The importance of research in identifying solutions and options for overcoming implementation obstacles in health systems and programmes is widely recognized. This form of research addresses implementation bottlenecks, identifies optimal approaches for a particular setting, and promotes the uptake of research findings. Ultimately, it leads to improved health care and its delivery.

While IR has been defined in various ways by different institutions, common interpretations focus on a systematic approach to understanding and addressing barriers to effective and quality implementation of health interventions, strategies and policies. IR is demand-driven and the underlying research questions are framed around and based on needs identified together with relevant stakeholders and implementers who are themselves embedded in the local context. Uniquely, programme implementers are an integral part of the research process itself.

IR has been applied to increase the effectiveness of bed nets used to reduce malaria in Africa; address the rise in multidrug-resistant TB in eastern Europe; prevent mother-to-child transmission of HIV in South Africa; and ensure that the medicine ivermectin is distributed to 60 million Africans to control onchocerciasis (river blindness). It is a very powerful and essential form of research that identifies contextual implementation barriers, helps design and put in place strategies to address them, and ultimately leads to improved health outcomes.