Implementation research can enhance health research systems and reduce dependency on external aid

Implementation research is essential for moving research findings into everyday practice. It is intentionally geared towards local ownership and sustainability, and contributes to more effective health policies, improved service delivery, better resource allocation and strengthened health research systems. By engaging with non-specialist researchers who have in-depth understanding of the context in which interventions occur, implementation research utilises existing capacity and ingenuity for localised problem-solving. Although it is now changing, the traditional global health research paradigm has been of extractive research which undermined local knowledge and expertise and perpetuated asymmetrical research relationships. The failure of global research partnerships to focus on systems strengthening has hindered the ability of poorer countries to compete internationally for research funds, meaning that countries with the weakest health research systems have been hardest hit by the recent shrinking of international health research and programme funds. The gap between decolonial discourse and action is wide. The 'research for development' community is significantly under-exploiting the potential of stronger implementation research capability in the world's poorest countries to narrow this gap. A deliberate and sustained shift toward strengthening research systems with a greater focus on implementation research would be an effective way to promote genuine research partnerships. It could also contribute to reducing external dependency on programme delivery and agenda-setting and promote more equitable global health outcomes.