Table 3 Measures and data sources for degree and variation of implementation success (Aim 2)

Continuation

Yes/No indicating ceased or continued to offer group antenatal care

Benchmarks

Reach

% in group care based on the total number of antenatal care clients

Benchmarks

Fidelity

Quarterly clinic mean scores; High fidelity indicated by high group engagement, high session management and interpersonal facilitation skills (e.g., controlling negativity, drawing out participants), and overall rating as more like discussion than classroom.

Observations

Intervention

• Time: Group vs. usual time required to deliver antenatal care

Interviews

Study Notes

• Additional group care expenses: training, equipment and supplies

• Other: factors affecting implementation (space, scheduling)

Outer Setting

• Ministry of Health (annually); District Health Office (annually); Safe Motherhood Task Force (Quarterly); Other stakeholders, as needed

Meetings

Interviews

Inner Setting

• Clinic characteristics and events reported (staff transfers, leadership, interactions)

• Successes, challenges, solutions, decisions, interpersonal interactions, and evaluation of evidence; coded as positive, negative or mixed

Benchmarks

Interviews

Observation

Individual

(Staff)

• Basic demographics, including education level and experience

Survey

• Maslach Burnout Inventory (9 items; α > .79) [74,75,76];

• Health Worker Motivation (10-item; range 10–50) [77, 78];

• Perspectives on group care (5 items) at baseline and beginning and end of sustain

Process

• Quarterly Benchmark Scores: 25 yes/no items (1 point for each yes). Integrates co-facilitators’ self-evaluation of fidelity and time records. Patterns over time: Fail; Interrupted; Sporadic; Continuous

Benchmarks

Self-evaluations

• Fidelity: Quarterly ratings

Observations