Table 1 Summary of characteristics of included studies

Adamu 2019 [50]

Nigeria

TDF

Qualitative

Pre-implementation use of IR to guide the implementation of a quality improvement programme for improving routine childhood immunisation services

Parents and caregivers of children attending primary health care facilities

Facilitators: Perceived benefits of vaccines and adequate communication of benefits

Barriers: inadequate knowledge of the vaccines, non-screening of home-based records, health worker’s refusal to offer immunization services, and husband’s refusal due to socio-cultural beliefs

To reduce missed opportunities for vaccination and improve routine childhood immunisation coverage

Adamu 2020 [51]

Nigeria

CFIR

Mixed methods

IR used to guide data collection, data analysis and post-implementation evaluation of routine childhood immunisation services

Primary health care facility staff

Facilitators: Intervention flexibility, self-efficacy among health workers, health workers’ confidence in the intervention, services integration.

Barriers: Vaccine stock out, faulty cold chain infrastructure, lack of incentives, and socio-cultural beliefs

Improved access to routine childhood immunisation services

Anaba 2019 [52]

Ghana

NPT

Quantitative

IR used to guide data collection, data analysis and post-implementation evaluation of malaria rapid diagnostic test (mRDT) practices among health workers

Health workers

Facilitators: three or more years of experience, clarity on the benefits, availability of innovation champions or initiators and readiness for change practices

Barriers: poor monitoring

Optimised intention to use mRDT in the diagnosis of malaria

Barac 2018 [53]

Multi-country, including Nigeria and South Africa

CFIR

Mixed methods

IR used to guide data collection, data analysis and post-implementation evaluation of typhoid control interventions

Organisations involved in implementation; Health policy and health system leaders at national or subnational levels

Facilitators: Use of multiple implementation strategies to target behaviour change.

Barriers: Limited resources and planning, habitual behaviours and cultural practices.

Better understanding of the effectiveness of typhoid control interventions

Bardosh 2017 [54]

Multi-country, including Kenya

CFIR

Qualitative

IR-oriented mid-implementation and evaluation of a mobile health (mHealth) intervention.

Health care workers, research team members, and community members

Facilitators: Perceived positive impact on patients

Barriers: Illiteracy, stigma

and, patients’ lack of phone making contact difficult

Improved HIV and Maternal, Neonatal and Child Health (MNCH) service delivery.

Cole 2018 [55]

Mozambique

CFIR

Mixed methods

IR used to guide post-implementation evaluation of a maternal health programme.

Health providers in facilities involved in implementation; Patients benefiting from intervention

Facilitators: Programme adaptability, shared perceives and collective goals among stakeholders.

Barriers: use of volunteer-based

implementation with actors outside of the formal health

system, with limited retention..

To explore the contextual factors that may have contributed to observed increases in skilled birth attendance.

Cooke 2019 [56]

Tanzania

CFIR

Qualitative

IR-oriented implementation and evaluation of an integrated anti-retroviral therapy and opioid treatment programme.

Patients benefiting from intervention; Health providers in facilities involved in implementation

Facilitators: Clearly understood roles among stakeholders and programme adaptability

Barriers: lack of space for patient confidentiality and stigma

To understand the contextual factors that influence the effectiveness of integrated methadone and anti-retroviral therapy implementation

Eboreime 2018 [57]

Nigeria

QIF

Qualitative

IR used to guide post-implementation evaluation of a primary health care system improvement intervention.

Primary health care programme managers

Facilitators: Adequate pre-intervention planning and stakeholder engagement

Barriers: Inadequate stakeholder engagements and poor fidelity to planned implementation processes

To identify factors influencing the implementation of a primary health care quality improvement programme.

Eboreime 2019 [58]

Nigeria

MUSIQ

Mixed methods

IR used to guide post-implementation evaluation of a primary health care system improvement intervention.

Primary health care programme managers

Facilitators: Subnational political will

Barriers: suboptimal subnational government leadership, management, financial and technical support

To identify factors influencing a primary health care quality improvement programme’s implementation outcomes

English 2013 [59]

Kenya

CFIR and TDF

Qualitative

IR-oriented pre-implementation evaluation of a child health programme.

Organisations involved in implementation

Facilitators: peer pressure, clear communications, provision of feedback, development of a learning climate,

leadership engagement, enhancement of self-efficacy

Barriers: knowledge and skills of personnel

To develop a system-oriented intervention to improve services for children in district hospitals

Finocchario-Kessler 2015 [60]

Kenya

Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) model

Quantitative

Using programme data to guide post-implementation evaluation and contextualising lessons learnt.

Mother-infant pairs utilising EID services and government health care providers and lab personnel

Facilitators: Strong and sustained collaborations with stakeholders improve the quality and reach of eHealth public health interventions.

Barriers: Local leadership and resource constraints.

Improve HIV early infant diagnosis (EID)

Gimbel 2016 [61]

Multi-country, including Mozambique, Kenya, Cote d’Ivoire

CFIR

Qualitative

IR-oriented post-implementation evaluation of a mother-to-child-transmission (PMTCT) and paediatric HIV programme

Organisations involved in implementation

Facilitators: communication, available resources, external change agents, executing, and reflecting and evaluating

Barriers: Resistance from the lead nurse

To define the core and adaptable components of a facility-based intervention to address implementation challenges in prevention of mother to child transmission (PMTCT), and identify contextual influences that explain implementation heterogeneity

Gimbel 2017 [62]

Multi-country, including Mozambique, Rwanda, and Zambia

CFIR

Mixed methods

IR-oriented post-implementation evaluation of data quality assessment and improvement activities within the PHIT programmes

Organisations involved in implementation

Facilitators: intervention components that aligned with user priorities and government systems and the use of evidence to justify intervention to stakeholders.

Barriers: Lack of support from District Health Office

To improve aaccess to comprehensive, accurate data to guide resource allocation and programmatic improvement efforts

Jones 2018 [63]

Zambia

CFIR

Mixed methods

IR-oriented mid-implementation evaluation of a voluntary male medical circumcision programme

Lay counsellors and nursing staff

Facilitators: Performance evaluation with remedial feedback

Increased acceptability and uptake of voluntary male medical circumcision

Maruma 2018 [64]

South Africa

TFA

Mixed methods

IR-oriented post-implementation evaluation of data collection by community health workers for tuberculosis contact tracing

CHWs

Facilitators: Feedback through pre-and post-assessmentsg.

Barriers: Inadequate training, lack of community acceptance and resource constraints.

To determine factors influencing the collection of information by community health workers for tuberculosis contact tracing

McRobie 2017 [65]

Uganda

CFIR

Mixed methods

IR-oriented pre-implementation evaluation of HIV testing, care and treatment policy implementation

Health providers in facilities involved in implementation

Facilitators: donor investment and support, strong scientific evidence, low policy complexity, phased implementation and effective planning.

Barriers: Limited human resources, infrastructure and health management information systems.

To assess implementation of national HIV policies regarding testing, treatment, and retention at health facilities serving two health and demographic surveillance sites

Nabyonga-Orem 2014 [66]

Uganda

(MRT)

Mixed methods

IR-oriented post-implementation evaluation of barriers and facilitating factors to the uptake of evidence in the process of user fee abolition

Donors, policymakers, researchers, civil society, journalist, private service provider

Facilitators: The political window and alignment of the evidence with overall government discourse enhanced uptake of evidence

Uptake of evidence in the process of user fee abolition

Naidoo 2018 [67]

South Africa

CFIR

Qualitative

IR-oriented post-implementation evaluation of community-based HIV programmes

Community members, CHWs, team leaders, facility staff, community leaders, and social workers

Facilitators: networking and peer-support, recognition of the CHWs by the government, standardised training.

Barriers: Limited space and infrastructure for CHWs to work in.

To explore barriers and facilitators to implementation of community-based HIV programmes in order to produce actionable findings to improve them

Newman-Owiredu 2017 [68]

Multi-country, including Malawi, Nigeria, and Zimbabwe

NR

Mixed methods

IR-oriented post-implementation review of HIV (PMTCT) implementation capacity building activities

Health care workers, research team members, and community members support staff (Expert Mothers/Mother Mentors/Mother Support Groups)

Facilitators: financial incentives offered as part of national training exercises.

Barriers: health workers’ perception of research as additional work rather than an opportunity to learn or develop professionally.

Scaling up Option B+ antiretroviral treatment and retention in care.

Petersen Williams 2015 [69]

South Africa

CFIR

Qualitative

Use of IR for pre-implementation design of a screening, referral and treatment programme for substance use among women receiving antenatal care

Health providers in facilities involved in implementation

Facilitators: training,

adequate support, guidance, and mentoring.

Barriers: intervention being considered as additional work, lack of interest from staff, time constraints, staff shortages, overburdened workloads, and language barriers.

To investigate health care providers’ perceptions of the acceptability and feasibility of providing screening, brief intervention, and referral to treatment to address maternal substance use among pregnant women attending antenatal care

Rodriguez 2017 [70]

South Africa

CFIR

Qualitative

Qualitative interviews, focus groups discussions, workshop with district directors, clinic leaders, staff, and patients. Prospective programme evaluation.

Health providers in facilities involved in implementation; health policy and health system leaders at national or subnational levels; patients benefiting from intervention

Facilitators: Leader support, and employee readiness and motivation

Barriers: Hierarchical relationships between staff

To identify barriers and facilitators in the implementation, uptake, and sustainability of PMTCT protocols in a rural areas

Rodriguez 2019 [71]

Zambia

CFIR

Mixed-methods

Quantitative and qualitative evaluations of organisational, burnout, and organisational readiness functioning and barriers to implementation.

Health care providers

Facilitators: community engagement, leadership support, employee readiness and motivation.

Barriers: Resource constraints and poor communication of programme benefits.

Uptake of voluntary medical male circumcision

Soi 2018 [72]

Mozambique

CFIR

Qualitative

IR-oriented post-implementation evaluation of the scale-up of an human papillomavirus (HPV) vaccination programmes

Health providers and educators in facilities and schools involved in implementation; health and education policy and health system leaders at national or subnational levels

Facilitators: Health workers’ beliefs in importance of vaccines and an organisational culture of making personal sacrifice for immunisation, advocacy and social mobilisation through the right opinion leaders and champions

Barriers: weak infrastructural characteristics and insufficient organisational incentives

To identify implementation barriers and facilitators affecting the scale-up of HPV vaccination in Mozambique

Warren 2017 [73]

Kenya

CFIR

Qualitative

Using IR an analytical lens for post-implementation evaluation of a complex, multifaceted maternal health programme

Community, facility (nurses and midwives), and policy stakeholders (ministry of health), Federation of Women’s Lawyers - FIDA

Facilitators: individual champions, Collaboration with civil-society organisations like FIDA

To address the causes of mistreatment during childbirth and promote respectful maternity care

White 2019 [74]

Benin

CFIR

Mixed methods

IR used to guide mid- implementation evaluation of a quality improvement programme as well as the contextualisation of evaluation findings.

Health providers in facilities involved in implementation

Facilitators: Surgical enthusiasm, self-efficacy and motivation, in-depth stakeholder engagement at multiple levels

Barriers: Staff viewed the checklist as irrelevant or a waste of time and leadership appeared arrogant.

To measure the sustainability of surgical safety checklist use and to evaluate the acceptability, adoption, appropriateness, feasibility and fidelity of nationwide checklist implementation, including penetration of the checklist into operating room culture

Zitti 2019 [75]

Mali

CFIR

Qualitative

IR used to guide post-implementation evaluation of a pilot performance based healthcare financing programme

Health facility staff and managers

Facilitators: Implementing a pilot project and good leadership

Gaining contextual understanding of performance-based healthcare financing.