Our Symposium on implementation research (IR) at the Micronutrient Forum, co-sponsored with Sight & Life, was a unique opportunity to hear from four highly respected implementation stakeholders (representing government, NGO, donors and academia), about their sectors’ perspectives on IR.  What was striking about their reflections was not, as you might expect, the differences, but, the overwhelming similarities in their views. This is fertile ground on which to leverage change in terms of attitudes towards and application of IR.

Whilst the panelists highlighted some sector specific challenges, the following emerged as common issues across the sectors:

• IR is currently undervalued: IR must become embedded in the central activities of all nutrition stakeholder organizations.
• IR needs to build its credibility: IR needs greater respect and acceptance, and must become prioritized by research funders and peer-reviewed journals.
• Effective partnership is needed: Academia and implementers must collaborate so that research is relevant for improving outcomes in the ‘real-world’.
• Substantial resources are needed: Capacity must be strengthened for conducting research and to promote a culture of evidence-based decision-making.
• Flexible funding is required: Funders should allow research adaptation in light of emerging evidence, or support multistage projects (i.e. proof of concept, piloting, scale-up), with longer funding cycles to support these stages.
• A body of evidence on outcome improvements delivered by IR is needed: The cycle between evidence generation and field application needs to be shorter and whilst evidence should be published in peer-reviewed journals, some data can be used locally and immediately to great effect.

Canvassing the floor for opinion, session moderator, Dr. Meera Shekar (World Bank), established that there was also audience consensus on the above. However, there was split opinion ‘whether priorities for increasing capacity for IR should be at country (i.e. numerous small studies tailored to local context) vs. international (i.e. fewer larger scale generic studies) level’. The response indicates a need for thorough deliberation on the pros and cons of each approach.

As the session drew to its close, Dr. Shekar guided participants to voice their thoughts on possible solutions to the issues raised. The discussion centered on three topics.

1. Creating a country-driven harmonized research agenda

For IR to be relevant to the ‘real-world’, previous field experience, policy-context, and country specific systems and processes need to be considered during the study design stage. In relation to the latter, the feasibility of implementing interventions within such complex systems must be evaluated at the outset. Historically, formative research has been successful at the community and household level, however we need tools for conducting formative research in delivery systems themselves. 

2. Where are the ‘low-hanging fruit’?

We need to consider the ‘low hanging fruit’ i.e. where can we most easily achieve an impact? What areas have the greatest economies of scale?  For example, obesity is a critical global issue where many of the bottlenecks are common across countries and cultures, and where implementation strategies would have a very broad reach for application (and could be adapted for local use). There would also be opportunities for low-cost tools for formative research that could be applied by local stakeholders in different contexts. 

3. The role of the ‘knowledge broker’

Implementation is highly complex, with multiple concepts, contexts, systems and stakeholders to be considered. Is navigating this complexity and bridging between academia and practice a specialist role? SISN thinks so, and the session revealed that our panelists and audience concur. Such a specialist might be able to broker collaborations, interface with policy makers, ‘translate’ research into practical applications for implementers and provide expert guidance on program enhancements with relatively modest investments. Could this be one of, the ‘low-hanging fruit’ that Dr. Shekar asks us to consider, and if so what would be the scope of this role and how do we support its development, take-up and funding? These are questions that SISN will explore in a future blog.

Have an idea or a comment on any of the issues discussed above? We welcome your feedback – you can comment on this post on our LinkedIn feed (The Society for Implementation Science in Nutrition) or write to us using the email address above.

Interested in advancing the use of IS in nutrition?  Consider becoming a member of SISN.  Contact us by email at implementnutrition@gmail.com.