Table 3 Major themes emerged and rating for PARIHS construct and sub-elements
Construct and Sub-element | Major theme emerged | Rating |
|---|---|---|
Evidence | ||
Research evidence | - Local research ongoing, research focus on implementation not focusing on effectiveness | Low |
Clinical experience | - Positive observation, feedback and small-scale data analysis from early practice | High |
Patient preference and experience | - Some patient feedback, very limited patient preference | Low |
External evidence | - Published literature to create early awareness but not fully applicable - Knowledge received from international, national and hospital-level expert training - Observed evidence from exchange visits from other countries (especially high-income countries) | Moderate |
Context | ||
Culture | - Learning and communication culture through continuous training, communication between hospitals and among medical staff - Culture of multidisciplinary teamwork, between doctors and nurses, between obstetric and pediatric departments - Some opportunity for innovation | High |
Leadership | - Strong support from leadership considered as pre-requisite, especially to tackle organizational resistance to change - Task-driven organizational structure led to fast resource mobilization and organizational changes | High |
Evaluation | - Small scale data audit and feedback to maintain quality of implementation | High |
Resources | - Limited physical environment and human resources constrained intervention scale-up - Financial resource and concern over out-of-pocket charges | Moderate |
Facilitation | ||
Purpose | - “Task”: raising awareness, allocating resources, setting target and supporting staff | High |
Role | - “Enabling”: moderate intervention initiation including disseminate training and allocate resource - “Practical”: supervision of practice | |
Skills and attribute | - Varied attributes between facilitators, some more proactive in training and motivating staff | |