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Health systems and environmental sustainability: updating frameworks for a new era

Embedding implementation research to cross the quality of care chasm during the covid-19 pandemic and beyond

Michael Peters and colleagues argue that concerted efforts to embed implementation research can improve health services, even in the most challenging operating environments As countries emerge from the acute phase of the SARS-CoV-2 (covid-19) pandemic, there is a need to reflect on global systems of knowledge production and uptake. The rapidly evolving context of the covid-19 pandemic response demanded timely interpretation and translation of evidence into policy and action to reduce morbidity and mortality, yet existing systems were largely unable to keep up with demand.1 Decision making informed by health services research was essential during this time of flux but is also important for continuous improvement of quality healthcare delivery. Before 2020, poor quality healthcare contributed to more lives lost in low and middle income countries (LMICs) than lack of access to health services.2 The size of the gap between the care patients should receive and the care patients actually receive was characterised in the American health system as a “quality chasm” as early as 2001.3 This chasm also exists globally: the Lancet global health commission on high quality health systems found that poor quality care is common across countries and is preventing people from realising optimal health.45 The covid-19 pandemic further widened the quality chasm, emphasising the need for strategies to improve delivery of health services. 267 In a research environment that historically prioritises the development of new technologies or interventions over improving the delivery of existing interventions, emphasis should be placed on strategies that enable health research to improve implementation.8 Delivering evidence based health interventions with a minimum acceptable level of quality to improve outcomes is particularly challenging, making quality improvement a prime target for implementation research.910 Bridging this gap is achieved by understanding what works in “real …

Stock the Trailer returns to county fair - Seymour Tribune

From Samoa to West Coast to serve: Rural programme strikes a chord with Pacific students

Samoan-born medical student Michaela Peters took a leap last month, moving from Wellington to Greymouth to spend a year in rural general practice

How Service Delivery Implementation Strategies Can Contribute to Attaining Universal Health Coverage: Lessons from Polio Eradication Using an Implementation Science Approach

"Health care providers and community health workers...need to transform beyond providing health services (competence and knowledge) to become trust agents (morality and compassion for the people they serve) fostering community ownership and engagement while serving as pillars to strengthen service delivery."

From moneysaving apps to switching the boiler off at night, your tips to help save money

Indie Spotlight: April 2022

A Multi-Pronged Scoping Review Approach to Understanding the Evolving Implementation of the Smallpox and Polio Eradication Programs: What Can Other Global Health Initiatives Learn?

"[G]lobal health programs can continue to learn from each other's implementation experiences more effectively when this experience is captured and made available in user-friendly formats." Two global eradication efforts, the Smallpox Eradication Program (SEP), which was launched in 1959, and the Global Polio Eradication Initiative (GPEI), which was

Conflict, Community, and Collaboration: Shared Implementation Barriers and Strategies in Two Polio Endemic Countries

Owoaje, Akinyemi); Global Innovations Consultancy Services ( Rahimi); Johns Hopkins Bloomberg School of Public Health ( Kalbarczyk, Peters, Alonge) "The power of community engagement at all levels (from leadership to membership) cannot be overstated, particularly in countries facing civil unrest and insecurity." Despite efforts over decades by the Global Polio Eradication Initiative (GPEI), transmission of wild poliovirus (WPV) is ongoing in Afghanistan, and circulating vaccine-derived poliovirus (cVDPV) is still occurring in Nigeria. Despite their unique sociocultural characteristics, these countries share risk factors for the spread of polio, including civil unrest and conflict; vaccine refusals, mistrust, and fatigue; and competing political agendas. This paper shares research conducted by the Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE) consortium (