Building the Future of Implementation Science Education in Africa: Highlights from Day 2 of the IS4NCDs Regional Consortium Meeting

5 May 2026

The IS4NCDs (Implementation Science for Non-Communicable Diseases) programme aims to build regional capacity to address the growing burden of NCDs through evidence-based, contextualised implementation science. Central to this mission is the development and piloting of curriculum modules — core, intermediate, and advanced — designed to equip a diverse range of learners with the skills to bridge the gap between research evidence and real-world health practice.

Day 2 focused on two major areas: the operational and structural decisions needed to move the modules from design to delivery, and a deeper exploration of the content and frameworks underpinning the core modules.

Setting the Stage: From Recap to Decision-Making

The day opened with a structured recap of Day 1, which had covered the IS4NCDs competency framework — a set of five competency clusters spanning implementation science expertise, general research competence, communication and dissemination, and interpersonal and participatory research skills. These competencies formed the basis for linking learning outcomes across all modules.

Rather than proceeding directly to content discussions, the consortium made an important procedural decision: to first settle the operational questions — where modules will be piloted, in what format, under which accreditation structures, for which audiences, and over what duration. This decision-first approach was seen as essential for ensuring that subsequent content discussions would be grounded in realistic, agreed-upon parameters.

To support this process, a shared Excel template was distributed to all participants and working groups, enabling structured, parallel discussions across the core, intermediate, advanced, and executive course groups simultaneously.

Core Modules: Operational Decisions

The core module group — the Copperbelt University team — presented the following agreed positions:

Format: All core modules will be delivered in a hybrid workshop format, combining online and in-person elements. This was chosen to balance accessibility with the interactive, collaborative nature of the learning activities.

Piloting Across Four Institutions: A key proposal was to pilot all core modules at all four consortium institutions simultaneously. To make this feasible, the proposed model involves online lectures streamed into classrooms at each institution, with local facilitators supporting face-to-face group work in each location. This approach was noted for its efficiency — effectively running twelve pilots in the time of one — while also enabling institutions to slightly tailor the experience to their local context and target audience.

Accreditation: In Zambia, micro-credentialing frameworks do not yet exist in the same form as elsewhere. The consortium agreed to proceed with workshop delivery and Certificate of Attendance as an immediate outcome, while simultaneously pursuing formal accreditation through higher education authorities — a process estimated to take approximately six months. The long-term goal is formal micro-credentialing or short course accreditation across all participating institutions, with the understanding that terminology varies across national qualification frameworks (NQF).

There was substantive discussion around the distinction between a Certificate of Attendance and a Certificate of Competence. While the latter is more valuable to participants — particularly where credits could contribute toward a degree — it requires prior formal accreditation. Given programme timelines, the Certificate of Attendance approach for the pilot phase was accepted as a pragmatic necessity, with competence-based certification as a medium-term goal.

Target Audience: The core modules will target individuals with a minimum of a bachelor's degree, drawn from multidisciplinary backgrounds including health professionals, social scientists, computer scientists, and those already working in or adjacent to implementation science. Discussion surfaced important nuances around NQF levels — particularly for nurses and midwives whose qualifications may not be classified at bachelor's level in all national frameworks, and how institutions might accommodate this variation.

Duration: The core modules are planned as six-week programmes, with approximately 24 hours of contact time spread across the period, supplemented by individual study, group assignments, and field activities. Some participants advocated for a more compact format — ideally condensed into one or two weeks — based on experience that continuity and engagement tend to suffer in programmes spread over many weeks among working professionals.

Intermediate and Advanced Modules: Overview

While the core modules were the primary focus of the day's content discussions, leads from the intermediate and advanced module groups also presented their operational decisions.

Intermediate Modules: All intermediate modules — covering Quality Improvement, Mixed Methods, and Participatory Action Research — will be delivered fully online, structured as five-day intensive short courses with subsequent assignment periods. The exception is the Mixed Methods module, which will run over six months, with the intensive week followed by a forty-hour proposal preparation phase. Accreditation will be sought at NQF Level 9. The target audience includes health systems programme managers, clinicians, and public health practitioners, with researchers included specifically for the Mixed Methods and Participatory Action Research modules.

Advanced Modules: The advanced modules — covering Health Economics and Implementation Science, Multisectoral Approaches and Context Adaptation, and Adapting Theories, Models and Frameworks — will be delivered in a hybrid format, largely because challenge-based learning (a key pedagogical approach) was seen as difficult to implement effectively in a fully online environment. The advanced modules target participants with at least two years of experience as implementers, researchers, or programme officers. Health Economics will be offered as a five-day course, while the other two will be delivered as intensive two-and-a-half-day workshops.

Core Module Content: What Will Be Taught?

Following the operational discussion, the consortium turned to the substance of the core modules, presented by the Copperbelt University team responsible for their development.

Module 1: Fundamentals of Implementation Science

This foundational module introduces participants to the theory and practice of implementation science, with a particular focus on the African health context. Key conceptual areas include:

• Differentiating efficacy, effectiveness, and implementation — moving from "can it work?" to "does it work?" to "how can we make it work in our setting?"
• The Consolidated Framework for Implementation Research (CFIR 2.0) — a widely used framework covering intervention characteristics, inner and outer organisational settings, individual factors, and implementation processes.
• The RE-AIM Framework — focusing on Reach, Effectiveness, Adoption, Implementation, and Maintenance, with particular attention to equity across each dimension.
• Fidelity and Adaptation — exploring the balance between implementing a programme as designed and contextualising it for local realities, and the concept of core functions versus adaptable forms.

The module grounds these frameworks in the African context, where health systems have historically been oriented toward infectious disease management and are now navigating a significant epidemiological transition toward NCDs.

Module 2: NCD Epidemiology and Determinants

This module situates NCDs within the broader epidemiological and social landscape of Africa. Key areas include:

• The Syndemic Framework — rather than viewing NCDs in isolation, this framework examines the interactions between infectious diseases, NCDs, and structural barriers. For example, long-term HIV treatment has contributed to rising rates of metabolic conditions and cardiovascular disease in the region.
• The Social Ecological Model — exploring how individual health outcomes are shaped by community, organisational, and policy-level factors, and how implementation strategies must account for this hierarchy.
• Commercial Determinants of Health — including the role of industries such as tobacco, alcohol, and processed food in undermining health promotion efforts.
• Equity — a throughline across the module, examining how social determinants such as socioeconomic status continue to produce health disparities even when programmes are being implemented.

Module 3: Monitoring, Evaluation, and Programme Design

This module focuses on designing, implementing, and evaluating programmes using implementation science tools. Key areas include:

• The ERIC Taxonomy — a framework of 73 implementation strategies grouped into categories, supporting practitioners in selecting and categorising their implementation approach.
• The Implementation Logic Model — mapping from problem identification through inputs, activities, outputs, and proximal and distal outcomes.
• Implementation, Service, and Client Outcomes — understanding how effectiveness is measured at multiple levels, from programme penetration to quality of life improvements.
• Economic Evaluation — an introduction to costing and economic considerations in implementation, with deeper content reserved for the advanced Health Economics module.

Curriculum Development: A Knowledge Co-Creation Process

A distinctive feature of the IS4NCDs curriculum development process has been the formation of Knowledge Creation Teams (KCTs) — multi-stakeholder groups that contributed to shaping the content of each module. KCT members included academic staff from consortium universities, postgraduate students (including Master of Public Health students), frontline health workers such as physicians, and policy makers from Ministries of Health.

Through structured needs assessments and consultations, the KCTs informed the curriculum in four key areas: institutional resource assessment, learner career trajectory and demand, practitioner buy-in and perceived need, and policy alignment. The resulting curriculum content was then mapped against the IS4NCDs competency framework to ensure alignment and completeness.

This process also surfaced important contextual differences between institutions — for example, stronger methodological expertise at some institutions and deeper clinical context at others — which informed how content is balanced and where each institution's contribution is most valuable.

Cross-Cutting Themes: Equity, Sustainability, and South-to-South Learning

Several themes recurred throughout the day's discussions, reflecting the programme's broader values and commitments.

Equity was raised repeatedly — not only in terms of curriculum content (ensuring that learning addresses the needs of marginalised populations), but also in terms of access to the programmes themselves. Participants emphasised the importance of avoiding financial or logistical barriers that would exclude the very practitioners the programme seeks to reach. The observation that previous online pilot offerings attracted hundreds of applicants was taken as evidence of strong demand — and as a reminder that design choices around format, cost, and scheduling have real equity implications.

Long-term sustainability was a major concern. The consensus view was that the pilot phase serves not only project deliverables but also the long-term goal of embedding these modules into the regular offerings of each consortium university. Some institutions are already planning to integrate short-course participants into existing postgraduate classes, creating a pathway that serves both short-course and degree-seeking students simultaneously.

South-to-South collaboration was highlighted as a distinctive and underappreciated strength of the programme. While much global health capacity building flows from North to South, IS4NCDs deliberately fosters peer-to-peer exchange between Zambia and South Africa — building shared knowledge and institutional relationships that will outlast the project itself.

Looking Ahead

The discussions concluded with a clear sense of direction. Operational decisions have been made — or are close to being finalised — across all module tiers. The curriculum content for the core modules has been presented and is undergoing refinement through competency and learning outcome mapping. The next steps involve deeper content-level discussions for all modules, finalising roadmaps for each institutional pilot, and continuing the parallel accreditation processes.

The IS4NCDs consortium is demonstrating what becomes possible when institutions across countries and disciplines work together with a shared commitment to relevance, equity, and rigour. The modules being designed are not just courses — they are an investment in a generation of implementation scientists equipped to address the NCD challenge in Africa and beyond.