Innovative strategies must be developed to overcome obstacles to successful health interventions, according to participants at a recent NIH gathering of scientists and medical professionals. The two-day annual NIH Conference on Dissemination and Implementation Science, which was followed by a workshop on impact evaluation organized by Fogarty, included sessions on global health and a panel symposium featuring international experts.
Implementation science, or research designed to speed the translation of evidence-based findings into everyday practice, can strengthen health programs operating in low-resource settings and allow them to overcome barriers such as resource constraints and cultural practices.
The importance of setting priorities as part of effective implementation was emphasized by Dr. Jane Kengeya-Kayondo, a WHO epidemiologist who heads several tropical disease projects. “It’s very nice to do interesting things, but how do we know the things we are doing are the things that need doing?” she said. Kayondo is working with USAID and the U.S. President's Emergency Plan for AIDS Relief to embed research into their programs and improve uniformity in global health curricula and teaching materials. “If people are learning the same thing,” she explained, “they can share tools and adopt each other’s experiences.”
Dr. Vikram Patel, a professor of international mental health at the London School of Hygiene and Tropical Medicine, shared insights from his work in India. To offset a shortage of psychiatrists, Patel’s program used “task-shifting” - a process of training laypeople or less specialized health workers - to deliver mental health services to under-resourced communities. Another solution was delivering therapy sessions via telephone for day laborers who would lose wages if they took time off for counseling.
Panel chair Dr. Russell Glasgow, deputy director of dissemination and implementation science at the National Cancer Institute, praised the spread of “disruptive innovations” in developing countries, such as delivering health interventions at low cost. “We in the U.S. have at least as much to learn from the international examples about how we can apply things here,” he said.
Fogarty organized an adjacent workshop on impact evaluation using randomized trials. The training was supported by the Abdul Latif Jameel Poverty Action Lab, a network of empirical research economists based in Cambridge, Mass.