The Research and Evaluation Strategic Initiative team published 14 posts during the last quarter in our blog, R&E Search for Evidence. For those not familiar with our blog, it features FHI 360 thought leaders who write about research and evaluation methodology and practice, compelling evidence for development programming and new findings from recent journal publications. We have published 31 original posts to date.
Research
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Standing up for science
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Now, more than ever, is a time to stand up for science. The U.S. administration’s proposed budget for fiscal year 2018 calls for severe cuts to several key science-generating institutions, including the U.S. National Institutes of Health, the U.S. Centers for Disease Control and Prevention, the U.S. Agency for International Development and the U.S. Environmental Protection Agency. These cuts would result in a deterioration of the science that has allowed the United States to be the global leader in medicine, public health and environmental science. They would also stall progress in global development, an area which has benefited greatly from the many lifesaving solutions produced through science.
Given the administration’s apparent disregard for science, we should take a step back and ask ourselves what may seem like a simple question: What is science and why does it matter? Of the many definitions, the most basic is the standard dictionary definition: a systematically organized body of knowledge on a particular matter. More importantly though, science is a process or way of thinking that seeks to reveal the “truth.” Not knowing the truth about something is like driving through a heavy fog. Science can cut through this fog and reveal the truth.
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Four major famines have taken place so far in 2017, which has renewed attention on the urgent need to address food security globally. However, food security involves much more than responding to famines, and it is closely linked to factors such as governance, which plays a significant role in fragile states and developing countries. FHI 360 held a Facebook Live discussion on how integrating governance, agriculture and food security can benefit food security programs. The conversation was moderated by Gregory Adams, Director of the Locus Coalition at FHI 360, with FHI 360 experts Joseph Sany, Technical Advisor, Peacebuilding and Conflict Mitigation, and Annette Brown, Director, Research and Evaluation Strategic Initiative.
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FHI 360’s Research and Evaluation Strategic Initiative team is pleased to report that we have already published 15 posts in FHI 360’s newest blog, R&E Search for Evidence, since its launch in February. The R&E Search for Evidence blog features posts that engage readers with discussions of innovative methodologies, evidence reviews and analyses of recent journal publications. We focus on delivering in-depth coverage of research and evaluation methods and findings to better address the world’s most complex human development challenges.
Stay tuned for what’s to come on “R&E Search for Evidence” in future weeks. Weekly blog posts will continue to feature the analysis of FHI 360 thought leaders to promote a culture of generating and using evidence for making development solutions a reality. Upcoming posts will explore the evaluation of quality improvement programming, additional guidance on sampling, promising evidence on integrated development and much more!
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The full version of this post originally appeared on R&E Search for Evidence. Reposted with permission.
The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is a remarkable success story built on the effective use of data. The achievements of this landmark initiative have played a central role in getting us to the point where we can finally talk about controlling the HIV epidemic and creating an AIDS-free generation.
Through 2016, US$70 billion has been invested in this unprecedented disease control effort. The accomplishments to date have been extraordinary and unimaginable just a few years ago: In 2016 alone, 74 million people were tested for HIV infection; since the start of PEPFAR, 2 million babies were born HIV-free due to women receiving prevention of mother-to-child HIV transmission (PMTCT) treatment; 12 million voluntary medical male circumcisions have been performed; and PEPFAR accounted for 12 million of the 18 million people globally receiving life-extending antiretroviral therapy (ART).
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When we tackle complex, global challenges and their many root causes, intuition tells us that development initiatives need to be more holistic — the approaches may need to be as interconnected as the problems. Even the Sustainable Development Goals (SDGs) agenda states its aims are integrated and indivisible. Yet, the critically important question, “What evidence supports integrated development in practice?” can best be answered through the saying “context is king.”Integration is an umbrella phrase that can describe thousands of different cross-sector approaches — from health and microfinance, to nutrition and education, to conservation and livelihoods. Consider how evidence showing huge impacts in the integration of savings groups with girls’ education would be relevant for people trying to decide whether to integrate agriculture and environmental conservation. Context matters. A lot. What is being integrated with what? How? For what purpose?
Global development decisionmakers must resist the temptation for a simple, universal answer to whether integration works. The notion that any one gold-standard study on its own will answer the integrated development hypothesis is false. Evidence for cross-sector approaches will always depend on the specific sectors, geography and people in question.
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Creating healthier Nigerian communities through laboratory strengthening
An Interview with
Kwasi Torpey, Director, Technical Support Division, FHI 360
Laboratory strengthening is a component of Strengthening Integrated Delivery of HIV/AIDS Services (SIDHAS), a five-year project to build local capacity for the delivery of sustainable, high-quality and comprehensive HIV/AIDS prevention, treatment, care and support services. FHI 360 implements SIDHAS in 13 states in Nigeria.
What is laboratory strengthening and how is SIDHAS meeting this need?
Lab strengthening is a form of support to improve the capacity of a lab for quality service delivery, helping to achieve optimal performance, increase productivity and efficiency, deliver accurate and replicable diagnostics services, achieve customer satisfaction and promote safety. Lab strengthening also provides infrastructural development, equipment maintenance and quality control services to allow timely delivery and accurate results.
FHI 360 has supported the improvement of labs through training and mentoring to facilitate good quality management systems and record keeping. This work in lab improvement aligns with the World Health Organization Africa Regional Office (WHO-AFRO) initiative known as Strengthening Laboratory Management Towards Accreditation (SLMTA). Working within SLMTA parameters with our Nigerian government counterparts provides regular collaboration and deepens the leadership, stewardship and sustainability of the country’s labs.
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At FHI 360, cultivating partnerships and building capacity are high priorities that lead to lasting impact globally. Capacity development in global health has many facets. In the more than 70 countries where we work, many of our global health, population and nutrition programs and research studies include the training of public health workers and scientists. We also value partnerships in the United States that foster the development of the next generation of public health leaders.This year marks the 10th anniversary of the FHI 360 and University of North Carolina (UNC) Gillings School of Global Public Health Research Fellowship Program. This relationship provides graduate students from the Gillings School with the opportunity to work side by side with leading global health researchers. For the last decade, FHI 360 and UNC have built and sustained a local partnership through which yearly at least two students from the Gillings School work at FHI 360 and are mentored by our global health research experts.
Through this program, FHI 360 has had the privilege of working with some of the brightest young minds in the growing field of global health research. Over the years, 23 fellows have worked on a wide range of topics, generated research protocols, analyzed data, written manuscripts for scientific journals and developed technical skills that are essential to global health research.
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What is implementation science, and what can it do for the field of global health?
Earlier this month, FHI 360 brought together over 150 public health specialists, researchers, scholars and donors in Washington, DC, for a day-long symposium to wrestle with these questions.
One clear conclusion emerged: There is no single definition for implementation science. Symposium speakers used definitions including: the scientific study of methods to promote the integration of research findings and evidence-based interventions into health care practice and policy (U.S. National Institutes of Health); the application of systematic learning, research and evaluation to improve health practice, policy and programs (U.S. Agency for International Development); and the study of methods to improve the uptake, implementation and translation of research findings into routine practices (U.S. President’s Emergency Plan for AIDS Relief).
Despite the lack of consensus on definitions, symposium participants agreed that implementation science can make essential contributions to global health. Setting implementation science apart from other research disciplines is its focus on how to implement proven interventions in real-world contexts, delivered at scale. Noting that implementation occurs within complex systems, Greg Aarons of the University of California, San Diego, introduced participants to frameworks that help us consider the interaction of factors that affect the success of the implementation process. (View the symposium’s presentations and webcast.)
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Earlier this month, the U.K. Department for International Development (DFID) released a report that seeks to answer a compelling question: Does research drive international development?Through an extensive literature review, the authors examined the evidence supporting the commonly held assumption that investing in research leads to positive impacts on socioeconomic development. One of the specific pathways they explored is whether investment in research leads to development through more evidence-informed policy and practice. While the authors provide several examples of how research has led to policy and program improvements, they also conclude that “there are significant gaps in the capacity, incentives and systems necessary to ensure that research is systematically used in decision making.”
To put it more simply, research can be a powerful development tool if the results are used. Generating new evidence or finding a new solution is half the battle. Only when that solution is adopted in policy and practice can research lead to impact. But, the reality is that no matter how compelling a body of evidence or research finding may be, information does not put itself into practice. As a result, large gaps or long time lags too often exist between what we know and what we do.
Obstacles to putting research into practice
The barriers to getting research into practice are well documented. They include limited end-user involvement in research, weak attempts to communicate research findings and advocate for their use, and research designs that fail to consider the potential for scale-up. Other barriers noted by the DFID report include the inadequate capacity of decision makers to understand and use research evidence and the lack of incentives to drive research utilization. Short of a miracle occurring, overcoming these barriers requires deliberate, planned and sustained efforts over time.