31 January, 2020

Meet Dr. Archana Shrestha

The incoming chair of the GRIT consortium shares her 2020 vision for global health research and implementation science

Female smiling directly at camera facing forward
Dr. Archana Shrestha

Implementation Science (IS) strives to synergize research and practice to improve population health outcomes. For this, Implementation scientists must embrace diversity and work with scientific communities, local government, the public, and other relevant stakeholders. As a researcher, we should put organizations and community members on equal footing by building strategies and adopting approaches that cultivate relationships and trust between the scientists and implementers/users contributing to equal partnerships.

For implementation science to reach its full potential to improve population health, it must shift gears from just creating evidence, publishing in scientific journals and synthesizing research to greater and meaningful stakeholder engagement and reporting to lay communities. This shift will improve the relevance of the research that will help guide decision-makers in their selection and application of research-tested interventions and strategies.

Woman behind podium making a presentation using power point
Dr Shrestha presenting on the Capacity Building efforts in Nepal at the 1st Annual TREIN/Hy-TREC Meeting

As we struggle to close the gap between evidence and practice, it is essential, especially in a low-resource setting, to increase institutional and professional capacity to plan, implement and evaluate evidence-based practices. Capacity building should target institutions and people beyond academia and reach policymakers, program implementers, and evaluators at the government level, private and non-profit sectors. Rather than evaluating a program at the end of a long period of operation by an ‘expert’, the planners and implementors should be skilled to constantly evaluate fidelity and quality that allows for nimble adjustments. When proven effective, it is tempting to stop evaluating something that works. However, it is important to understand why and how it works or does not work in different settings to make the greatest possible difference.

We should acknowledge that addressing population health is complex. So, getting evidence into routine practice through a step-by-step approach may not be straight-forward. We should consider the dynamic properties of the system where the population health and health care functions. Multiple forces and influences must be factored into any change process, and uncertainty and unpredictability should be accepted as a part of a dynamic intricate system.