Implementation research for scaling-up of evidence based innovations and good practice in Europe and low- and middle-income countries
Research evidence and technological and process improvements during the past decades present a large opportunity for improving the functioning and sustainability of health systems[[A health system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health (WHO)]]. However, the uptake of well-researched and proven interventions addressing current challenges is still slow. Implementation research on scaling up evidence-based innovations and good practices intervention should facilitate the transferability of these practices across the borders of Europe and beyond.
Based on the concept of implementation research[[The scientific study of methods to promote the uptake of research findings (Walker AE, 2003). Process modelling in implementation research. doi:10.1186/1472-6963-3-22)]], proposals should seek to replicate and scale up a comprehensive intervention in the field of health systems that is innovative and well-researched, supported by sufficient documented evidence. This scaling up can take place within Europe as well as outside it, notably in low- and middle-income countries (LMIC). The topic does not cover micro-level interventions, e.g. to promote a specific therapeutic regimen for a single disease.
The selected intervention to be scaled up should be one that has proven to make health systems and health services more responsive, person-centred, safe, effective, and efficient. Its stated impact should be broad, addressing economic and social benefits and its effect on reducing inequalities. The research should identify the facilitators of and barriers to scaling-up, including context-specific factors and differing social and health systems environments in Europe or in LMIC.
Proposals should be multidisciplinary and relevant gender aspects should be taken into account. They also should reflect and take advantage of the regional diversity across Europe and/or the diversity of LMIC settings. Relevant stakeholders and end-users of research should be identified and involved throughout the project lifetime. Innovative approaches towards gathering their inputs for the scaling up process should be considered, notably of patients when relevant.
The organisational and resource requirements (data, personnel and financing) necessary for the implementation of the intervention must be tracked and evaluated in detail. The research and system-wide scientific monitoring should allow future users (researchers, healthcare providers, policy makers, and the public) to review the step-by-step, partial outcomes of the intervention, thus facilitating a wider adoption of these practices. The appropriate contextual, financial and political-economy[[ “Political economy analysis is concerned with the interaction of political and economic processes in a society; including the distribution of power and wealth between groups and individuals, and the processes that create, sustain and transform these relationships over time" (OECD –DAC)]] analysis should be provided.
The Commission considers that proposals requesting a contribution from the EU of between EUR 4 and 6 million would allow this specific challenge to be addressed appropriately. Nonetheless, this does not preclude submission and selection of proposals requesting other amounts.
- A larger group of citizens benefits from the studied health system intervention. The intervention should lead to improving the functioning and sustainability of health systems, and greater health equity and additional societal benefits.
- A validated framework and strategy for a large-scale implementation of an effective and safe evidence-based health systems intervention will be available to healthcare providers and policy makers that will facilitate the transferability of these practices.
- In the medium and long-term, the health systems will be more effective, efficient and equitable; health services are more responsive to the needs of users.