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Introduction to OR/IR: purpose and definitions
Jane Kengeya-Kayondo, WHO/TDR
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Scope of the presentation
• The value of IR/OR• Definition of IR/OR• 2 activities
-one completed
-one ongoing
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Value of IR/OR
"Money plus technology is 5 percent of the solution; the other 95 percent is delivery and implementation" (William Easterly, Washington Post of Sunday July 2, 2006)
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Value of IR/OR
"Too often, investments worth many millions of dollars are being made in the absence of good data, and too often we fail to learn from and share all our experience…" (Michel Kazatchkine, the executive Director of the Global Fund, AIDS conference 2008)
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Value of IR/OR
• For many diseases and conditions, tools, strategies, interventions and policies exist
• Financial resources are becoming increasingly available (Global Fund, PEPFAR, GAVI etc.)
• What is lacking is evidence-based implementation knowledge and know-how
• IR/OR address this gap.
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OR/IR can accomplish thefollowing:
• to learn about management, administrative, cultural, social, behavioral, economic and other factors that exist as bottlenecks to effective implementation
• test new, more effective approaches to programming• identify and solve program problems in a timely manner• help policy-makers and program managers make
evidence-based program decisions• improve program quality and performance using
scientifically valid methods• help program managers and staff understand how their
programs work and how to make them work better
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IR/OR defined broadly
Any research producing practically-usableknowledge (evidence, findings, information,etc) which can improve programimplementation (e.g., effectiveness,efficiency, quality, access, scale-up,sustainability) regardless of thetype of research (design, methodology, approach)falls within the boundaries ofImplementation/operations research.
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ResearchUtility
Research Domain
Operational
Health system
Local Broad
Research Users
Implementation
Health care providers
Programme managers
Health system managers / Policy makers
IR/OR Defined in the context of Research to improve health systems and programmes
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Research Domain PRIMARY CHARACTERISTIC
Focus for the research Users of the research Research utility*
Operational operational issues of specific health programmes
health care providers Local
Implementation implementation strategies for specific interventions e.g. products or services
implementers: e.g. programme managers, R&D managers
Local/broad
Health Systemcrosscutting issues or challenges looking at the health system as a whole.
health system managers, policy makers Broad
* How amenable the research is to adaptation and use in other locations.
Scope of IR/OR within Health System Research
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IR/OR defined as a Science
• Implementation science is the scientific study of
methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice in clinical, community and policy contexts, and, hence, to improve the quality and effectiveness of health services and care
• addresses the level to which health interventions can fit within real-world public health and clinical service systems
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IR/OR defined in terms of what it can achieve
• Action-oriented
• Respond to operational problem and challenges
• Work towards developing targeted solutions
• Knowledge translation (KT)
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IR/OR – what it is not
• Does not test the efficacy of a potential intervention, but rather seeks to improve the effectiveness of a proven strategy or treatment
• may need to use study designs that will not always allow for strict control all variables, which, in turn, may affect the generalizability of results
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Framework for Operations and Implementation
Research in Health and
Disease Programs
(Logos show Partners)
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Developing a core curriculum for IR
Research Institutions
Control Programmes
IR country teams
AcademicInstitutions
HealthcareProviders
Policy makers
CURRICULA TOEMBED IR TRAINING INTO MASTERS PROGRAMMES
CURRICULA TOTRAIN IR TEAMS
CURRICULA TO TRAIN IR USERS
Partners – USAID, PEPFAR, IR Platform, others
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Building IR country teams: the modular cyclic concept
ProposalDevelopment
Community Of
Practice
Fundamentals of IR
Mentorship
Utilization
Reporting Dissemination
Publication
Statistical Analysis
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Thank You
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