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This chapter provides an overview of the science of implementation together with practical implementation frameworks and processes conceptualized through the work of the National Implementation Research Network (NIRN). The recommendations for moving science to service are informed by a comprehensive review of the implementation evaluation and research literature across multiple domains and the resulting synthesis of the literature by Fixsen et al. from extensive reviews of diffusion and dissemination literature. The chapter highlights certain prerequisite conditions for making good use of science in the real world. In order for an evidence-based intervention to be well operationalized, the core intervention components must be clearly specified. The implementation stages describe the essential activities that occur during the planning and execution of implementation efforts in education and other human service settings. The implementation drivers are grouped into the following three domains: competency drivers, organization drivers, and leadership drivers.
Dr. Jeffrey Sach's recent United Nations report, “Investing in Development: A Practical Plan to Achieve the Millennium Development Goals,” has brought renewed discussion on the role of economic development in reducing poverty and improving health in the developing world. While much of the public debate in developed countries has focused on the amount of aid and the implementation of this proposal, there has been limited discussion on the role economic development has already played and continues to play in the improvement of health in developing countries. Increases in the GNP (gross national product), a key indicator of economic growth, are associated with an increased life expectancy at birth (figure 8.1) because of increased nutrition and decreased deaths due to infectious and parasitic diseases. Childhood immunization programs and water development projects have also played significant roles in improving child health. As people survive to older ages, the main causes of death are typically chronic and noncommunicable conditions such as heart disease and stroke. This shift in the burden of disease from infectious diseases to chronic conditions is called the “epidemiologic transition.” Developing countries' health systems are frequently ill equipped to manage the new health concerns that arise during this transition, especially those in countries that continue to face high rates of infectious disease.
Rather than following the “classic” pattern of epidemiologic transition, sub-Saharan Africa is facing what some have dubbed the “double burden” of disease because economic development is leading to an increasingly significant burden from chronic diseases while the rate of morbidity and mortality from infectious agents remains high.
'HIV/AIDS, Illness and African Well-Being' highlights the specific health problems facing Africa today, most particularly the HIV/AIDS pandemic. Taking a multi-disciplinary approach, the book presents not only various health crises, but also the larger historical and contemporary contexts within which they must be understood and managed. Chapters offering analysis of specific illness case studies, and the effects of globalization and underdevelopment on health, provide an overarching context in which HIV/AIDS and other health-related concerns can be understood. The contributions on the HIV/AIDS pandemic grapple with the complications of national and international policies, the sociological effects of the pandemic, and policy options for the future. 'HIV/AIDS, Illness and African Well-Being' thus provides a comprehensive view of health issues currently plaguing the continent and the many different ways that scholars are interpreting the health outlook in Africa. Contributors: Obijiofor Aginam, Yacouba Banhoro, Richard Beilock, Charity Chenga, Mandi Chikombero, Kaley Creswell, Freek Cronjé, Frank N. F. Dadzie, Gabriel B. Fosu, Stephen Obeng-Manu Gyimah, Kathryn H. Jacobsen, W. Bediako Lamousé-Smith, William N. Mkanta, Gerald M. Mumma, Kalala Ngalamulume, Raphael Chijioke Njoku, Cecilia S. Obeng, Iruka N. Okeke, Akpen Philip, Baffour K. Takyi, Melissa K. Van Dyke, Sophie Wertheimer, Ellen A. S. Whitney. Toyin Falola is the Francis Nalle Higgenbothom Centennial Professor of History and Distinuished Teaching at the University of Texas at Austin. Matthew M. Heaton is a PhD candidate at the University of Texas at Austin.