Lost in translation: key lessons from conducting dissemination and implementation science in Zambia.


Journal

Implementation science communications
ISSN: 2662-2211
Titre abrégé: Implement Sci Commun
Pays: England
ID NLM: 101764360

Informations de publication

Date de publication:
29 Oct 2024
Historique:
received: 09 05 2024
accepted: 12 10 2024
medline: 30 10 2024
pubmed: 30 10 2024
entrez: 30 10 2024
Statut: epublish

Résumé

As the field of implementation science continues to grow, its key concepts are being transferred into new contexts globally, such as Low and Middle Income Countries (LMICs), and its use is constantly being reexamined and expanded. Theoretical and methodological positions commonly used in implementation research and practice have great utility in our work but in many cases are at odds with LMIC contexts. As a team of implementation scientists based in Zambia, we offer this commentary as a critical self-reflection on what has worked and what could limit us from fully utilizing the field's promise for addressing health problems with contextual understanding. We used a 'premortem,' an approach used to generate potential alternatives from failed assumptions about a particular phenomenon, as a way to reflect on our experiences conducting implementation research and practice. By utilizing prospectively imagined hindsights, we were able to reflect on the past, present and possible future of the field in Zambia. Six key challenges identified were: (i) epistemic injustices; (ii) simplified conceptualizations of evidence-informed interventions; (iii) limited theorization of the complexity of low-resource contexts and it impacts on implementation; (iv) persistent lags in transforming research into practice; (v) limited focus on strategic dissemination of implementation science knowledge and (vi) existing training and capacity building initiatives' failure to engage a broad range of actors including practitioners through diverse learning models. Implementation science offers great promise in addressing many health problems in Zambia. Through this commentary, we hope to spur discussions on how implementation scientists can reimagine the future of the field by contemplating on lessons from our experiences in LMIC settings.

Sections du résumé

BACKGROUND BACKGROUND
As the field of implementation science continues to grow, its key concepts are being transferred into new contexts globally, such as Low and Middle Income Countries (LMICs), and its use is constantly being reexamined and expanded. Theoretical and methodological positions commonly used in implementation research and practice have great utility in our work but in many cases are at odds with LMIC contexts. As a team of implementation scientists based in Zambia, we offer this commentary as a critical self-reflection on what has worked and what could limit us from fully utilizing the field's promise for addressing health problems with contextual understanding.
MAIN BODY METHODS
We used a 'premortem,' an approach used to generate potential alternatives from failed assumptions about a particular phenomenon, as a way to reflect on our experiences conducting implementation research and practice. By utilizing prospectively imagined hindsights, we were able to reflect on the past, present and possible future of the field in Zambia. Six key challenges identified were: (i) epistemic injustices; (ii) simplified conceptualizations of evidence-informed interventions; (iii) limited theorization of the complexity of low-resource contexts and it impacts on implementation; (iv) persistent lags in transforming research into practice; (v) limited focus on strategic dissemination of implementation science knowledge and (vi) existing training and capacity building initiatives' failure to engage a broad range of actors including practitioners through diverse learning models.
CONCLUSION CONCLUSIONS
Implementation science offers great promise in addressing many health problems in Zambia. Through this commentary, we hope to spur discussions on how implementation scientists can reimagine the future of the field by contemplating on lessons from our experiences in LMIC settings.

Identifiants

pubmed: 39473012
doi: 10.1186/s43058-024-00663-z
pii: 10.1186/s43058-024-00663-z
pmc: PMC11520656
doi:

Types de publication

Journal Article

Langues

eng

Pagination

121

Informations de copyright

© 2024. The Author(s).

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Auteurs

Patricia Maritim (P)

Implementation Science Centre for Advancing Practice and Training (IMPACT), University of Zambia, Lusaka, Zambia. triciamarie20@gmail.com.
Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia. triciamarie20@gmail.com.

Margarate Nzala Munakampe (MN)

Implementation Science Centre for Advancing Practice and Training (IMPACT), University of Zambia, Lusaka, Zambia.
Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia.

Mweete Nglazi (M)

Implementation Science Centre for Advancing Practice and Training (IMPACT), University of Zambia, Lusaka, Zambia.

Chris Mweemba (C)

Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia.

Kombatende Sikombe (K)

Implementation Science Department, Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.

Wilson Mbewe (W)

Ministry of Health, Lusaka, Zambia.

Adam Silumbwe (A)

Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia.

Choolwe Jacobs (C)

Department of Epidemiology and Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia.

Joseph Mumba Zulu (JM)

Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia.

Michael Herce (M)

Implementation Science Department, Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.

Wilbroad Mutale (W)

Implementation Science Centre for Advancing Practice and Training (IMPACT), University of Zambia, Lusaka, Zambia.
Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia.

Hikabasa Halwindi (H)

Implementation Science Centre for Advancing Practice and Training (IMPACT), University of Zambia, Lusaka, Zambia.

Classifications MeSH