Health extension workers walking to a village in Ethiopia for data collection training and pre-testing. Photo credit: Danielle Charlet

Translating Research into Action (TRAction) Project

The Challenge

For maternal, newborn, and child health (MNCH) services in developing countries, addressing the “know–do gap” is critical. The delay between the discovery of effective ways to combat the causes of mortality and morbidity and the application of proven interventions on a wide scale takes on life or death importance.

Overview and Objectives

TRAction addressed challenges to MNCH through implementation research – a rigorous approach that uses scientific principles to understand and improve the implementation of key interventions. TRAction worked at two levels: awarding and managing subawards focused on well-defined MCNH challenges, and actively building global support and momentum around implementation through information and knowledge exchange.

TRAction solicited and awarded health research grants to research organizations to evaluate ways to effectively and efficiently introduce, implement, and scale up evidence-based MNCH interventions. The project sought to strengthen the research capacity of host country collaborators and maximize opportunities to involve new local partners in implementation research.

Achievements

URC made over 40 subawards in the areas of respectful maternal care, equitable health care access, human resources for health (task shifting/sharing), integrated community case management of childhood illness, recognition and care seeking for maternal and newborn health complications, management of unclassified fever, malaria, performance-based incentives/quality of care, household air pollution, and water, sanitation, and hygiene.

One of TRAction’s best-known achievements was the landscape analysis, “Exploring the Evidence of Disrespectful and Abusive Childbirth,” a seminal compilation of evidence on disrespectful and abusive childbirth, its manifestations, causes, and interventions. The findings were presented at international and regional maternal health conferences, facilitating an exchange among policymakers, programmers, and researchers interested in building evidence and taking action for respectful, non-abusive facility-based care during childbirth and led to calls for funding implementation research on the topic.

Similarly, TRAction prepared a landscape analysis of the scientific evidence on the causes and health impact of indoor air pollution and promising approaches to reduce indoor air pollution, especially use of improved cookstoves and less polluting fuel.

Analysis and case studies on quality of care within performance-based incentives (PBI) programs examined how PBI programs assess or incentivize quality of care and the intended and unintended consequences of these programs on the quality of MNCH services.

TRAction hosted an international consultation, “Mind the Gap: Research & Evaluation Methods for Scaling Up Evidence-Based Interventions,” involving senior researchers, policymakers, and implementers of MNCH programs to review and discuss the wide variety of research methods that could be employed to help accelerate the effective design, implementation and scale-up of key evidence-based MNCH interventions in developing countries.

TRAction also supported a range of capacity-building activities for local researchers, including training in data collection and analysis, grant writing, and team building.

Duration
2009–2017

Countries
Bangladesh, Democratic Republic of the Congo, Ethiopia, Ghana, Guatemala, India, Indonesia, Kenya, Malawi, Mozambique, Nigeria, Rwanda, Senegal, Tanzania, Uganda, Zambia

Regions
Africa, Asia, Latin America and the Caribbean

Expertise
Family Planning and Reproductive Health, Health Systems Strengthening, Implementation Science, Maternal and Child Health, Quality Improvement, Social and Behavior Change

Funders
USAID

Partners
Harvard T.H. Chan School of Public Health