2. Addressing Implementation Science
Nelson Otwoma
NEPHAK, Kenya
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3. Outline Some Reflections The ‘Emergency – Science’ Tension
The Implementation Science Challenge
Mitigating Challenges
Proposed Actions
Conclusion and Next Steps

4. . This approach can also weigh opportunity costs against competing priorities elsewhere in the health sector23.
Some Reflections
The research – implementation continuum is increasingly becoming popular in health programming.
The traditional understanding of ‘Evidence Based Interventions’ leads the impression that program implementation comes after research
The best approach is where implementation is informed by and integrated with science i.e. happening at the same time ...
Often implementation of interventions may ‘precede’ science or policy and revise the continuum

5. The tension between ‘Emergency and Science’
. This approach can also weigh opportunity costs against competing priorities elsewhere in the health sector23.
The tension between ‘Emergency and Science’
Health interventions, including those designed to prevent and manage HIV are based on the public health imperative of saving lives, improving the health and well-being of communities.
To some extent, health interventions are conceived of as ‘emergency response’
Recent arguments equate access to health services is an aspect of health justice.
The human rights perspective of access to health services reinforces the public health imperative that a health intervention is an emergency.
The perception of health services as an emergency response tends to suggest that science and research may be necessary but not mandatory …

6. The Implementation Science Challenge
Adherence procedures and processes need additional resources, including time and staffing
Translating implementation science into policy may take long and tedious process
Program implementers may be reluctant to incorporate implementation science especially if it comes with additional tasks (data capture and documentation etc)
Often, implementers may be reluctant to change their ways of doing business (especially if it has been ‘working’).
Socio-cultural and political challenge: Whose science counts?

7. Application of Implementation Science
In policy and programming, time is of essence
It is because of the many and un-ending considerations and reflections that we should stop worrying about the definition and get to work … take Implementation Science for policy and programme application at scale.
In the long term, implementation science makes policies and programs better!

8. Mitigating the Challenges
Undertake Environmental Scan (PESTEL) to understand the context
Invest in resources, including personnel capacity and numbers
Leverage political commitment (leadership and community ownership)
Foster Community Ownership by identifying, engaging and motivating champions

9. notwoma@nephak.or.ke @Njotwoma
Thank you!
@Njotwoma