Implementation playbook, delivering impact for health – World

Introduction

In 1975, Rahima Banu, a three-year-old girl from Bangladesh became the last person in the world to contract smallpox. Five years later during the 33rd World Health Assembly – nearly two hundred years after the English doctor Edward Jenner inoculated his patients with cowpox pus and established the first vaccine – smallpox was declared eradicated and this terrible disease came to an end.

Although great public health successes like these can sometimes seem miraculous – and subsequently almost inevitable – it would be a mistake to believe so. Rather, smallpox eradication was the result of unwavering focus, clear prioritization, evidence-based interventions and relentless implementation efforts on the ground. It is important not to lose sight of these critical factors, all of which helped to achieve such monumental impact.

Whether you aspire to make a landmark change like eradicating a disease or to improve the health of your community on a smaller scale, this Playbook provides a principled and structured approach to implementation that will help to accelerate progress towards the impact you want to achieve.

While other technical resources provide details on what needs to be done, the Implementation Playbook guides teams on how to go about doing it: from identifying your priority issues and setting measurable targets, through to problem-solving and creating an institutional culture of data-driven action.

What does the Implementation Playbook offer?

The Implementation Playbook is based on the core principles that data and planning are not sufficient endpoints in and of themselves: you need to keep asking what for? in order to initiate actions that are likely to keep up the momentum of your implementation efforts and increase the likelihood of reaching the desired results.

The foundation of the Playbook is an impact cycle (see Fig. 1 in the PDF), developed in collaboration with the World Health Organization (WHO) Evidence-Informed Policy Network (EVIPNet) and adapted from their Policy-to-Action Cycle (Fig. 1), which focuses on hands-on implementation and puts a strong emphasis on long-term sustainability for transformational change. The impact cycle provides a clear framework along with proven tools to advance your implementation efforts systematically and effectively. The process of applying the impact cycle to your work should be flexible and iterative, but the end goal remains clear: achieving impact means measurably improving health outcomes.

Public health measures are applied to complex working environments, with solutions (policies, strategies and interventions) that require collaboration and coordination. This Implementation Playbook recognizes these challenges but provides an approach which can filter through the complexity and keep teams aligned, sharpen focus on the next steps and connect the day-to-day work of implementation with measurable impact.

The impact cycle and Playbook content were developed by drawing on many best practices and resources such as WHO EVIPNet, Project Management Centre of Excellence (PMCoE) and Deliverology®, as well as on health systems and implementation science.

Who is the Implementation Playbook for?

This Implementation Playbook is designed to respond to the needs of a broad audience of health systems leaders and “change-makers” at all levels. It should be especially useful for those working with policy-makers and programme managers, including those with roles and responsibilities related to delivering the health-related Sustainable Development Goals (SDGs). To that end, the Implementation Playbook can be used by anyone aiming to improve their implementation capacity and how they connect their day-to-day efforts with achieving impact.

How to use the Implementation Playbook

The Implementation Playbook and impact cycle recognize that implementation efforts need to be flexible and iterative. It has been designed so that you can follow the cycle stepwise from the first through to the last stage, but alternately may be used as a resource to consult on specific steps or topics based on your team’s level of advancement and needs. Although its content is interconnected, each chapter is intended to be effective as a stand-alone step. Throughout its pages, you will discover crucial topics such as using data and evidence for decision-making, stakeholder engagement, active problem-solving and considerations for promoting equity.

Use the Implementation Playbook to establish and institutionalize these approaches and tools in your implementation efforts to overcome past, present and future challenges. Applying the impact cycle to your work will help to enhance alignment, promote action and accelerate progress towards achieving impact.