Embedded health service development and research: why and how to do it (a ten-stage guide)
Abstract In a world of changing disease burdens, poor quality care and constrained health budgets, finding effective approaches to developing and implementing evidence-based health services is crucial. Much has been published on developing service tools and protocols, operational research and gettin...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-07-01
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| Series: | Health Research Policy and Systems |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12961-018-0344-7 |
| _version_ | 1818195988704133120 |
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| author | John Walley Mohammad Amir Khan Sophie Witter Rumana Haque James Newell Xiaolin Wei |
| author_facet | John Walley Mohammad Amir Khan Sophie Witter Rumana Haque James Newell Xiaolin Wei |
| author_sort | John Walley |
| collection | DOAJ |
| description | Abstract In a world of changing disease burdens, poor quality care and constrained health budgets, finding effective approaches to developing and implementing evidence-based health services is crucial. Much has been published on developing service tools and protocols, operational research and getting policy into practice but these are often undertaken in isolation from one another. This paper, based on 25 years of experience in a range of low and middle income contexts as well as wider literature, presents a systematic approach to connecting these activities in an embedded development and research approach. This approach can circumvent common problems such as lack of local ownership of new programmes, unrealistic resource requirements and poor implementation. We lay out a ten-step process, which is based on long-term partnerships and working within local systems and constraints and may be tailored to the context and needs. Service development and operational research is best prioritised, designed, conducted and replicated when it is embedded within ministry of health and national programmes. Care packages should from the outset be designed for scale-up, which is why the piloting stage is so crucial. In this way, the resulting package of care will be feasible within the context and will address local priorities. Researchers must be entrepreneurial and responsive to windows of funding for scale-up, working in real-world contexts where funding and decisions do not wait for evidence, so evidence generation has to be pragmatic to meet and ensure best use of the policy and financing cycles. The research should generate tested and easily usable tools, training materials and processes for use in scale-up. Development of the package should work within and strengthen the health system and other service delivery strategies to ensure that unintended negative consequences are minimised and that the strengthened systems support quality care and effective scale up of the package. While embedded development and research is promoted in theory, it is not yet practiced at scale by many initiatives, leading to wasted resources and un-sustained programmes. This guide presents a systematic and practical guide to support more effective engagements in future, both in developing interventions and supporting evidence-based scale-up. |
| first_indexed | 2024-12-12T01:26:56Z |
| format | Article |
| id | doaj.art-39cefe2459c24ff1b5a5184caa1b655e |
| institution | Directory Open Access Journal |
| issn | 1478-4505 |
| language | English |
| last_indexed | 2024-12-12T01:26:56Z |
| publishDate | 2018-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Health Research Policy and Systems |
| spelling | doaj.art-39cefe2459c24ff1b5a5184caa1b655e2022-12-22T00:43:03ZengBMCHealth Research Policy and Systems1478-45052018-07-011611810.1186/s12961-018-0344-7Embedded health service development and research: why and how to do it (a ten-stage guide)John Walley0Mohammad Amir Khan1Sophie Witter2Rumana Haque3James Newell4Xiaolin Wei5Leeds Institute of Health Sciences, University of LeedsAssociation for Social DevelopmentInstitute for Global Health and Development, Queen Margaret University EdinburghUniversity of DhakaLeeds Institute of Health Sciences, University of LeedsDalla Lana School of Public Health, University of TorontoAbstract In a world of changing disease burdens, poor quality care and constrained health budgets, finding effective approaches to developing and implementing evidence-based health services is crucial. Much has been published on developing service tools and protocols, operational research and getting policy into practice but these are often undertaken in isolation from one another. This paper, based on 25 years of experience in a range of low and middle income contexts as well as wider literature, presents a systematic approach to connecting these activities in an embedded development and research approach. This approach can circumvent common problems such as lack of local ownership of new programmes, unrealistic resource requirements and poor implementation. We lay out a ten-step process, which is based on long-term partnerships and working within local systems and constraints and may be tailored to the context and needs. Service development and operational research is best prioritised, designed, conducted and replicated when it is embedded within ministry of health and national programmes. Care packages should from the outset be designed for scale-up, which is why the piloting stage is so crucial. In this way, the resulting package of care will be feasible within the context and will address local priorities. Researchers must be entrepreneurial and responsive to windows of funding for scale-up, working in real-world contexts where funding and decisions do not wait for evidence, so evidence generation has to be pragmatic to meet and ensure best use of the policy and financing cycles. The research should generate tested and easily usable tools, training materials and processes for use in scale-up. Development of the package should work within and strengthen the health system and other service delivery strategies to ensure that unintended negative consequences are minimised and that the strengthened systems support quality care and effective scale up of the package. While embedded development and research is promoted in theory, it is not yet practiced at scale by many initiatives, leading to wasted resources and un-sustained programmes. This guide presents a systematic and practical guide to support more effective engagements in future, both in developing interventions and supporting evidence-based scale-up.http://link.springer.com/article/10.1186/s12961-018-0344-7Health servicesEmbedded development and researchOperational researchResearch into practiceKnowledge co-productionIntervention scale-up |
| spellingShingle | John Walley Mohammad Amir Khan Sophie Witter Rumana Haque James Newell Xiaolin Wei Embedded health service development and research: why and how to do it (a ten-stage guide) Health Research Policy and Systems Health services Embedded development and research Operational research Research into practice Knowledge co-production Intervention scale-up |
| title | Embedded health service development and research: why and how to do it (a ten-stage guide) |
| title_full | Embedded health service development and research: why and how to do it (a ten-stage guide) |
| title_fullStr | Embedded health service development and research: why and how to do it (a ten-stage guide) |
| title_full_unstemmed | Embedded health service development and research: why and how to do it (a ten-stage guide) |
| title_short | Embedded health service development and research: why and how to do it (a ten-stage guide) |
| title_sort | embedded health service development and research why and how to do it a ten stage guide |
| topic | Health services Embedded development and research Operational research Research into practice Knowledge co-production Intervention scale-up |
| url | http://link.springer.com/article/10.1186/s12961-018-0344-7 |
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