Implementation Research uses systematic research methods to improve policies and programme delivery. The World Health Organization (WHO) has adopted this method to understand and address barriers to the implementation of effective and quality health interventions, strategies and policies.
Commonwealth Alumnus Dr Tarannum Ahmed is a Senior Consultant at the National Health Systems Resource Centre (NHSRC), the technical support unit of the Ministry of Health and Family Welfare (MoHFW), India. NHSRC also serves as the Secretariat for the Implementation Research for Health System Strengthening (IR-HSS) Platform, under the MoHFW. Dr Ahmed serves as the nodal officer for the IR-HSS Platform, leading its strategic development and coordination.
The IR-HSS Platform is a first-of-its-kind initiative under the MoHFW. The platform was established to systematically synthesise inputs from diverse stakeholders involved in public health delivery at both national and state levels. By identifying emerging health system challenges and priorities, it enables the commissioning of focused research aimed at generating actionable evidence to strengthen health policy, planning, and implementation across the country.
Tarannum joined the NHSRC in 2021 and was entrusted with leading the development of the IR-HSS Platform framework and preparing it for submission to the MoHFW for approval and national implementation.
Using data to create change
Data is gathered through a series of rounds and five regional workshops held with representatives and stakeholders from a range of institutions responsible for public health, including state and central government, academic institutions and civil bodies. The workshops are designed to gather information at the micro and macro level, with stakeholders representing multiple groups of healthcare professionals, from policy makers to frontline healthcare workers.
“From these conversations, we gain more than data; we gain grounded insights into what communities are truly facing. Stakeholders share the realities of their health programmes- the struggles, the breakthroughs and the gaps that statistics alone cannot capture. We hear where the burden of disease is heaviest, which interventions are working, and which are not. Just as importantly, we learn from what has gone right: the innovations, the local solutions, and the successes that can be adapted and shared with other states facing similar challenges.”
Using the platform, the data is analysed and scored to rank health priorities. In consultation with a technical advisory group (TAG) comprised of research experts representing different fields of public health, 10-15 health priorities are then identified for each region.
Following this stage, Tarannum is then responsible for identifying appropriate institutions to conduct intensive 12-month research into these priority areas and produce actionable research outcomes and recommendations on ways to address these health priorities through existing healthcare systems.
Over the 12-months, Tarannum and her team provide comprehensive support throughout the entire appraisal and approval process, including ongoing data collection and technical guidance.
“We take a deeply hands-on approach because meaningful change doesn’t happen from a distance. As the nodal officer, I’m involved in every step of the process, not just overseeing it, but walking alongside it. From organising the regional workshops and identifying the most urgent research questions, to selecting the right institutions to carry the work forward, we remain closely engaged. We guide each team through every stage: from the birth of an idea to the rigour of data collection, through analysis, writing, and finally, ensuring that the evidence reaches the people who can act on it. This isn’t just about generating research; it’s about ensuring that research serves the public good and drives equity in health systems.”
Final reports are submitted to the government to support policy and decision makers in approving timely healthcare programmes and interventions and to allocate budget at the national and state level to implement these.
Tarannum shares that the IR-HSS Platform was developed in alignment with the 2017 National Health Policy’s emphasis on health systems research, fulfilling its mandate to institutionalise implementation research and generate timely, context-specific evidence to inform healthcare planning, programme design, and policy decision-making.
“While research has long been named in national health policies, it was often treated as an afterthought. The most recent policy, however, placed it where it belongs; at the heart of health system strengthening. That shift opened the door for platforms like IR-HSS, which are grounded in the belief that evidence, when rooted in lived realities, can drive more just and effective healthcare for all.”
Strengthening primary and secondary care services
Dr Ahmed during a field visit with an ASHA worker, whose grassroots efforts are vital to strengthening primary healthcare in India
The impact of research conducted under the IR-HSS Platform is beginning to take shape, with several recommendations already being adopted at the state level. The platform has supported studies across a range of domains, including non-communicable diseases (NCDs), strengthening primary healthcare, the role of Accredited Social Health Activists (ASHAs), and the adoption of digital technologies in healthcare delivery.
Among these, one key study focused on assessing the performance of newly introduced mid-level healthcare providers, the Community Health Officers (CHOs) within the Ayushman Bharat scheme of the Government of India. While Tarannum was not involved in the initial rollout of the CHO cadre or the scheme itself, she led a research initiative under the IR-HSS platform to develop a novel assessment tool that evaluates the ability of CHOs to deliver quality primary care at the Ayushman Arogya Mandir- Sub Health Centres (AAM-SHCs), which is the first point of contact of the community. Given that CHOs represent a critical new addition in India’s primary healthcare system, this research was instrumental in understanding their role and effectiveness in advancing universal health coverage (UHC).
The tool was first piloted in one state and has since been used for assessment in two additional states, signalling growing recognition of its value in strengthening primary healthcare systems. Tarannum is now excited to support further implementation of the tool and to generate deeper evidence on how CHOs can drive equitable, and quality healthcare in diverse settings across India.
Using the Scholarship to consider new perspectives
Tarannum credits her Commonwealth Shared Scholarship and Master’s in Global Health at the London School of Economics and Political Science with providing an opportunity to critically think about health challenges from new perspectives, something she didn’t feel able or encouraged to do before.
“I feel like the Master’s gave me more than just knowledge; it gave me the courage to reimagine what’s possible. It taught me that we don’t have to accept systems as they are. We can innovate, challenge convention and build something profoundly better for those who need it most.”
She also feels fortunate to have taken up a role in the Ministry of Health in 2021, a couple of years following her studies.
“I feel incredibly fortunate to be where I am today. After studying global health, working within the Ministry of Health has given me a front-row seat to how public health systems operate in practice; how health policy in a country like India is shaped by political priorities, systemic constraints, and the ongoing pursuit of equity.”
Tarannum graduated into a very different world to the one in which she started her Master’s. Soon after returning home, the world went into lockdown due to the COVID-19 pandemic. She recalls the difficulties in finding a job during that time and instead took up volunteering opportunities to support the dissemination of healthcare information, in particular promoting the importance of mental health.
The impact of COVID-19 on mental has been globally recognised with many countries responding to its impact through a new or renewed focus on mental healthcare provision.
“In the aftermath of COVID-19, there was a global reckoning with the rising burden of mental health conditions. In India, this growing awareness prompted both the Health Minister and the Finance Minister to allocate increased funding for telemedicine services in the 2022 Union Budget, recognising the urgent need to expand access to mental healthcare.”
Utilising the skills and knowledge gained during her studies, and her volunteer experiences throughout the pandemic, in 2022, Tarannum contributed to the development of the Operational Guidelines for India’s first tele mental health programme, Tele MANAS. Designed to provide free, round-the-clock mental health support, Tele MANAS connects individuals to trained counsellors and specialised care through a nationwide network. Tarannum played a key role in shaping the framework for service delivery, referral mechanisms, and integration with existing national health programmes.
Tarannum stresses the importance of collaboration and stakeholder engagement in developing the guidelines and programme. The process involved consultations with government bodies, mental health institutions, psychiatrists, psychologists, and digital health experts to define the service delivery model, standardise counsellor training and qualifications, and establish a clear, tiered referral system. The guidelines also emphasised seamless integration with existing platforms like eSanjeevani and the National Mental Health Programme (NMHP), ensuring coordinated and accessible care across all states.
Launched on 10 October 2022, World Mental Health Day, Tarannum has supported the successful implementation of the guidelines in all states in India. This has included facilitating the development of the Tele MANAS application and its integration with the national teleconsultation services, eSanjeevani.
Over the last 1.5 years since its implementation, the service as received approximately 900,000 calls from patients to access treatment and counselling.
Tarannum is now involved in strengthening the service further, including the launch of a mobile app which she hopes will make the service more user-friendly.
Achievements from the Commonwealth Scholarship
Looking at the work she has achieved to date, Tarannum is proud of the contributions she has made to improving healthcare in India and in using her experiences and expertise to bring change.
“A significant achievement because of my Commonwealth Scholarship has been developing the ability to make impactful changes in the healthcare domain at the national level. The Scholarship didn’t just change my career, it changed me. It gave me the chance to step outside the world I knew, to ask bigger questions, and to imagine what justice in healthcare could truly look like. That experience of learning, unlearning, and seeing health through the eyes of those most often unheard gave me the courage to come back and try to make a difference, however small, within the systems I’m part of. It reminded me that healthcare isn’t just policy or infrastructure, it’s a matter of humanity. Without that opportunity, I wouldn’t have found the clarity or confidence to do this work. The Scholarship shaped not just my path, but the kind of person I’m still becoming, someone more hopeful and deeply committed to building a fairer future in health.”
Tarannum Ahmed is a 2018 Commonwealth Shared Scholar from India. She completed an MSc in Global Health at the London School of Economics and Political Science.
