Outcomes of IR

IR uses scientific inquiry to guide the problem-solving process, with a view to providing evidence for policy and programmatic decisions. In this way, IR lends itself to change through continuous learning and, where necessary, adaptation. Such change can be best achieved when implementers or programme personnel:

  • identify and describe an implementation problem clearly;
  • are engaged in the process of formulating research question(s) to address the problem;
  • work closely with researchers and specialist academics to conduct related IR.

The IR must have clear measurable outcomes.4 These can be conceptualized at three levels:5

  1. Client outcomes: Individual level; can be measured from client satisfaction whilst accessing the services, improvement in performance of the service provider / personnel and/or symptoms experienced.
  2. Service outcomes: Measured using the following quality dimensions: efficiency, safety, effectiveness, equity, patient-centeredness and timeliness.6
  3. Implementation outcomes: Measured using indicators of acceptability, adoption, appropriateness, costs, feasibility, fidelity, penetration and sustainability (See Table 1).

In the IR context, an ‘intervention’ is broadly defined as any health technology (medicine, vaccine or diagnostics), treatment and/or prevention practice and strategy, or efforts executed at the individual, community or institutional levels. Interventions include policy changes, strategies or scaling up health innovations that have demonstrated efficacy in the laboratory, clinical trials or small-scale pilot studies.7 Lack of compliance awareness or contextual issues related to culture, politics and geography can constitute barriers to the effective delivery of these interventions. It is critical to identify the intervention outcome indicators of key relevance to an IR project (see Table 2).

TDR Implementation research toolkit(Second edition)

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