Building Health System Capacity Through Implementation Research: Experience of INSPIRE—A Multi-country PMTCT Implementation Research Project

Abstract

Background:The INSPIRE-Integrating and Scaling Up PMTCT through Implementation REsearch-initiative was established as a model partnership of national prevention of mother-to-child transmission of HIV (PMTCT) implementation research in 3 high HIV burden countries-Malawi, Nigeria, and Zimbabwe. INSPIRE aimed to link local research groups with Ministries of Health (MOH), build local research capacity, and demonstrate that implementation research may contribute to improving health care delivery and respond to program challenges. Methodology:We used a mixed methods approach to review capacity building activities, as experienced by health care workers, researchers, and trainers conducted in the 6 INSPIRE projects before and during study implementation.Results: Between 2011 and 2016, over 3400 health care workers, research team members, and community members participated in INSPIRE activities. This included research prioritization exercises, proposal development, good clinical practice and research ethics training, data management and analysis workshops, and manuscript development. Health care workers in clinics and district health offices acknowledged the value of hosting implementation research projects and how the quality of services improved. Research teams acknowledged the opportunities that projects provided for personal development and the value of participating in a multicountry research network.Discussion: INSPIRE provided an opportunity for African-led research in which researchers worked closely with national MOH to identify priority research questions and implement studies. Close partnerships between research teams and local implementers facilitated project responsiveness to local program issues. Consequently, processes and training needed for study implementation also improved local program management and service delivery. Additional benefits included improved data management, publications, and career development.

Building capacity in dissemination and implementation science: a systematic review of the academic literature on teaching and training initiatives

“…Appraising existing CBIs is one way which can help to understand individual needs for D&I research and practice [ 14 , 50 , 51 , 55 ] and identify priorities for D&I capacity building [ 50 , 51 ]. Articles in our review evaluated CBIs to varying degrees.…”

“…‘educators’ ). Such training endeavours include short courses, workshops and webinars or they may form part of academic programmes [ 16 – 18 , 46 – 49 ]—all of these can be important in ensuring individuals have the requisite knowledge and skill-set to successfully implement scientific discoveries across diverse populations [ 14 – 17 , 50 , 51 ]. Given the value of D&I CBIs, it is of interest to examine the type and range of training opportunities available [ 15 – 18 ] and how these extend to a wide range of individuals (implementers, researchers and educators) [ 14 , 17 , 52 – 56 ].…”

Delivering preexposure prophylaxis to pregnant and breastfeeding women in Sub-Saharan Africa

“…Similar to operational research that helped optimize delivery of ART to pregnant and breastfeeding women [36, 37], we need additional studies that operationalize how best to (1) deliver PrEP (e.g. through pharmacies, in community pick up points, or within clinical visits), (2) monitor PrEP adherence, and (3) counsel pregnant and breastfeeding women to optimize PrEP initiation, retention and effective use during periods of condomless sex with HIV-infected partners or partners of unknown serostatus.…”

Brief Report: Integration of PrEP Services Into Routine Antenatal and Postnatal Care: Experiences From an Implementation Program in Western Kenya

“…5–7 Programmatic delivery of PrEP for pregnant and postpartum women is being considered in high-prevalence regions 8 ; however, implementation approaches have not been defined. Similar to operational research that optimized prevention of mother-to-child HIV transmission (PMTCT) programs 9,10 , research is needed to optimize PrEP delivery to this unique population. 4…”