Introduction to OR/IR: purpose and definitions Jane Kengeya-Kayondo, WHO/TDR

Scope of the presentation The value of IR/OR Definition of IR/OR 2 activities -one completed -one ongoing

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)

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)

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.

OR/IR can accomplish the following: 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

IR/OR defined broadly Any research producing practically-usable knowledge (evidence, findings, information, etc) which can improve program implementation (e.g., effectiveness, efficiency, quality, access, scale-up, sustainability) regardless of the type of research (design, methodology, approach) falls within the boundaries of Implementation/operations research.

Research Utility Research Domain Operational Health system LocalBroad 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

Research Domain PRIMARY CHARACTERISTIC Focus for the researchUsers of the researchResearch utility* Operational operational issues of specific health programmes health care providersLocal Implementation implementation strategies for specific interventions e.g. products or services implementers: e.g. programme managers, R&D managers Local/broad Health System crosscutting 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

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

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)

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

Framework for Operations and Implementation Research in Health and Disease Programs (Logos show Partners)

Developing a core curriculum for IR Research Institutions Control Programmes IR country teams Academic Institutions Healthcare Providers Policy makers CURRICULA TO EMBED IR TRAINING INTO MASTERS PROGRAMMES CURRICULA TO TRAIN IR TEAMS CURRICULA TO TRAIN IR USERS Partners – USAID, PEPFAR, IR Platform, others

Building IR country teams: the modular cyclic concept Proposal Development Community Of Practice Fundamentals of IR Mentorship Utilization Reporting Dissemination Publication Statistical Analysis

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