s keynote address to the 65th Annual Clinical and Scientific Meeting of the American College of Obstetricians and Gynecologists highlighted the importance of linking implementation practice to implementation science, with the former driving the latter and the latter, in turn, supporting the former. This speech, published in a 2018 report in Obstetrics & Gynecology, indicated the imperative of being mission-driven, science-driven, and team-driven as we strive to achieve our global health goals and objectives. Further, as we have described, success on this front depends on highly effective collaborations between researchers, practitioners, policymakers, and funders. During this period, the Center used its conceptual approach to implementation capacity building in the development and launch of the “Implementation for the Professional Learner Program” (View Our Work). The Center also, in 2019, entered into UNC’s first Memorandum of Understanding with UNICEF to collaborate in the implementation of global health policies, programs, and practices in low- and middle-income countries, as well as advancing the field of implementation science for global health.
With our redesignation in 2012, we took on the additional challenge of providing scientific and technical support for implementation and began to build our capacity in the new and rapidly evolving field of implementation science with Professor Dean Fixsen, the co-founder of the National Implementation Research Network, now based at the University of North Carolina at Chapel Hill. We then began working closely not only with WHO but also with UNICEF and UNFPA, as the major United Nations counterpart implementing agencies in women’s, children’s, and adolescents’ health. Together, in our 2012 report in Obstetrics & Gynecology, we described our approach to building strong linkages between implementation challenges and the innovations, including implementation science, needed to address them. In 2015, the Director of WHO’s Department of Reproductive Health and Research, including the co-sponsored Special Programme of Research, Development and Research Training in Human Reproduction (RHR/HRP), invited our Center Director, Professor Peterson to give an address to its Policy and Coordinating Committee. The address entitled, “Implementation Science: What Is It and How Can WHO Use It More Effectively”, highlighted the importance of linking implementation science to implementation practice. The important role of implementation and implementation science in the evolution of global health was a central theme of Professor Peterson’s keynote speech to the XXI International Federation of Gynecology and Obstetrics (FIGO) World Congress in 2015.
When we were initially designated as the World Health Organization’s Collaborating Center for Research Evidence for Sexual and Reproductive Health in 2008, our primary mission was to support WHO’s commitment to science-driven and up-to-date guidance. Our principal contribution on that front was supporting the development and ongoing application of the Continuous Identification of Research Evidence (CIRE) System. The CIRE System provides a ‘finger on the pulse’ capacity to identify, critically appraise and synthesize evidence and to update guidance when, and as, appropriate. The focus of the CIRE System on addressing needs from the field — and having the gaps in evidence for meeting these needs as a driver for research priorities — are key components of our approach to accelerating science-driven solutions, described with WHO colleagues in a 2011 report in Obstetrics & Gynecology. The potential for research evidence to drive policy and practice was further demonstrated when we led a special theme issue of The Lancet; that served as the scientific and technical underpinning for the London Summit on Family Planning in 2012. The Summit, in turn, led to the launch of the FP2020 initiative, which raised an initial $2.6 billion to meet the unmet need for contraception among the world’s poorest women.