Implementation Science in Nutrition: Concepts and Frameworks for an Emerging Field of Science and Practice

Abstract

Malnutrition in all its forms has risen on global and national agendas in recent years because of the recognition of its magnitude and its consequences for a wide range of human, social, and economic outcomes. Although the WHO, national governments, and other organizations have endorsed targets and identified appropriate policies, programs, and interventions, a major challenge lies in implementing these with the scale and quality needed to achieve population impact. This paper presents an approach to implementation science in nutrition (ISN) that builds upon concepts developed in other policy domains and addresses critical gaps in linking knowledge to effective action. ISN is defined here as an interdisciplinary body of theory, knowledge, frameworks, tools, and approaches whose purpose is to strengthen implementation quality and impact. It includes a wide range of methods and approaches to identify and address implementation bottlenecks; means to identify, evaluate, and scale up implementation innovations; and strategies to enhance the utilization of existing knowledge, tools, and frameworks based on the evolving science of implementation. The ISN framework recognizes that quality implementation requires alignment across 5 domains: the intervention, policy, or innovation being implemented; the implementing organization(s); the enabling environment of policies and stakeholders; the individuals, households, and communities of interest; and the strategies and decision processes used at various stages of the implementation process. The success of aligning these domains through implementation research requires a culture of inquiry, evaluation, learning, and response among program implementers; an action-oriented mission among the research partners; continuity of funding for implementation research; and resolving inherent tensions between program implementation and research. The Society for Implementation Science in Nutrition is a recently established membership society to advance the science and practice of nutrition implementation at various scales and in varied contexts.

Developing a conceptual framework for implementation science to evaluate a nutrition intervention scaled-up in a real-world setting

“…Finally, we identified thirty articles ( Fig. 1), which provided a framework, theory or a model for implementation science (10)(11)(12) .…”

“…Recently in the nutrition field, several scholars have used implementation science to support scaling-up of evidence-based nutrition interventions (10)(11)(12) . In 2016, the Society for Implementation Science in Nutrition (SISN) was formed to promote implementation science for addressing malnutrition burdens in low-and middleincome countries (13) .…”

Micronutrient powder programs: New findings and future directions for implementation science

“…This collection of eight papers focusing on factors affecting adherence provides an opportunity to assess current practices for generating knowledge concerning MNP implementation, using the frameworks recently developed by the Society for Implementation Science in Nutrition (Tumilowicz et al, ). In doing so we also consider a broader systematic review of factors affecting MNP adherence (Tumilowicz, Schnefke, Neufeld, & Pelto, ) and the broader consultations and reviews of MNP program experiences (Nyhus Dhillon et al, ) conducted at approximately the same period of time.…”

“…When examined in relation to the SISN frameworks (Tumilowicz et al, ), these observations suggest that the current research on MNP adherence is primarily focusing on factors related to caregivers (with an emphasis on their knowledge and perceptions), which is only one of five categories in the SISN framework. The other categories, which are much less studied, relate to implementing organizations and staff, the enabling environment, planning and implementation processes and characteristics of the intervention itself.…”

Evaluación de procesos de una intervención: actividad física durante el embarazo y postparto

“…Este artículo se centra en la EsIAN para beneficiarias con embarazo-pp, con el objetivo de evaluar los procesos de una intervención de actividad física durante el embarazo y el postparto (11,12) .…”