Addressing The Tensions And Complexities Involved In Commissioning And Undertaking Implementation Research In Low- And Middle-Income Countries

### Summary boxAgainst a background of rapid scale-up of new policies and guidelines in the context of weak health systems in low/middle-income countries (LMIC), implementation research is especially important for understanding the ‘evidence-implementation’ gap. Implementation research investigates the various factors that affect how a new health policy or intervention may be implemented in usual practice settings and the contextual factors that affect implementation at scale.1–4 A wide range of qualitative and quantitative methods can be used in implementation research including: pragmatic trials, quality improvement studies, participatory action research and mixed methods evaluation studies where both quantitative and qualitative methods of data collection and analysis are used in the same study.1There has been an increase in funder requests for research proposals that document and evaluate implementation strategies and impacts of large-scale health interventions aimed at supporting the delivery of health services, programmes and policies.5 The concomitant emergence of ‘global health’ as a field within North American and European universities (referred to here as the ‘Global North’) has led to a plethora of institutions who commission, undertake and collaborate on implementation research within LMIC settings (referred to here as the ‘Global South’), sometimes as part of countries’ overseas development assistance (ODA). …