On the eve of 2015 when MDG targets were expected to be met some progress had been made yet critical targets had not been met. Global forums concluded that research should not stop after providing the proof of principle for a product, or after demonstrating its effectiveness in selected situations, but that it has an additional critical role to play in helping to solve major implementation problems.  A systematic approach to understanding and addressing barriers to effective and quality implementation of health innovations, strategies and policies with the hope of scaling up the results (Implementation research) is needed in low and middle income countries.