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The RE-AIM framework-based evaluation of the implementation of the Maternal and Child Health Handbook program in Angola: a mixed methods study
BACKGROUND: The World Health Organization recommends the Maternal and Child Health Handbook (MCH-HB) to promote health service utilization from pregnancy to early childhood. Although many countries have adopted it as a national health policy, there is a paucity of research in MCH-HB’s implementation...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9395902/ https://www.ncbi.nlm.nih.gov/pubmed/35996173 http://dx.doi.org/10.1186/s12913-022-08454-9 |
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author | Aoki, Ai Mochida, Keiji Kuramata, Michiru Sadamori, Toru Bhandari, Aliza K C Freitas, Helga Reis da Cunha, João Domingos Francisco, Ketha Rubuz Sapalalo, Pedro Tchicondingosse, Lino Balogun, Olukunmi Omobolanle Aiga, Hirotsugu Takehara, Kenji |
author_facet | Aoki, Ai Mochida, Keiji Kuramata, Michiru Sadamori, Toru Bhandari, Aliza K C Freitas, Helga Reis da Cunha, João Domingos Francisco, Ketha Rubuz Sapalalo, Pedro Tchicondingosse, Lino Balogun, Olukunmi Omobolanle Aiga, Hirotsugu Takehara, Kenji |
author_sort | Aoki, Ai |
collection | PubMed |
description | BACKGROUND: The World Health Organization recommends the Maternal and Child Health Handbook (MCH-HB) to promote health service utilization from pregnancy to early childhood. Although many countries have adopted it as a national health policy, there is a paucity of research in MCH-HB’s implementation. Thus, this study aimed to evaluate the MCH-HB’s implementation status based on the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance), and identify facilitators of, and barriers to its implementation in Angola to understand effective implementation strategies. METHODS: A cross-sectional survey was conducted targeting all health facilities which implemented MCH-HB, subsamples of health workers, and officers responsible for the MCH-HB at the municipality health office. Using the 14 indicators based on the RE-AIM framework, health facilities’ overall implementation statuses were assessed. This categorized health facilities into optimal-implementation and suboptimal-implementation groups. To identify barriers to and facilitators of MCH-HB implementation, semi-structured interviews were conducted among health workers and municipality health officers responsible for MCH-HB. The data were analyzed via content analysis. RESULTS: A total of 88 health facilities and 216 health workers were surveyed to evaluate the implementation status, and 155 interviews were conducted among health workers to assess the barriers to and facilitators of the implementation. The overall implementation target was achieved in 50 health facilities (56.8%). The target was achieved by more health facilities in urban than rural areas (urban 68.4%, rural 53.6%) and by more health facilities of higher facility types (hospital 83.3%, health center 59.3%, health post 52.7%). Through the interview data’s analysis, facilitators of and barriers to MCH-HB were comprehensively demonstrated. MCH-HB’s content advantage was the most widely recognized facilitator and inadequate training for health workers was the most widely recognized barrier. CONCLUSIONS: Strengthening education for health workers, supervision by municipality health officers, and community sensitization were potential implementation strategies. These strategies must be intensified in rural and lower-level health facilities. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-08454-9. |
format | Online Article Text |
id | pubmed-9395902 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-93959022022-08-23 The RE-AIM framework-based evaluation of the implementation of the Maternal and Child Health Handbook program in Angola: a mixed methods study Aoki, Ai Mochida, Keiji Kuramata, Michiru Sadamori, Toru Bhandari, Aliza K C Freitas, Helga Reis da Cunha, João Domingos Francisco, Ketha Rubuz Sapalalo, Pedro Tchicondingosse, Lino Balogun, Olukunmi Omobolanle Aiga, Hirotsugu Takehara, Kenji BMC Health Serv Res Research Article BACKGROUND: The World Health Organization recommends the Maternal and Child Health Handbook (MCH-HB) to promote health service utilization from pregnancy to early childhood. Although many countries have adopted it as a national health policy, there is a paucity of research in MCH-HB’s implementation. Thus, this study aimed to evaluate the MCH-HB’s implementation status based on the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance), and identify facilitators of, and barriers to its implementation in Angola to understand effective implementation strategies. METHODS: A cross-sectional survey was conducted targeting all health facilities which implemented MCH-HB, subsamples of health workers, and officers responsible for the MCH-HB at the municipality health office. Using the 14 indicators based on the RE-AIM framework, health facilities’ overall implementation statuses were assessed. This categorized health facilities into optimal-implementation and suboptimal-implementation groups. To identify barriers to and facilitators of MCH-HB implementation, semi-structured interviews were conducted among health workers and municipality health officers responsible for MCH-HB. The data were analyzed via content analysis. RESULTS: A total of 88 health facilities and 216 health workers were surveyed to evaluate the implementation status, and 155 interviews were conducted among health workers to assess the barriers to and facilitators of the implementation. The overall implementation target was achieved in 50 health facilities (56.8%). The target was achieved by more health facilities in urban than rural areas (urban 68.4%, rural 53.6%) and by more health facilities of higher facility types (hospital 83.3%, health center 59.3%, health post 52.7%). Through the interview data’s analysis, facilitators of and barriers to MCH-HB were comprehensively demonstrated. MCH-HB’s content advantage was the most widely recognized facilitator and inadequate training for health workers was the most widely recognized barrier. CONCLUSIONS: Strengthening education for health workers, supervision by municipality health officers, and community sensitization were potential implementation strategies. These strategies must be intensified in rural and lower-level health facilities. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-08454-9. BioMed Central 2022-08-22 /pmc/articles/PMC9395902/ /pubmed/35996173 http://dx.doi.org/10.1186/s12913-022-08454-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Aoki, Ai Mochida, Keiji Kuramata, Michiru Sadamori, Toru Bhandari, Aliza K C Freitas, Helga Reis da Cunha, João Domingos Francisco, Ketha Rubuz Sapalalo, Pedro Tchicondingosse, Lino Balogun, Olukunmi Omobolanle Aiga, Hirotsugu Takehara, Kenji The RE-AIM framework-based evaluation of the implementation of the Maternal and Child Health Handbook program in Angola: a mixed methods study |
title | The RE-AIM framework-based evaluation of the implementation of the Maternal and Child Health Handbook program in Angola: a mixed methods study |
title_full | The RE-AIM framework-based evaluation of the implementation of the Maternal and Child Health Handbook program in Angola: a mixed methods study |
title_fullStr | The RE-AIM framework-based evaluation of the implementation of the Maternal and Child Health Handbook program in Angola: a mixed methods study |
title_full_unstemmed | The RE-AIM framework-based evaluation of the implementation of the Maternal and Child Health Handbook program in Angola: a mixed methods study |
title_short | The RE-AIM framework-based evaluation of the implementation of the Maternal and Child Health Handbook program in Angola: a mixed methods study |
title_sort | re-aim framework-based evaluation of the implementation of the maternal and child health handbook program in angola: a mixed methods study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9395902/ https://www.ncbi.nlm.nih.gov/pubmed/35996173 http://dx.doi.org/10.1186/s12913-022-08454-9 |
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