Decolonizing implementation science: Centering community in the transition from intervention delivery to structural transformation

Colonial legacies in global health have entrenched structural inequities through unequal resource distribution, Western epistemic dominance, and the marginalization of Global South voices. Although implementation science aims to close the evidence-practice gap, its dominant frameworks often reinforce these hierarchies rather than dismantle them. Current approaches insufficiently consider communities' positionality within global power structures, emphasize provider-level factors over social determinants, and overlook colonial histories and epistemic hierarchies. To advance decolonization, we propose a community-centred and equity-oriented recalibration of established implementation science frameworks. Specifically, Community, Reach, Effectiveness, Adoption, Implementation, Maintenance (CREAIM) is presented as an adaptation of the Reach, Effectiveness, Adoption, Implementation, and Maintenance RE-AIM framework, adding "Community" as a cross-cutting foundation that contextualizes Reach, Effectiveness, Adoption, Implementation, and Maintenance through explicit reflection on power, agency, and justice. In parallel, a decolonial recalibration of Consolidated Framework of Implementation Research (CFIR) emphasizes political economy analysis, locally led adaptation, equitable resource control, and co-created implementation processes. Together, these adaptations reposition implementation science from a technical instrument for intervention delivery into a vehicle for structural change. Embedding decolonial principles within implementation frameworks can reorient the field toward community leadership, epistemic justice, and sustainable global health equity.