Implementation Research and Policy Advocacy
Generating rigorous, locally relevant operational research and translational evidence to inform national public health policy.
Implementation Research and Policy Advocacy
Generating local evidence to drive sustainable health system improvements and transform national public health policies in Cameroon.
Field Implementation
- Pillar 1: ISD
- Pillar 2: HSS
Embedded Research
- Implementation bottlenecks
- Cost effectiveness studies
Policy Advocacy
- District health plans
- National EML Expansion
The Strategic Need: Why Embedded Implementation Research?
While health interventions like Integrated Community Case Management (iCCM) or active respiratory screening are proven globally, their execution frequently fails at the frontline due to localised health system bottlenecks. In northern regions like Adamawa, severe workforce deficits, incomplete DHIS2 reporting, and supply chain gaps mean that off-the-shelf health solutions cannot simply be dropped into place without contextual adaptation.
Embedded Implementation Science treats the health system itself as a learning platform. Rather than testing clinical efficacy in controlled trials, THRIVE studies how, why, and under what real-world conditions integrated maternal, child, and respiratory care models can be sustainably delivered, scaled, and institutionalised.
Contextual Challenges in Implementation Research
Drawing directly from the structural gaps identified in frontline primary care, THRIVE addresses five critical bottlenecks:
The "Know-Do" Gap
Proven syndromic algorithms exist on paper, but health workers face severe cognitive overload due to acute staffing shortages (3.1 workers per 10,000).
Underutilised Data
Community-level indicators in the DHIS2 framework remain incomplete and are rarely analyzed to inform local health district policies.
Policy Invisibility
Chronic lung conditions like asthma and COPD lack structured national surveillance or standardized implementation guidelines.
Medicines Exclusions
Inhaled corticosteroids remain largely absent from essential medicine procurement lists for primary health centers.
Research Disconnect
Academic research often occurs in isolation from operational authorities, leading to delayed or unfeasible policy translation.
Core Focus Area and Pragmatic Activities
Embedded Implementation Science
THRIVE embeds pragmatic implementation research directly into ongoing ISD and HSS operations to evaluate feasibility, fidelity, and cost-effectiveness.
- Feasibility Studies: Evaluating accuracy and adoption of digital decision-support tools for combined MNCH and respiratory screening.
- Bottleneck Analysis: Utilising mixed-methods approaches to identify fidelity gaps in clinical triage and community follow-up.
- Cost-Effectiveness Models: Generating economic evidence comparing multi-disease screening against traditional vertical outreach.
Routine Health Data Translation
Building on DHIS2 community data pipelines, this focus area converts raw data into actionable policy tools for health district leaders.
- Data Reviews: Co-hosting quarterly Implementation Science Roundtables with District Medical Officers to analyse real-time trends.
- Policy Briefs: Synthesising routine primary healthcare data into high-impact briefs highlighting mortality risks and screening gaps.
- DHDP Integration: Ensuring empirical research findings are incorporated into annual District Health Development Plans.
Evidence-Informed Policy Advocacy
THRIVE leverages field-generated research to advocate for structural policy changes alongside professional medical societies.
- EML Policy Advocacy: Advocating for the formal inclusion and primary-tier distribution of core inhaled respiratory medicines on the Essential Medicines List.
- Respiratory Guidelines: Translating field lessons into standardised clinical practice guidelines for asthma and COPD for national scaling.
- Institutionalizing Protocols: Contributing empirical evidence to support the operationalisation of upcoming national community health frameworks.