Improving the standards-based management: recognition initiative to provide high-quality, equitable maternal health services in Malawi. An implementation research protocol: Table 1

摘要

Background:udThe Government of Malawi is seekingudevidence to improve implementation of its flagshipudquality of care improvement initiativeud—udthe StandardsudBased Management-Recognition for ReproductiveudHealth (SBM-R(RH)).udObjective:udThis implementation study will assess theudquality of maternal healthcare in facilities where theudSBM-R(RH) initiative has been employed, identifyudfactors that support or undermine effectiveness of theudinitiative and develop strategies to further enhance itsudoperation.udMethods:udData will be collected in 4 interlinkedudmodules using quantitative and qualitative researchudmethods. Module 1 will develop the programme theoryudunderlying the SBM-R(RH) initiative, using documentudreview and in-depth interviews with policymakers andudprogramme managers. Module 2 will quantitativelyudassess the quality and equity of maternal healthcareudprovided in facilities where the SBM-R(RH) initiativeudhas been implemented, using the Malawi IntegratedudPerformance Standards for Reproductive Health.udModule 3 will conduct an organisational ethnographyudto explore the structures and processes through whichudSBM-R(RH) is currently operationalised. Barriers andudfacilitators will be identified. Module 4 will involveudcoordinated co-production of knowledge byudresearchers, policymakers and the public, to identifyudand test strategies to improve implementation of theudinitiative.udPotential impact:udThe research outcomes willudprovide empirical evidence of strategies that willudenhance the facilitators and address the barriers toudeffective implementation of the initiative. It will alsoudcontribute to the theoretical advances in the emergingudscience of implementation research.