The Indian Council of Medical Research (ICMR) has launched the Grants Programme for Implementation Research on Maternal and Child Health.
“Implementation research is the scientific inquiry into questions concerning implementation—the act of carrying an intention into effect, which in health research can be policies, programmes, or individual practices (collectively called interventions).” IR can consider any aspect of implementation – including the factors affecting implementation, the processes of implementation, and the results of implementation, including how to introduce potential solutions into a health system or how to promote their large scale use and sustainability.
The intent is to understand what, why, and how interventions work in “real world” settings and to test approaches to improve them. National Implementation Research platform: Realising the need and relevance, a national platform for technical support for implementation research (IR) has been created to address maternal and child health issues including nutrition. This platform aims to provide opportunity to frame implementation research in the most useful and imaginative way to contribute to effective scale up of MNCH care.
The ICMR’s initiative in this regard is significant as India has made significant progress in reducing under five, neonatal and infant mortality rates and maternal mortality ratio. However, the rates are still very high in many parts of the country. Under the National Health Mission (NHM) of Government of India, evidence based interventions that improve maternal and child survival are being promoted. Many challenges are being faced by programme managers while implementing these interventions/programmes.
To achieve Sustainable Development Goal 3, efforts are needed to reach healthcare for all by ensuring implementation of known interventions, developing better means of delivery of the existing interventions to address health issues of mothers and children specifically in states with high mortality rates, identifying bottleneck in delivery of health care and finding solutions to remove the bottlenecks.
The ICMR has now called for Letters of Intent (LOI) from research institutions and teams within the country who are involved or interested in implementation research by May 31, 2017.
The priority areas of this programme include Find and implement effective strategies to improve quality of care during childbirth in the public health system to achieve safe and healthy childbirth and early postnatal care; Develop effective strategies for early identification, referral and management of high risk pregnancies with clear links between the different levels of the health system; Find and implement effective strategies for improving Emergency Obstetric Care (EmOC) services to successfully manage maternal and fetal complications; Learn how to effectively implement the new WHO ANC model, to reduce stillbirths and early neonatal deaths; Develop effective delivery of evidence-based care protocols/ algorithms for prevention and management of post partum haemorrhage at different levels of care Newborn Health; and Develop and implement at scale strategies to provide high quality care for small and sick babies in hospitals (SNCUs).
Other priority areas of this programme include Develop and implement strategies at scale for integrated and comprehensive maternal and newborn health care package across the continuum of care (improve link between care in labour room, postpartum ward and SNCU); Strategies to scale up Home Based Newborn Care: Role assignment and rationalization for frontline workers, barrier identification and mitigation, cost effectiveness; Implementation at scale of treatment of suspected neonatal sepsis at outpatient level (sub-centre, PHC, CHC or hospital) when inpatient treatment is not possible; Develop and implement strategies for effective maternal and perinatal and newborn healthcare in the urban areas; achieving high coverage and quality of home-based newborn care in diverse rural / tribal / urban settings; harnessing mobile technology; and Establishing an innovative framework of monitoring and supervision with in-built mechanism of accountability to improve performance of frontline workers and health personnel involved in neonatal care (e.g., physical supervision; engaging PRIs and clients; use of ICT, telemedicine, mHealth).