Introduction to OR/IR: purpose and definitions

www.ias2011.org

Introduction to OR/IR: purpose and definitions

Jane Kengeya-Kayondo, WHO/TDR

www.ias2011.org

Scope of the presentation

• The value of IR/OR• Definition of IR/OR• 2 activities

-one completed

-one ongoing

www.ias2011.org

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)

www.ias2011.org

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)

www.ias2011.org

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.

www.ias2011.org

OR/IR can accomplish thefollowing:

• 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

www.ias2011.org

IR/OR defined broadly

Any research producing practically-usableknowledge (evidence, findings, information,etc) which can improve programimplementation (e.g., effectiveness,efficiency, quality, access, scale-up,sustainability) regardless of thetype of research (design, methodology, approach)falls within the boundaries ofImplementation/operations research.

www.ias2011.org

ResearchUtility

Research Domain

Operational

Health system

Local Broad

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

www.ias2011.org

Research Domain PRIMARY CHARACTERISTIC

Focus for the research Users of the research Research utility*

Operational operational issues of specific health programmes

health care providers Local

Implementation implementation strategies for specific interventions e.g. products or services

implementers: e.g. programme managers, R&D managers

Local/broad

Health Systemcrosscutting 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

www.ias2011.org

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

www.ias2011.org

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)

www.ias2011.org

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

www.ias2011.org

Framework for Operations and Implementation

Research in Health and

Disease Programs

(Logos show Partners)

www.ias2011.org

Developing a core curriculum for IR

Research Institutions

Control Programmes

IR country teams

AcademicInstitutions

HealthcareProviders

Policy makers

CURRICULA TOEMBED IR TRAINING INTO MASTERS PROGRAMMES

CURRICULA TOTRAIN IR TEAMS

CURRICULA TO TRAIN IR USERS

Partners – USAID, PEPFAR, IR Platform, others

www.ias2011.org

Building IR country teams: the modular cyclic concept

ProposalDevelopment

Community Of

Practice

Fundamentals of IR

Mentorship

Utilization

Reporting Dissemination

Publication

Statistical Analysis

www.ias2011.org

Thank You

www.who.int/tdr