Beyond the Science: Advancing the “Art and Craft” of Implementation in the Training and Practice of Global Health

Document Type: Perspective

Authors

1 Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada

2 Department of Planning, Research and Statistics, National Primary Health Care Development Agency, Abuja, Nigeria

3 Department of Health Policy, London School of Economics and Political Science, London, UK

Abstract

Interesting debates are ongoing on how to develop practical implementation science competencies that can bridge the “know-do” gap in global health. We advance these debates by arguing that apprenticeship and mentorship models drawn from “art and craft” used in industry is the missing piece of the puzzle that will bridge the persisting gap between academics and real-world practitioners. We propose examples of such models and how they can be applied to improve existing capacity building programs, as well as implementation in practice.

Keywords


  1. Puchalski Ritchie LM, Khan S, Moore JE, et al. Low- and middle-income countries face many common barriers to implementation of maternal health evidence products. J Clin Epidemiol. 2016;76:229-237. doi:10.1016/j.jclinepi.2016.02.017
  2. Ridde V. Need for more and better implementation science in global health. BMJ Glob Health. 2016;1(2):e000115. doi:10.1136/bmjgh-2016-000115
  3. Binagwaho A, Frisch MF, Udoh K, et al. Implementation research: an efficient and effective tool to accelerate universal health coverage. Int J Health Policy Manag. 2020;9(5):182-184. doi:10.15171/ijhpm.2019.125
  4. Van Belle S, van de Pas R, Marchal B. Towards an agenda for implementation science in global health: there is nothing more practical than good (social science) theories. BMJ Glob Health. 2017;2(2):e000181. doi:10.1136/bmjgh-2016-000181
  5. Smith M. What is praxis? Encyclopedia of Informal Education. https://infed.org/mobi/what-is-praxis/. Accessed July 4, 2020. Published 2011.
  6. Ramaswamy R, Mosnier J, Reed K, Powell BJ, Schenck AP. Building capacity for Public Health 3.0: introducing implementation science into an MPH curriculum. Implement Sci. 2019;14(1):18. doi:10.1186/s13012-019-0866-6
  7. Albers B, Shlonsky A, Mildon R. Implementation Science 3.0. Springer International Publishing; 2020.
  8. Turcotte-Tremblay AM, Fregonese F, Kadio K, Alam N, Merry L. Global health is more than just 'public health somewhere else.' BMJ Glob Health. 2020;5(5):e002545. doi:10.1136/bmjgh-2020-002545
  9. King NB, Koski A. Defining global health as public health somewhere else. BMJ Glob Health. 2020;5(1):e002172. doi:10.1136/bmjgh-2019-002172
  10. Fischer SE, Patil P, Zielinski C, et al. Is it about the 'where' or thSare 'how'? comment on defining global health as public health somewhere else. BMJ Glob Health. 2020;5(5). doi:10.1136/bmjgh-2020-002567
  11. Koplan JP, Bond TC, Merson MH, et al. Towards a common definition of global health. Lancet. 2009;373(9679):1993-1995. doi:10.1016/s0140-6736(09)60332-9
  12. Beaglehole R, Bonita R. What is global health? Glob Health Action. 2010;3:10.3402/gha.v3i0.5142. doi:10.3402/gha.v3i0.5142
  13. Ridde V, Pérez D, Robert E. Using implementation science theories and frameworks in global health. BMJ Glob Health. 2020;5(4):e002269. doi:10.1136/bmjgh-2019-002269
  14. Breton E, De Leeuw E. Theories of the policy process in health promotion research: a review. Health Promot Int. 2011;26(1):82-90. doi:10.1093/heapro/daq051
  15. Andersen F, Anjum RL, Rocca E. Philosophical bias is the one bias that science cannot avoid. Elife. 2019;8:e44929. doi:10.7554/eLife.44929
  16. Stapleton G, Schröder-Bäck P, Laaser U, Meershoek A, Popa D. Global health ethics: an introduction to prominent theories and relevant topics. Glob Health Action. 2014;7:23569. doi:10.3402/gha.v7.23569
  17. McKee M, Stuckler D. The crisis of capitalism and the marketisation of health care: the implications for public health professionals. J Public Health Res. 2012;1(3):236-239. doi:10.4081/jphr.2012.e37
  18. Means AR, Kemp CG, Gwayi-Chore MC, et al. Evaluating and optimizing the consolidated framework for implementation research (CFIR) for use in low- and middle-income countries: a systematic review. Implement Sci. 2020;15(1):17. doi:10.1186/s13012-020-0977-0
  19. Gilson L. Health Policy and Systems Research: A Methodology Reader. Geneva: Alliance for Health Policy and Systems Research, World Health Organization; 2012.
  20. Kruk ME, Gage AD, Arsenault C, et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Glob Health. 2018;6(11):e1196-e1252. doi:10.1016/s2214-109x(18)30386-3
  21. Alonge O, Rao A, Kalbarczyk A, et al. Developing a framework of core competencies in implementation research for low/middle-income countries. BMJ Glob Health. 2019;4(5):e001747. doi:10.1136/bmjgh-2019-001747
  22. Eboreime E, Abimbola S, Bozzani F. Access to routine immunization: a comparative analysis of supply-side disparities between Northern and Southern Nigeria. PLoS One. 2015;10(12):e0144876. doi:10.1371/journal.pone.0144876
  23. Banke-Thomas A, Madaj B, Kumar S, Ameh C, van den Broek N. Assessing value-for-money in maternal and newborn health. BMJ Glob Health. 2017;2(2):e000310. doi:10.1136/bmjgh-2017-000310
  24. Watson DE, Broemeling AM, Wong ST. A results-based logic model for primary healthcare: a conceptual foundation for population-based information systems. Healthc Policy. 2009;5 Spec No:33-46.
  25. McCoy D, Kembhavi G, Patel J, Luintel A. The Bill & Melinda Gates Foundation's grant-making programme for global health. Lancet. 2009;373(9675):1645-1653. doi:10.1016/s0140-6736(09)60571-7
  26. Rao P. Philanthropists join forces to fund Africa’s cash-strapped health sector. Afr Renew. 2017;3(2):14-15.
  27. Kirkpatrick I, Lonsdale CC, Neogy I. Management consulting in health. In: Ferlie E, Montgomery K, Pedersen AR, eds. The Oxford Handbook of Health Care Management. Oxford, United Kingdom: Oxford University Press; 2016.
  28. Leeman J, Birken SA, Powell BJ, Rohweder C, Shea CM. Beyond "implementation strategies": classifying the full range of strategies used in implementation science and practice. Implement Sci. 2017;12(1):125. doi:10.1186/s13012-017-0657-x
  29. Bossidy L, Charan R. Execution: The Discipline of Getting Things Done. New York: Crown Publishing Group; 2002.
  30. Boulton R, Sandall J, Sevdalis N. The cultural politics of 'implementation science.' J Med Humanit. 2020;41(3):379-394. doi:10.1007/s10912-020-09607-9
  31. Westerlund A, Sundberg L, Nilsen P. Implementation of implementation science knowledge: the research-practice gap paradox. Worldviews Evid Based Nurs. 2019;16(5):332-334. doi:10.1111/wvn.12403
  32. Welch J, Byrne JA. Jack: Straight from the Gut. New York: Warner Books; 2001.
  33. Harris A, Jones MS, Adams D, Perera CJ, Sharma S. High-performing education systems in Asia: leadership art meets implementation science. Asia-Pac Educ Res. 2014;23(4):861-869. doi:10.1007/s40299-014-0209-y
  34. Currie GM. The art/science continuum. J Med Imaging Radiat Sci. 2014;45(4):352-353. doi:10.1016/j.jmir.2014.02.003
  35. Le Breton-Miller I, Miller D. The arts and family business: linking family business resources and performance to industry characteristics. Entrep Theory Pract. 2015;39(6):1349-1370. doi:10.1111/etap.12177
  36. Siddiqui S. Of mentors, apprenticeship, and role models: a lesson to relearn? Med Educ Online. 2014;19:25428. doi:10.3402/meo.v19.25428
  37. Ramaswamy R, Chirwa T, Salisbury K, et al. Developing a field of study in implementation science for the Africa region: The Wits–UNC AIDS Implementation Science Fogarty D43. Pedagogy Health Promot. 2020;6(1):46-55. doi:10.1177/2373379919897088
  38. Brownson RC, Proctor EK, Luke DA, et al. Building capacity for dissemination and implementation research: one university's experience. Implement Sci. 2017;12(1):104. doi:10.1186/s13012-017-0634-4
  39. Padek M, Mir N, Jacob RR, et al. Training scholars in dissemination and implementation research for cancer prevention and control: a mentored approach. Implement Sci. 2018;13(1):18. doi:10.1186/s13012-018-0711-3
  40. Subramanian RE, Herrera DG, Kelly PM. An evaluation of the global network of field epidemiology and laboratory training programmes: a resource for improving public health capacity and increasing the number of public health professionals worldwide. Hum Resour Health. 2013;11:45. doi:10.1186/1478-4491-11-45
  41. Shah SK, Nodell B, Montano SM, Behrens C, Zunt JR. Clinical research and global health: mentoring the next generation of health care students. Glob Public Health. 2011;6(3):234-246. doi:10.1080/17441692.2010.494248
  42. Eboreime EA. Bridging the 'two communities': how an emerging primary healthcare global research consortium can help achieve universal health coverage in low and middle-income countries. BMJ Glob Health. 2019;4(Suppl 8):e001573. doi:10.1136/bmjgh-2019-001573
  43. Kemmis S. Critical theory and participatory action research. In: Reason P, Bradbury-Huang H, eds. The SAGE Handbook of Action Research. 2nd ed. SAGE Publications Ltd; 2008. doi:10.4135/9781848607934.n14
  44. Baum F, MacDougall C, Smith D. Participatory action research. J Epidemiol Community Health. 2006;60(10):854-857. doi:10.1136/jech.2004.028662
  45. McTaggart R, Nixon R, Kemmis S. Critical participatory action research. In: Rowell L, Bruce C, Shosh J, Riel M, eds. The Palgrave International Handbook of Action Research. New York: Palgrave Macmillan; 2017:21-35. doi:10.1057/978-1-137-40523-4_2
  46. Coghlan D, Brydon-Miller M. Critical participatory action research. In: The SAGE Encyclopedia of Action Research. SAGE Publications Ltd; 2014. doi:10.4135/9781446294406.n92