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The full programme and attendance is accessible through the HSR2020 website.
Session overview
This session will review experiences and lessons learnt from embedding implementation research in programme implementation processes, and discuss implications for scaling up in the context of health system strengthening.
Session description
Substantial investment has been made in the past three decades to establish and maintain national routine immunization systems and progress has been remarkable. Yet, while vaccination coverage for DTP3 has steadily increased in the past decades, it has recently stagnated at 76% in the African region, suggesting that countries may have reached a plateau of coverage (WHO global and regional data and statistics, accessed Feb 2020). Moreover, inequalities have widened, as variability in coverage between countries is largest for the poorest than for the wealthiest quintiles of a population (Barros et al., 2012, Restrepo-Mendez, 2016). Even within countries, where there is greater potential for consistent resource allocation, coverage is uneven (LaFond 2015).
If immunization programs are to effectively scale up coverage, a comprehensive understanding of how to reach the unreached must be developed. A basic readiness to deliver immunization services is important but not sufficient to drive coverage beyond a certain level. Scaling up coverage requires implementation research (IR). Implementation research allows to shed light on how implementation or system barriers are impeding immunization programs from achieving their full effectiveness, and inform how implementation can be tailored to specific settings and community needs, for effectively reaching under-immunized populations and zero-dose children.
Embedded research is carried out as an integrated and systematic part of decision-making and implementation processes. Embedding research to support implementation helps ensure the relevance and applicability of empirical findings. Grounded in locally-designed and driven research, embedded implementation research helps strengthen local capacity and supports the effective generation and use of contextual information and knowledge that guides adaptive planning and decision making.
In the past 5 years, the Alliance for Health Policy and Systems Research (Alliance HPSR) and UNICEF in collaboration with Gavi, the Vaccine Alliance (Gavi) and several country partners, have developed, tested and refined an embedded implementation research approach in numerous countries. This session will discuss these experiences and lessons learnt for scaling up implementation research in the context of immunization programs in countries.
Purpose and objectives
The purpose of this session is:
To demonstrate the role of implementation research in supporting local innovation and knowledge use to improve access and equity in immunization services.
To demonstrate the contribution of embedded implementation research in building local capacity and research-practice-policy links to strengthen evidence informed health systems.
Discuss the implications of these experiences for scaling up embedded implementation research in the context of health systems strengthening.
Session contributors
The session will be split into three parts.
Part 1. How can implementation research support local innovation and knowledge use to improve access and equity in immunization services?
Dr Kabir Sheikh (Alliance for Health Policy and Systems Research), moderator
Dr Marta Feletto (Alliance for Health Policy and Systems Research), opening remarks
Dr Meseret Zelahem (MCH Directorate, Federal Ministry of Health, Ethiopia), keynote
Dr Assad Hafeez (Health Services Academy, Ministry of NHSRC, Pakistan), keynote
Part 2. How can implementation research support local capacity and research-practice-policy links to strengthen evidence informed health systems?
Dr Alyssa Sharkey (UNICEF, Implementation Research & Delivery Science Unit), moderator
Dr Binyam Tilahun (University of Gondar, Ethiopia), opening remarks
Dr Sulistyawati Sulistyawati (Universitas Ahmad Dahlan, Indonesia), keynote
Dr Pamela Bakkabulindi (Makerere School of Public Health, Uganda), keynote
Part 3. Implications of these experiences for scaling up embedded implementation research in the context of health systems strengthening (panel)
Dr Hope Johnson (Gavi, the Vaccine Alliance), moderator
Binay Kumar (Gavi, the Vaccine Alliance), opening remarks
All speakers then join a panel discussion