When people live with multiple chronic diseases: a collaborative approach to an emerging global challenge

Abstract

One of the greatest challenges facing the global health community is how to take proven interventions and implement them in the real world. Research on health systems, such as implementation research, is crucial to meeting that challenge, providing a basis for the context-specific, evidence-informed decision-making needed to make what is possible in theory a reality in practice. The World Health Organization (WHO) has long played a leading role in promoting health policy and systems research (HPSR)—including implementation research, with notable recent initiatives including the 2011 report: Implementation Research for the Control of Infectious Diseases of Poverty and the 2012 publication of its first strategy on HPSR called ‘Changing Mindsets’, which advocated for greater embedding of research into decision- making and called for more demand-driven research. With this Guide, WHO continues its support for this area, offering an introduction to the often challenging field of implementa- tion research. Because implementation research is a relatively new and somewhat neglected field, there is a need to bring it into sharper focus, defining exactly what it is and what it can offer. As such, this Guide presents an introduction to basic concepts used in implementation re- search and describes the range of approaches and applications that it can be used for. The main aim of the Guide is to support the development of and demand for implementation research that is problem-focused, action-oriented and above all aligned with health system needs. Research on implementation requires the engagement of a wide range of stakeholders and draws on multiple disciplines in order to address complex implementation challenges. As this Guide points out, at its best, implementation research is often a collective and collab- orative endeavor and in many cases it is people working on the front line of health care, whether running specific programmes, or working in health systems, who ask the questions around which it is built. It is therefore essential that all stakeholders understand the im- portance of collaboration in the implementation research endeavor. It is our hope that this Guide will encourage that collaboration, and facilitate the coming together of stakeholders across the broad spectrum of health systems, all of which, on a daily basis, wrestle with the challenge of implementation.