Spotlight on Implementation Science: Dr. E. Anne Peterson, MD, MPH
November 5, 2018
Why is implementation science important from the perspective of a health program implementation organization like Americares?
Americares is an organization that primarily funds its own work through private donations, which means it has a fair amount of autonomy and flexibility in deciding how and where to spend money for the greatest impact. As Americares responds to complex health needs, we regularly find ourselves implementing interventions in spaces where there is an absence of evidence, or there may be standards of practice, but little to no evidence on whether the standards of practice are effective in achieving the desired outcomes or impacts. Funding decisions require knowing the evidence and effectiveness of interventions. When the evidence is lacking, we do implementation science out of dire necessity.
One example is with Americares’ response to the major earthquake in Nepal in 2015. In addition to rebuilding health system infrastructure, Americares supported mental health interventions among villages affected by the earthquake, which was a roughly half-million-dollar investment and included non-conventional components such as the use of theater as a psychosocial intervention. In cases like these, we must be able to understand whether the intervention was successful and worth the investment in order to make it part of our regular response.
Once we successfully had the data to demonstrate the programmatic effectiveness of this intervention, our next question become one of generalizability. Will what worked in one context work in others? In any evaluation we have to remember there are different levels of evidence, and where possible we need to find opportunities for the synthesis of evidence from a larger body of studies that cover a range of contexts to if and how the intervention can be replicated in diverse circumstances.