Realizing the potential of embedded implementation research: Lessons from Pakistan

At the inception meeting for the project in Pakistan that this supplement draws from, a provincial immunization manager complained about researchers. He was scathing in his assessment that researchers were not helpful to him, that their research was irrelevant to the problems he faced in his work, and moreover, that researchers did not engage with him or share their research. His contention was that their only concern was in publishing papers. These questions about the usefulness of research and the behaviour of researchers may rarely be expressed so bluntly, but they reflect common concerns for policy-makers and programme managers 1. The incentives of research and practice are often misaligned, and there is a disproportionate focus on research that addresses the “what” rather than the “how”, or on problems rather than solutions 2. A nascent field, ‘embedded implementation research’ (the integration of research methods and approaches within existing health programme implementation and policymaking cycles in order to improve service delivery and overcome bottlenecks), represents an attempt to address these issues. If implementation research itself aims to squarely focus on the “how” of implementation 3, ‘embedded’ implementation research aims to supplement this focus by prioritizing the involvement and perspective of implementers in the research process itself 4,5. This occurs through the positioning of research within the context of actual health programmes to solve challenges to service delivery, meaningful engagement and leadership by practitioners and decision-makers to ensure the relevance and application of research studies, and the alignment of research activities with implementation, funding and policy cycles, with continuing engagement. The studies in this supplement illustrate the purpose and potential of embedded implementation research while also highlighting some of the challenges.

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Rasanathan, K., N. Tran, H. L. Johnson, A. Hafeez, S. Peterson, A. Ghaffar (2021) Realizing the potential of embedded implementation research: Lessons from Pakistan. Journal of Global Health 10(2): 10.7189/jogh.10.020104.