Conducting implementation research means adapting to, and coping with, changes in the external operating environment. In Kenya the REACHOUT team has had to conduct their research on improving the quality of close-to-community health programmes whilst the country implements the process of devolution. This has created new challenges and opportunities that we have needed to respond to. Our experiences provide lessons for other countries undergoing similar changes.

Devolution refers to the process of decentralization of government that Kenya underwent in 2014 from one centralized government to 47 counties with responsibility for hiring, budget and decision making leaving the national government with capacity building, standards and policy making
In 2013, LVCT Health conducted a context analysis on community health services in Kenya which identified lack of supportive supervision as a factor influencing performance of community health workers. The second phase of the study involved implementing a supportive supervision intervention in four community health units in Nairobi and Kitui counties, Kenya.
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