Implementation research logic model in the design and execution of eHealth innovations for maternal and newborn healthcare in Ethiopia
Abstract Background The use of eHealth innovations is becoming increasingly important in improving health outcomes, especially for maternal and newborn health. However, planning and executing these innovations can be challenging due to their complex nature. To provide guidance and clarity on impleme...
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BMC
2025-01-01
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| Series: | Health Research Policy and Systems |
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| Online Access: | https://doi.org/10.1186/s12961-024-01259-8 |
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| author | Dabere Nigatu Muluken Azage Eyaya Misgan Daniel A. Enquobahrie Tegegn Kebebaw Enyew Abate Esubalew Alemneh Mirkuzie Woldie Tsinuel Girma |
| author_facet | Dabere Nigatu Muluken Azage Eyaya Misgan Daniel A. Enquobahrie Tegegn Kebebaw Enyew Abate Esubalew Alemneh Mirkuzie Woldie Tsinuel Girma |
| author_sort | Dabere Nigatu |
| collection | DOAJ |
| description | Abstract Background The use of eHealth innovations is becoming increasingly important in improving health outcomes, especially for maternal and newborn health. However, planning and executing these innovations can be challenging due to their complex nature. To provide guidance and clarity on implementation approaches, researchers need to use implementation research (IR) tools. We conducted IR to recognize the challenges in implementing eHealth innovations in the context of maternal and newborn healthcare using the implementation research logic model (IRLM). Therefore, this paper aims to describe the practical application of IRLM to design, execute and evaluate eHealth innovations that improve maternal and newborn care in public facilities in Ethiopia. Methods We employed rapid review, formative assessment and process evaluation of an eHealth innovation in selected healthcare facilities serving maternal and newborn care. The eHealth innovation we developed and deployed was named ‘ADHERE’ (Antenatal Care, ChilDbirtH CarE and Postnatal CaRE), representing the continuum of maternal care. The rapid review was conducted as an initial step using the Consolidated Framework for Implementation Research (CFIR). We employed a mix of data collection methods: interview/discussion, eHealth system or document review and direct observation. Furthermore, we executed various stakeholder engagement activities: two co-creation workshops and on-site iterative discussions. We applied the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME-IS) to capture ongoing implementation learnings. Results We developed IRLM of the eHealth innovation implementation for three contexts: urban, peri-urban and remote public healthcare facilities. The model depicted the mechanism of interaction between implementation determinants and implementation strategies to produce the intended implementation outcomes. The IRLM helped to identify more than 35 implementation barriers or facilitators for eHealth interventions and to develop over 17 mitigation strategies for the study contexts. The initial IRLM was refined through ongoing implementation learnings and the mitigation strategies that were executed. Conclusions The IRLM is a comprehensive and effective guiding tool for the development, implementation and evaluation of innovations in various low- and middle-income contexts. Researchers and implementing partners should adapt and use it. |
| format | Article |
| id | doaj-art-21a53b0840e646a88697ee7eb7c85cd9 |
| institution | Kabale University |
| issn | 1478-4505 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Health Research Policy and Systems |
| spelling | doaj-art-21a53b0840e646a88697ee7eb7c85cd92025-01-12T12:44:58ZengBMCHealth Research Policy and Systems1478-45052025-01-0123111410.1186/s12961-024-01259-8Implementation research logic model in the design and execution of eHealth innovations for maternal and newborn healthcare in EthiopiaDabere Nigatu0Muluken Azage1Eyaya Misgan2Daniel A. Enquobahrie3Tegegn Kebebaw4Enyew Abate5Esubalew Alemneh6Mirkuzie Woldie7Tsinuel Girma8Department of Reproductive Health and Population Studies, School of Public Health, College of Medicine and Health Sciences, Bahir Dar UniversitySchool of Public Health, College of Medicine and Health Sciences, Bahir Dar UniversitySchool of Medicine, College of Medicine and Health Sciences, Bahir Dar UniversityDepartment of Epidemiology, School of Public Health, University of WashingtonICT4D Research Center, Bahir Dar Institute of Technology, Bahir Dar UniversitySchool of Medicine, College of Medicine and Health Sciences, Bahir Dar UniversityICT4D Research Center, Bahir Dar Institute of Technology, Bahir Dar UniversityDepartment of Health Policy and Management, Institute of Health, Jimma UniversitySchool of Public Health, College of Medicine and Health Sciences, Bahir Dar UniversityAbstract Background The use of eHealth innovations is becoming increasingly important in improving health outcomes, especially for maternal and newborn health. However, planning and executing these innovations can be challenging due to their complex nature. To provide guidance and clarity on implementation approaches, researchers need to use implementation research (IR) tools. We conducted IR to recognize the challenges in implementing eHealth innovations in the context of maternal and newborn healthcare using the implementation research logic model (IRLM). Therefore, this paper aims to describe the practical application of IRLM to design, execute and evaluate eHealth innovations that improve maternal and newborn care in public facilities in Ethiopia. Methods We employed rapid review, formative assessment and process evaluation of an eHealth innovation in selected healthcare facilities serving maternal and newborn care. The eHealth innovation we developed and deployed was named ‘ADHERE’ (Antenatal Care, ChilDbirtH CarE and Postnatal CaRE), representing the continuum of maternal care. The rapid review was conducted as an initial step using the Consolidated Framework for Implementation Research (CFIR). We employed a mix of data collection methods: interview/discussion, eHealth system or document review and direct observation. Furthermore, we executed various stakeholder engagement activities: two co-creation workshops and on-site iterative discussions. We applied the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME-IS) to capture ongoing implementation learnings. Results We developed IRLM of the eHealth innovation implementation for three contexts: urban, peri-urban and remote public healthcare facilities. The model depicted the mechanism of interaction between implementation determinants and implementation strategies to produce the intended implementation outcomes. The IRLM helped to identify more than 35 implementation barriers or facilitators for eHealth interventions and to develop over 17 mitigation strategies for the study contexts. The initial IRLM was refined through ongoing implementation learnings and the mitigation strategies that were executed. Conclusions The IRLM is a comprehensive and effective guiding tool for the development, implementation and evaluation of innovations in various low- and middle-income contexts. Researchers and implementing partners should adapt and use it.https://doi.org/10.1186/s12961-024-01259-8Implementation scienceImplementation research logic modelMaternal healthcareNewborn healthcareImplementation strategieseHealth |
| spellingShingle | Dabere Nigatu Muluken Azage Eyaya Misgan Daniel A. Enquobahrie Tegegn Kebebaw Enyew Abate Esubalew Alemneh Mirkuzie Woldie Tsinuel Girma Implementation research logic model in the design and execution of eHealth innovations for maternal and newborn healthcare in Ethiopia Health Research Policy and Systems Implementation science Implementation research logic model Maternal healthcare Newborn healthcare Implementation strategies eHealth |
| title | Implementation research logic model in the design and execution of eHealth innovations for maternal and newborn healthcare in Ethiopia |
| title_full | Implementation research logic model in the design and execution of eHealth innovations for maternal and newborn healthcare in Ethiopia |
| title_fullStr | Implementation research logic model in the design and execution of eHealth innovations for maternal and newborn healthcare in Ethiopia |
| title_full_unstemmed | Implementation research logic model in the design and execution of eHealth innovations for maternal and newborn healthcare in Ethiopia |
| title_short | Implementation research logic model in the design and execution of eHealth innovations for maternal and newborn healthcare in Ethiopia |
| title_sort | implementation research logic model in the design and execution of ehealth innovations for maternal and newborn healthcare in ethiopia |
| topic | Implementation science Implementation research logic model Maternal healthcare Newborn healthcare Implementation strategies eHealth |
| url | https://doi.org/10.1186/s12961-024-01259-8 |
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