BACKGROUND:
Despite numerous life-saving innovations, significant implementation gaps and inequities remain, especially in maternal and newborn health (MNH), where progress toward Sustainable Development Goals (SDGs) has stalled. A clear divide persists between what is known and what is done, highlighted by the global shortage of one million midwives.

OBJECTIVES:
This study was undertaken in support of the Lancet Commission on Evidence-based Implementation in Global Health. We focused on Implementer’s Voices and explored, how and why they use evidence, the barriers, and ways to bridge potential gaps between evidence and implementation, especially in resource-limited settings.

METHODS:
There were two phases. First, a global, multilingual crowdsourcing survey gathered quantitative and open-text data (July 2024-June 2025) from >1500 responses from 115 countries, including those affected by crisis or instability. Second, in-depth interviews were conducted with 40 selected implementers (including midwives, nurses, doctors, policymakers, academics, and health information specialists), representing diverse regions and sectors (Dec 2024-June 2025).

RESULTS:
Survey findings showed that while evidence and guidelines shape what to implement, less is known about how to implement effectively in varied contexts. Interviews highlighted the need for interventions and implementation strategies to reflect local values, priorities, and needs. Participants stressed the importance of participatory approaches that engage both communities and implementers.

CONCLUSIONS:
Implementers had a nuanced understanding of the complexities surrounding evidence use for maternal and newborn health and beyond, including for crisis-affected settings. Their experiences underscore the importance of empowering local voices to create more equitable and responsive health systems.

KEY MESSAGE:
Implementation must be embedded in systems that are responsive to local needs, realities, values and power dynamics. To meet SDG targets for MNH, global health efforts should prioritise inclusive, context-driven strategies guided by local communities and service providers. Poster session 4 (Group B)