Implementation Research Agenda

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Goals 4 and 5 called for a two-thirds reduction in mortality among children less than 5 years of age and a three-quarters reduction in maternal mortality between 1990 and 2015, respectively.1 Five years before the goals came to a close, the Muskoka Initiative was launched at the G8 summit to intensify efforts toward improving maternal, newborn and child health in low- and middle-income countries, with Canada investing 2.85 billion to reduce the burden of disease, improve nutrition and strengthen health systems in areas with the greatest need.2 Although there have been substantial gains in reducing global maternal and child mortality, progress has been insufficient to achieve the Millennium Development Goals’ targets.3,4 Unacceptably high numbers of women and children are still dying every year, largely due E82 CMAJ OPEN, 5(1) to conditions that could have been prevented or treated if existing cost-effective interventions were made universally available.5 Currently, there is insufficient knowledge on how to effectively implement proven affordable interventions in resource-limited settings.6 Over the past 5 years, Canadian funding through the Initiative has focused on scal- Competing interests: No authors declare any conflicts of interest related to this work.. Questions from 20 exercises n =45 Adolescent health n=4 Newborn health n=5 • Newborn care n = 1 • Low birth weight n = 1 • Preterm labour n = 1 • Neonatal resuscitation n = 1 • Birth asphyxia n = 1 Child health n = 16 • PMTCT n = 2 • Diarrhea n = 4 • Pneumonia n = 2 • Immunization n = 2 • Nutrition n = 1 • Malnutrition n = 2 • Zinc interventions n = 2 • Breastfeeding n = 1 • Adolescent health n = 1 • HIV/AIDS n = 2 • Adolescent pregnancy n = 1 Management and health systems n = 15 • Management health systems n=3 • Integrated MNCH services n=1 • IMCI n = 2 • CHWs n = 4 • Transport, communication, and referral n = 4 • Home care practices n = 1 Reproductive and maternal health n=5 • Family planning n = 2 •

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Long–range planning works best in the short term. | Doug Evelyn