The Indian Council for Medical Research (ICMR) will soon begin research to develop different options for addressing the implementation issue relevant to issues like how can mothers, newborns and children needing health care be reached in hard-to-reach places, and also to evaluate these options using appropriate study designs.

Senior ICMR officials said that improving maternal, newborn and child survival is a global and national priority. There are known, effective health interventions which can substantially improve survival, but these interventions are not reaching all those in need. Recognizing the role of implementation research in improving access to efficacious interventions, a national initiative supported by the World Health Organization (WHO) has been launched.

In this initiative, implementation research is defined as research that identifies common implementation problems and their main determinants which hinder effective access to interventions, and develops and tests practical solutions to these problems; and determines the best way of introducing these practical solutions into the health system and facilitates their full-scale implementation, evaluation and modification as required.

Earlier, the ICMR had conducted a national workshop in July 2011 to identify implementation research priorities. Programme managers, technical experts and national research organizations took part in the workshop. Key barriers for scaling up of interventions in the country were identified and research questions to address these barriers were listed. These questions were scored by participants based on six standard criteria, including answerability by research, potential impact, relevance to barriers to scaling up, innovation and originality, potential effect on equity, and likelihood of use of research results by policy-makers and programme managers.

How can doctors, nurses and technicians be attracted and retained in rural and hard to reach areas; how can mothers, newborns and children needing health care be reached in hard to reach places; how can the coverage and quality of home visits, particularly on the first day after birth, be improved; how can mobile phones be used to improve the delivery of maternal, newborn and child health services; how can quality maternal, newborn and child health care be provided in first level facilities in remote and hard to reach areas which do not have doctors; how can children with severe acute malnutrition be managed using a community-based strategy for identification and treatment; how can 24/7 availability of medicines and other necessary supplies to all health workers be ensured; how can health workers, at facility and community level, be supervised on a regular basis with high quality; how can motivation and performance of health care workers be achieved and maintained using financial and/or non-financial incentives; and how can quality of health care received by mothers, newborns and children in health facilities be improved were some of the questions emerged as the highest priorities in the workshop.

The ICMR has invited Letters of Intent from research institutions and teams within the country, who are involved or interested in implementation research for conducting implementation research studies that would address the above-mentioned priority questions.   It is expected that the proposed studies will develop different options for addressing the implementation issue relevant to the questions and evaluate these options using appropriate study designs.