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A comparative study of an NGO-sponsored CHW programme versus a ministry of health sponsored CHW programme in rural Kenya: a process evaluation.

Aridi JO, Chapman SA, Wagah MA, Negin J - Hum Resour Health (2014)

Bottom Line: The varied performance of Community Health Worker (CHW) programmes in different contexts has highlighted the need for implementation of research that focuses on programme delivery issues.This paper presents the results of process evaluations conducted on two different models of CHW programme delivery in adjacent rural communities in in Gem District of Western Kenya.One model was implemented by the Millennium Villages Project (MVP), and the other model was implemented in partnership with the Ministry of Health (MoH) as part of Kenya's National CHW programme.

View Article: PubMed Central - PubMed

Affiliation: The Ford Family Program in Human Development Studies and Solidarity, University of Notre Dame, Nairobi, Kenya. Jackline.Oluoch@gmail.com.

ABSTRACT
The varied performance of Community Health Worker (CHW) programmes in different contexts has highlighted the need for implementation of research that focuses on programme delivery issues. This paper presents the results of process evaluations conducted on two different models of CHW programme delivery in adjacent rural communities in in Gem District of Western Kenya. One model was implemented by the Millennium Villages Project (MVP), and the other model was implemented in partnership with the Ministry of Health (MoH) as part of Kenya's National CHW programme.

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Conceptual framework and assessment areas for the process evaluation.
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Fig3: Conceptual framework and assessment areas for the process evaluation.

Mentions: The evaluation was an implementation assessment that utilized process evaluation methods. Programme process evaluations typically attempt to verify what the programme is, as well as whether or not it is delivered as intended (or with fidelity) to the targeted recipients [27]. In the majority of studies of implementation fidelity, this is done through examining intervention adherence; in other words, the extent to which the programme delivered adheres to the programme’s design specifications with respect to coverage, frequency and duration of the intervention [28]. In addition to assessing intervention adherence, our evaluation also placed considerable emphasis on documenting the barriers and facilitators encountered when delivering the programme. These elements have been referred in the literature as intervention adherence ‘moderators’ [28], and cover a range of programme activities and attributes which include the comprehensiveness of the intervention policy; the support strategies adopted by the programme; the quality of the programme delivery; and the responsiveness of the programme participants [28]. Following the model proposed by Carroll et al. [28]; we used these moderators as a basis upon which to build a conceptual framework for the assessment of programme barriers and facilitators in the implantation evaluation. Within this conceptual framework, we identified ten priority assessment areas for CHW programmes which can be described as potential programme implementation moderators, and four priority assessment areas for programme adherence (Figure 3).Figure 3


A comparative study of an NGO-sponsored CHW programme versus a ministry of health sponsored CHW programme in rural Kenya: a process evaluation.

Aridi JO, Chapman SA, Wagah MA, Negin J - Hum Resour Health (2014)

Conceptual framework and assessment areas for the process evaluation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4230347&req=5

Fig3: Conceptual framework and assessment areas for the process evaluation.
Mentions: The evaluation was an implementation assessment that utilized process evaluation methods. Programme process evaluations typically attempt to verify what the programme is, as well as whether or not it is delivered as intended (or with fidelity) to the targeted recipients [27]. In the majority of studies of implementation fidelity, this is done through examining intervention adherence; in other words, the extent to which the programme delivered adheres to the programme’s design specifications with respect to coverage, frequency and duration of the intervention [28]. In addition to assessing intervention adherence, our evaluation also placed considerable emphasis on documenting the barriers and facilitators encountered when delivering the programme. These elements have been referred in the literature as intervention adherence ‘moderators’ [28], and cover a range of programme activities and attributes which include the comprehensiveness of the intervention policy; the support strategies adopted by the programme; the quality of the programme delivery; and the responsiveness of the programme participants [28]. Following the model proposed by Carroll et al. [28]; we used these moderators as a basis upon which to build a conceptual framework for the assessment of programme barriers and facilitators in the implantation evaluation. Within this conceptual framework, we identified ten priority assessment areas for CHW programmes which can be described as potential programme implementation moderators, and four priority assessment areas for programme adherence (Figure 3).Figure 3

Bottom Line: The varied performance of Community Health Worker (CHW) programmes in different contexts has highlighted the need for implementation of research that focuses on programme delivery issues.This paper presents the results of process evaluations conducted on two different models of CHW programme delivery in adjacent rural communities in in Gem District of Western Kenya.One model was implemented by the Millennium Villages Project (MVP), and the other model was implemented in partnership with the Ministry of Health (MoH) as part of Kenya's National CHW programme.

View Article: PubMed Central - PubMed

Affiliation: The Ford Family Program in Human Development Studies and Solidarity, University of Notre Dame, Nairobi, Kenya. Jackline.Oluoch@gmail.com.

ABSTRACT
The varied performance of Community Health Worker (CHW) programmes in different contexts has highlighted the need for implementation of research that focuses on programme delivery issues. This paper presents the results of process evaluations conducted on two different models of CHW programme delivery in adjacent rural communities in in Gem District of Western Kenya. One model was implemented by the Millennium Villages Project (MVP), and the other model was implemented in partnership with the Ministry of Health (MoH) as part of Kenya's National CHW programme.

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