Operationalizing Implementation Science in Nutrition: The Implementation Science Initiative in Kenya and Uganda

Isabelle Michaud-Létourneau, Marion Gayard, Brian Njoroge, Caroline N Agabiirwe, Ahmed K Luwangula, Laura McGough, Alice Mwangi, Gretel Pelto, Alison Tumilowicz, David L Pelletier, Isabelle Michaud-Létourneau, Marion Gayard, Brian Njoroge, Caroline N Agabiirwe, Ahmed K Luwangula, Laura McGough, Alice Mwangi, Gretel Pelto, Alison Tumilowicz, David L Pelletier

Abstract

Background: Implementation science (IS) has the potential to improve the implementation and impact of policies, programs, and interventions. Most of the training, guidance, and experience has focused on implementation research, which is only 1 part of the broader field of IS. In 2018, the Society for Implementation Science in Nutrition borrowed concepts from IS in health to develop a broader and more integrated conceptual framework, adapted to the particular case of nutrition and with language and concepts more familiar to the nutrition community: it is called the IS in Nutrition (ISN) framework.

Objective: The purpose of this research was to generate knowledge concerning challenges and strategies in operationalizing the ISN framework in low- and middle-income country (LMIC) settings.

Methods: The ISN framework was operationalized in partnership with country teams in Kenya and Uganda over a 3-y period as part of the Implementation Science Initiative. An action research methodology (developmental evaluation) was used to provide timely feedback to the country teams, facilitate adaptations and adjustments, and generate the data presented in this article concerning challenges and strategies.

Results: Operationalization of the ISN framework proceeded by first articulating a set of guiding principles as touchstones for the country teams and further articulating 6 components of an IS system to facilitate development of work streams. Challenges and strategies in implementing these 6 components were then documented. The knowledge gained through this experience led to the development of an IS system operational model to assist the application of IS in other LMIC settings.

Conclusions: Future investments in IS should prioritize a system- and capacity-building approach in order to realize its full potential and become institutionalized at country level. The operational model can guide others to improve the implementation of IS within a broad range of programs.

Keywords: capacity-building; developmental evaluation; implementation science; knowledge brokering; nutrition programs; operationalization; systems.

© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.

Figures

FIGURE 1
FIGURE 1
The Society for Implementation Science in Nutrition's Integrated Framework for Implementation Science in Nutrition. Adapted from (35) (copyright Current Developments in Nutrition).
FIGURE 3
FIGURE 3
An operational model of the Implementation Science System. BSI, bottleneck and solution inventory; IR, implementation research; KB, knowledge brokering.
FIGURE 2
FIGURE 2
Emergent process for operationalizing the ISN framework. IS, implementation science; ISN, Implementation Science in Nutrition.

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