Improving Program Implementation through Embedded Research (iPIER)

Implementation research is a crucial component of effective public health and clinical policies and programs. It promotes the generation and use of health policy and systems research (HPSR) as a means to improve health and health systems, and is particularly effective in low- and middle-income countries. HPSR, including implementation research, has been promoted by the World Health Organization (WHO) as an effective mechanism with which to identify gaps in a health system’s capacity, efficient functioning, and sustainable use of funds.

In the Region of the Americas, relevant and demand-driven research has the potential to make significant improvements to implementation and scale-up of health interventions. It also aligns with PAHO’s aims to promote universal health coverage. In light of this, since 2014 PAHO and the Alliance for Health Policy and Systems Research (an international partnership hosted by WHO) have carried out an embedded research initiative in the Region, entitled Improving Program Implementation through Embedded Research (iPIER), to address context-specific factors and advance toward population health impact.

iPIER places affected stakeholders—policymakers, district health officers, program managers, and frontline health workers—at the center of the research process in order to apply relevant, evidence-driven improvements to preexisting health policies and programs.

This supplement of the Pan American Journal of Public Health presents the rationale that underpins the embedded research initiative and the findings of 10 of these projects conducted within various health system settings in the Region. The supplement aims to provide critical knowledge emanating from the research, while documenting the general embedded research process and its potential outcomes. Through the iPIER initiative, PAHO brings its expertise supporting research in the Region to advocate for this innovative way of developing and using science.

Embedding research in health policy and systems in the Americas [Incorporación de la investigación en las políticas y los sistemas de salud de la Región de las Américas]

Embedding research to improve program implementation in Latin America and the Caribbean [Incorporación de las investigaciones para mejorar la ejecución de programas en América Latina y el Caribe]

Nhan Tran, Etienne V. Langlois, Ludovic Reveiz, Ilona Varallyay, Vanessa Elias, Arielle Mancuso, Francisco Becerra-Posada, and Abdul Ghaffar
Special Report | Abstract | PDF (English) | PDF (español) | Published 21 April |

Estrategia para mejorar el acceso al tratamiento etiológico para la enfermedad de Chagas en el primer nivel de atención en Argentina [Strategy to improve access to etiological treatment of Chagas disease at the first level of care in Argentina]

Karen Klein, María Soledad Burrone, Juan Pedro Alonso, Lucila Rey Ares, Sebastián García Martí, Antonia Lavenia, Estela Calderón, Cynthia Spillmann y Sergio Sosa Estani
Original Research | Abstract | PDF (español) | PDF (English) | Published 21 April |

Barreras del personal de salud para el tamizaje de sífilis en mujeres embarazadas de la Red Los Andes, Bolivia [Health-worker barriers to syphilis screening in pregnant women in Bolivia’s Los Andes network]

Evaluación del proceso de teleconsulta desde la perspectiva del proveedor, Programa de Telesalud de Oaxaca, México [Evaluation of the teleconsultation process from the perspective of the provider (Oaxaca Telehealth Program, Mexico)]

Evaluación de herramientas de implementación de la Guía de Práctica Clínica de infecciones de transmisión sexual [Evaluation of tools for the implementation of clinical practice guidelines on sexually transmitted infections]

Jaime Hernán Rodríguez Moreno, Antonio José Romero Vergara, Danilo De Jesús De Alba De Moya, Hernán Javier Jaramillo Rojas, Claudia Milena Díaz Rojas y Agustín Ciapponi
Original Research | Abstract | PDF (español) | PDF (English) | Published 21 April |

Barreras para el acceso a la atención integral de las personas afectadas por la coinfección por tuberculosis y virus de inmunodeficiencia humana en Perú, 2010–2015 [Access barriers to comprehensive care for people affected by tuberculosis and human immunodeficiency virus coinfection in Peru, 2010–2015]

Acceso a anticoncepción en adolescentes: percepciones de trabajadores de la salud en Huechuraba, Chile [Adolescent access to contraception: perceptions of health workers in Huechuraba, Chile]

Regionalización de la atención materna perinatal en la provincia de Santa Fe, Argentina [Regionalization of perinatal health care in the province of Santa Fe, Argentina]

Evaluación de la implementación del protocolo de manejo de coinfección de tuberculosis y VIH en los servicios de asistencia especializada del estado de Ceará, Brasil [Evaluation of implementation of the protocol for managing tuberculosis/ HIV coinfection in specialized care services in the state of Ceará, Brasil]

Silvia Helena Bastos de Paula, Telma Alves Martins, Sheila Maria Santiago Borges, Christiana Maria de Oliveira Nogueira y Valderina Ramos Freire
Original Research | Abstract | PDF (español) | PDF (English) | Published 21 April |

Knowledge of and attitudes toward heel prick screening for sickle cell disease in Saint Lucia [Conocimiento y actitudes respecto al tamizaje mediante punción del talón para la drepanocitosis en Santa Lucía]

Guías de práctica clínica: estudio cualitativo sobre su implementación en el sistema de salud de Chile [Clinical practice guidelines: a qualitative study of their implementation in the Chilean health system*]

Paloma Herrera, Valentina Fajreldin, María Francisca Rodríguez, Patricia Kraemer, Carolina Mendoza, Ignacio Pineda, Pamela Burdiles, Marco Cornejo, Julio Villanueva, María Dolores Tohá y Alonso Carrasco-Labra
Original Research | Abstract | PDF (español) | PDF English | Published 1 May