How to Formulate Implementation Research Questions from Programme Gaps

The chapter asks which programme implementation challenges need attention and which responses could be tested to address them. This separates the observed problem from the proposed solution. A topic such as ‘community health workers’ is too broad to function as a research question.

A useful question describes a specific gap in a specific setting. For instance, ‘Which parts of the resupply workflow contribute to repeated stock-outs in participating facilities?’ is more actionable than ‘How can we improve the health system?’

Questions may emerge from progress reports, HMIS trends, supervision or population surveys. A team should first establish whether a finding reflects actual delivery, measurement quality or both.

The module's historical examples include declining net use after sustained coverage and gaps between reported medicine distribution and repeated individual use. The lesson is to ask what the indicator truly measures: distribution does not guarantee correct or continued use.

Once the bottleneck is understood, ask whether a defined strategy can address it. A hypothetical resupply study might compare scheduled joint stock review with existing reporting arrangements and assess stock availability, staff workload and cost.

Do not make the strategy unnecessarily complex. If several activities are combined, describe their components and intended mechanisms. Otherwise a change in outcomes will be difficult to interpret or reproduce.

Research should answer a decision that implementers and communities actually face. Consider the seriousness of the gap, potential benefit for underserved groups, uncertainty, available resources and whether findings can inform action.

The slides discuss malaria testing, pregnancy prevention services and medicine distribution as examples of implementation questions. They are not prescribing instructions. A research proposal involving new tasks, tests or medicines requires appropriate clinical governance and current national authorization.

For a Nepal proposal, use the current programme policy and locally collected evidence. Label hypothetical examples clearly and avoid importing historical treatment schedules or foreign coverage targets into a present-day protocol.