Integrating implementation science into covid-19 response and recovery

Dear Editor

This is with reference to the article on implemental science on Covid-19 response [1]. The continuation of established interventions are more in sync with the administrative convenience and social-political and economic status quo, and hence easy to practice. What the article proposes is innovation and adaptation, apart from using own prior experiences and lesson from others, of newer and more effective interventions with changing scenario of COVID-19 depending on available resources and local conditions. However, it must be based on evidence generated by local data. Thus implementation science coming up with best outcome measures perforce exposes the protracted fallacies and lingering inadequacies of earlier policy/interventions and pose questions of accountability, which generally no one likes and particularly those in governance.

There is a parallel in the experimental approach to economics for alleviating global poverty for which the 2019 Economics Nobel Prize was awarded to Abhijit Banerjee, Esther Duflo and Michael Kremer. They did randomised control trials (RCTs) [2] to study different policies in action and to promote those that are most effective. For example, child mortality in the developing world is immensely influenced by women’s empowerment. The available policy interventions, even though not mutually exclusive could be educating mothers, or access to healthcare, or electoral representation, or marital age legislation. RCTs would tell us which one is most effective and practicable. In this sense implemental science provide the scope of developing framework to audit the pro-people quality of governance.

References.

1. Hirschhorn L, Smith J D, Frisch M F et al. Integrating implementation science into covid-19 response and recovery. BMJ 2020;369:m1888 (https://www.bmj.com/content/369/bmj.m1888)

2. Bhattacharjee A, Schaffer M. Why Banerjee, Duflo and Kremer won the Economics Nobel.Boston Business Journal. (https://www.bizjournals.com/boston/news/2019/10/14/why-banerjee-duflo-an... ) (2019)