How to leverage implementation research for equity in global health

Area of Science:

• Global Health
• Implementation Science
• Health Equity Research

Background:

• Implementation research (IR) is crucial for global health equity.
• Existing frameworks lack specific guidance for operationalizing IR to address health inequities in global health settings.
• There's a need to understand pathways for improving health equity through IR.

Purpose of the Study:

• To provide an overview of guidance and frameworks for integrating health equity into IR.
• To propose a novel approach for guiding implementation teams in applying IR for health equity in global health.
• To identify key equity considerations and causal pathways for achieving health equity through IR.

Main Methods:

• Review of existing guidance and frameworks for health equity in IR.
• Development of a proposed approach for operationalizing IR for health equity.
• Analysis of causal pathways, intervention levers, and power dynamics in global health IR.

Main Results:

• Identified gaps in current guidance for applying IR to global health equity.
• Described key equity considerations across IR aspects (contexts, strategies, outcomes, designs).
• Highlighted power asymmetries as central to health inequities and proposed strategies to address them.

Conclusions:

• Explicitly integrating health equity into IR is essential for achieving global health goals.
• Addressing structural determinants and power imbalances within IR is critical for reducing health inequities.
• A routine, retrospective, and prospective approach to analyzing and intervening on health inequities within IR is recommended.