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Developing a framework of core competencies in implementation research for low/middle-income countries
  1. Olakunle Alonge1,
  2. Aditi Rao1,
  3. Anna Kalbarczyk1,
  4. Dermot Maher2,
  5. Edwin Rolando Gonzalez Marulanda3,
  6. Malabika Sarker4,5,
  7. Latifat Ibisomi6,7,
  8. Phyllis Dako-Gyeke8,
  9. Yodi Mahendradhata9,
  10. Pascal Launois2,
  11. Mahnaz Vahedi2
  1. 1Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
  2. 2Research Capacity Building and Knowledge Management, Special Programme for Research and Training in Tropical Diseases, Geneva, Switzerland
  3. 3Facultad Nacional de Salud Publica, Universidad de Antioquia, Medellin, Colombia
  4. 4Center of Excellence for Implementation Science and Scale-up, BRAC James P Grant School of Public Health, Dhaka, Bangladesh
  5. 5Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
  6. 6Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
  7. 7Public Health and Epidemiology, Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria
  8. 8Department of Social and Behavioral Sciences, School of Public Health, University of Ghana, Legon, Ghana
  9. 9Department of Health Policy and Management, Universitas Gadjah Mada, Yogyakarta, Indonesia
  1. Correspondence to Dr Olakunle Alonge; oalonge1{at}


The field of implementation research (IR) is growing. However, there are no recognised IR core competencies in low/middle-income countries (LMICs), nor consistent curriculum across IR training programs globally. The goal of this effort is to develop a framework of IR core competencies for training programs in LMICs. The framework was developed using a mixed-methods approach consisting of two online surveys with IR training coordinators (n = 16) and academics (n = 89) affiliated with seven LMIC institutions, and a modified-Delphi process to evaluate the domains, competencies and proficiency levels included in the framework. The final framework comprised of 11 domains, 59 competencies and 52 sub-competencies, and emphasised competencies for modifying contexts, strengthening health systems, addressing ethical concerns, engaging stakeholders and communication especially for LMIC settings, in addition to competencies on IR theories, methods and designs. The framework highlights the interconnectedness of domains and competencies for IR and practice, and training in IR following the outlined competencies is not a linear process but circular and iterative, and starting points for training may vary widely by the project, institution and challenge being addressed. The framework established the need for a theory-based approach to identifying proficiency levels for IR competencies (ie, to determine proficiency levels for IR based on generalisable educational theories for competency-based education), and the relevance of various IR competencies for LMICs compared with high-income settings. This framework is useful for identifying and evaluating competencies and trainings, and providing direction and support for professional development in IR.

  • Implementation research
  • competencies
  • low- and middle-income countries
  • mixed methods
  • framework
  • training programs or education

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  • Handling editor Seye Abimbola

  • Contributors OA conceptualised the study and was the principal author, contributed to the data collection, analysis and managed all revisions. AR and AK contributed to the data collection, analysis and critical revisions of the paper. DM, ERGM, MS, LI, PD-G and YM contributed to critical revisions of the paper. PL and MV contributed to the data interpretation and critical revisions of the paper.

  • Funding This study was funded by a grant to the Johns Hopkins University from the Special Program for Research and Training in Tropical Diseases. The funding source had no role in the design of this study or in the decision to submit the report for publication.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical clearance for research outlined in this study was obtained from the Johns Hopkins Bloomberg School of Public Health Institutional Review Board, and the research activities were determined as non-human subject research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.