Looking under the hood: What will implementation science have to fix?
Much attention has been given to the need to strengthen health systems. Frenk has argued that health systems should not be viewed as either a black boxes or black holes: in other words, too complex or too expensive to really fix. Resource-limited countries, however, have much documentation about the severe limitations of their health systems with respect to all or some of the WHO Health System Strengthening Building Blocks such as funding, health work force, facilities, and availability of drugs. Despite these well-known limitations, the majority of attention and funding does not go to strengthening these systems, and the systems remain weak.
Working with colleagues at UW, Ministries of Health, donors, and Makerere University, Scott Barnhart has had the opportunity to look more closely at the state of hospital standards in Uganda, the effect of PEPFAR on the health system in Uganda, and at the inner workings, limitations, and improvement strategies for two district hospitals in Haiti. Each of these activities raise important implementation science questions. Dr. Barnhart will review the findings and identify specific areas where implementation science will need to succeed before care can actually improve.