CIRCLE YEAR THREE ANNUAL REPORT

The project's primary objective is to advance Agency priorities through strategic planning, stakeholder engagement, implementation research (IR), knowledge management, and research translation. In Year Three, CIRCLE accelerated its activities, growing in terms of staffing and work. The project managed 19 distinct activities spanning four objective areas: communicating the process and value of IR and sharing learning, engaging a broad range of stakeholders for shared learning to advance the use of evidence, supporting IR approaches to address key knowledge gaps, and assisting the Health Research Program to advance IR through project management and surge support. CIRCLE actively promoted the Health Research Program's role in increasing understanding of IR as a means to improve programs in real time. This understanding, and IR's subsequent increased uptake, can help accelerate the use of best practices and optimize health services. To boost this positioning, CIRCLE significantly contributed to raising the Health Research Program's presence through an active internet presence and constructive stakeholder engagement at key meetings. CIRCLE supported the Health Research Program's presence at the Health Systems Research Symposium in October 2018 in Liverpool, England, as a strong global advocate of IR in maternal and child health (MCH) programming. CIRCLE coordinated two satellite sessions, maintained an active web/social media presence, and announced the Partnership Statement to Achieve Health Results Through Advancing Implementation Research and Delivery Science, a partnership involving USAID and five other donor partners. CIRCLE is increasing the dialog about adaptive programming and co-design by continuously and effectively engaging a broad spectrum of health system participants across multiple sectors. CIRCLE broadly supports stakeholder engagement through communities of practice (CoP) on thematic topics, as well as local stakeholder engagement efforts to strengthen technical approaches and help countries to learn and apply findings as they implement programs. CIRCLE-supported CoPs for possible serious bacterial infection (PSBI), MCH care-seeking and referral, and urban health in sub-Saharan Africa collectively grew from 10 members in five countries in June 2018 to nearly 700 members from over 68 countries by September 2019. CIRCLE engaged these stakeholders to share expertise through 16 monthly webinars and provided expert technical assistance to partners in three countries who are implementing programs on these topics. To advance knowledge of how air pollution is affecting child health outcomes, CIRCLE organized a two-day Air Pollution Solutions workshop in New York City. This was the first-ever large-scale discussion on this topic and was attended by 44 experts from eight countries representing academia, donors, the United Nations (UN), philanthropic initiatives, civil society organizations, and the private sector. CIRCLE is managing four country-focused IR activities that are engaging multiple stakeholders to participate in the learning process in real time. CIRCLE/Tanzania completed two qualitative review cycles as well as the first cycle of research for the developmental evaluation (DE) of the Boresha Afya project in Tanzania and shared results with stakeholders that are being used to adapt three bilateral health programs during the program cycle. In summary, Year Three featured successful production of field-based research content, information presented in useful formats, placement of highly skilled technical assistance, and convening of a multitude of stakeholder partners including local government officials, program implementers, USAID staff, and researchers. All of these achievements were more notable with the U.S. government shutdown and a challenging landscape of local events. CIRCLE continues to provide key surge support and fast response for needs that the Health Research Program identifies. This support is key to helping the Health Research Program advance its goal to promote stakeholders' increased uptake of IR, which, in turn, helps a country progress on its journey to self-reliance.