Abstract
As part of a series on maternal, neonatal, and child health in sub-Saharan Africa, Valerie Snewin and colleagues discuss the challenges of implementation and research capacity in Africa.
Highlights
It is estimated that between 66% and 85% of Africa’s maternal, newborn, and child deaths could be avoided by implementing current interventions [3,4]
The recent evaluation of United Nations International Children’s Fund (UNICEF)’s Accelerated Child Survival and Development programme in West Africa showed that, while vertical preventive implementation did improve coverage, there was no acceleration in child survival [5]
While randomised controlled trials are considered the gold standard for evaluating interventions, there is little consensus on when these should be applied for evaluating complex interventions, or on what other methods are appropriate and in what circumstances
Summary
It is estimated that between 66% and 85% of Africa’s maternal, newborn, and child (under 5 years) deaths could be avoided by implementing current interventions [3,4]. The priority for maternal and child survival is not so much the development of new technologies but solving implementation issues, such as how to scale up and evaluate interventions within complex health systems. Such implementation research should focus the attention of policy makers and implementers, and improve decision making, enhance efficiency, and build understanding of why some programmes work and others do not. The evaluation of complex interventions is itself problematic and more work needs to be done on the development of robust and generally accepted methods for such evaluations [7,8]. While randomised controlled trials are considered the gold standard for evaluating interventions, there is little consensus on when these should be applied for evaluating complex interventions, or on what other methods are appropriate and in what circumstances
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