Guiding principles for quality, equity and sustainability in implementation research: Multicounty learnings from participatory action research to strengthen health systems

Ozano, Kim, Dean, Laura ORCID: https://orcid.org/0000-0002-4910-9707, Adekeye, Oluwatosin, Bettee, Anthony K, Dixon, Ruth, Ntuen, Uduak Gideon, Gwani, Noela, Isiyaku, Sunday, Kollie, Karsor, Lar, Luret, Oluwele, Akinola, Piotrowski, Helen, Thomson, Rachael, Yashiyi, James, Zawolo, Georgina, Theobald, Sally ORCID: https://orcid.org/0000-0002-9053-211X and Siakeh, Alice (2020) 'Guiding principles for quality, equity and sustainability in implementation research: Multicounty learnings from participatory action research to strengthen health systems'. Health Policy and Planning, Vol 35, Issue supp 2, ii137-ii149.

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Abstract

Global health gains can be achieved through strengthening health systems to identify and address implementation challenges in low- and middle-income countries. Participatory research, that promotes joint problem and solution finding between communities and different health systems actors, supports policy implementation analysis at all levels. Within the neglected tropical disease programmes in Liberia and Nigeria, we applied participatory action research (PAR) to address programmatic and health system bottlenecks with health systems strengthening embedded. This paper shares learning from 20 interviews with co-researchers, from national and sub-national levels and academic researchers who worked collaboratively to understand challenges, co-create solutions and advocate for policy change. Through analysis and reflections of existing PAR principles, we inductively identified five additional guiding principles for quality, ethical standards and ongoing learning within PAR projects that aim to strengthen health systems. (1) Recognize communities as units of identity and define stakeholder participation to ensure equitable engagement of all actors; (2) enable flexible action planning that builds on existing structures whilst providing opportunities for embedding change; (3) address health systems and research power differentials that can impede co-production of knowledge and solution development; (4) embed relational practices that lead to new political forms of participation and inquiry within health systems and (5) develop structures for ongoing learning at multiple levels of the health system. PAR can strengthen health systems by connecting and co-creating potentially sustainable solutions to implementation challenges. Additional research to explore how these five additional principles can support the attainment of quality and ethical standards within implementation research using a PAR framework for health systems strengthening is needed.

Item Type:	Article
Subjects:	WA Public Health > Health Problems of Special Population Groups > WA 300 General. Refugees WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
Faculty: Department:	Biological Sciences > Department of Tropical Disease Biology Clinical Sciences & International Health > Clinical Sciences Department Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1093/heapol/czaa123
Depositing User:	Tina Bowers
Date Deposited:	26 Nov 2020 13:53
Last Modified:	14 Dec 2020 10:28
URI:	https://archive.lstmed.ac.uk/id/eprint/16185

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