Eliciting the Initial Programme Theory in a Realist Evaluation of Facility-Based Maternal Death Reviews in Benin: Methodological Process, Challenges and Lessons Learned
The initial program theory (IPT) is a core element of realist evaluation. An IPT presents a hypothesis about how, for whom, why, and in what contexts an intervention is effective. Despite their importance within realist studies, methodological guidance on how to develop an IPT is relatively scarce....
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2025-12-01
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| Series: | International Journal of Qualitative Methods |
| Online Access: | https://doi.org/10.1177/16094069241309277 |
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| author | Christelle Boyi Hounsou Jean-Paul Dossou Thérèse Delvaux Lenka Beňová Edgard-Marius Ouendo Marjolein Zweekhorst Bruno Marchal |
| author_facet | Christelle Boyi Hounsou Jean-Paul Dossou Thérèse Delvaux Lenka Beňová Edgard-Marius Ouendo Marjolein Zweekhorst Bruno Marchal |
| author_sort | Christelle Boyi Hounsou |
| collection | DOAJ |
| description | The initial program theory (IPT) is a core element of realist evaluation. An IPT presents a hypothesis about how, for whom, why, and in what contexts an intervention is effective. Despite their importance within realist studies, methodological guidance on how to develop an IPT is relatively scarce. We describe the methodological process of eliciting an IPT of facility-based maternal death reviews (FbMDRs), a multicomponent intervention to improve the quality of maternal care. We used a four-step approach to elicit the IPT through a combination of literature review, document review, and in-depth interviews with key stakeholders while drawing on the experience of the research team. The literature and document reviews enabled us to identify facilitators and barriers influencing the functioning of FbMDRs. We used the causal pathway approach to deconstruct the maternal death review procedure and we elicited a causal explanation for each component on the basis of the results of the document review, the literature review and key respondent interviews. We organised stakeholder consultations that provided insights of key actors and validated its real-world relevance. We discuss the challenges encountered during its development and the lessons learned. The challenges include the fact that maternal death reviews are multicomponent interventions, for which a ‘simple’ programme theory cannot be defined, the positionality of the research team, and the visual representation of a programme theory with multiple components. |
| format | Article |
| id | doaj-art-c702161946734e9b8b2e4be399676580 |
| institution | Kabale University |
| issn | 1609-4069 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | International Journal of Qualitative Methods |
| spelling | doaj-art-c702161946734e9b8b2e4be3996765802025-01-03T18:03:20ZengSAGE PublishingInternational Journal of Qualitative Methods1609-40692025-12-012410.1177/16094069241309277Eliciting the Initial Programme Theory in a Realist Evaluation of Facility-Based Maternal Death Reviews in Benin: Methodological Process, Challenges and Lessons LearnedChristelle Boyi HounsouJean-Paul DossouThérèse DelvauxLenka BeňováEdgard-Marius OuendoMarjolein ZweekhorstBruno MarchalThe initial program theory (IPT) is a core element of realist evaluation. An IPT presents a hypothesis about how, for whom, why, and in what contexts an intervention is effective. Despite their importance within realist studies, methodological guidance on how to develop an IPT is relatively scarce. We describe the methodological process of eliciting an IPT of facility-based maternal death reviews (FbMDRs), a multicomponent intervention to improve the quality of maternal care. We used a four-step approach to elicit the IPT through a combination of literature review, document review, and in-depth interviews with key stakeholders while drawing on the experience of the research team. The literature and document reviews enabled us to identify facilitators and barriers influencing the functioning of FbMDRs. We used the causal pathway approach to deconstruct the maternal death review procedure and we elicited a causal explanation for each component on the basis of the results of the document review, the literature review and key respondent interviews. We organised stakeholder consultations that provided insights of key actors and validated its real-world relevance. We discuss the challenges encountered during its development and the lessons learned. The challenges include the fact that maternal death reviews are multicomponent interventions, for which a ‘simple’ programme theory cannot be defined, the positionality of the research team, and the visual representation of a programme theory with multiple components.https://doi.org/10.1177/16094069241309277 |
| spellingShingle | Christelle Boyi Hounsou Jean-Paul Dossou Thérèse Delvaux Lenka Beňová Edgard-Marius Ouendo Marjolein Zweekhorst Bruno Marchal Eliciting the Initial Programme Theory in a Realist Evaluation of Facility-Based Maternal Death Reviews in Benin: Methodological Process, Challenges and Lessons Learned International Journal of Qualitative Methods |
| title | Eliciting the Initial Programme Theory in a Realist Evaluation of Facility-Based Maternal Death Reviews in Benin: Methodological Process, Challenges and Lessons Learned |
| title_full | Eliciting the Initial Programme Theory in a Realist Evaluation of Facility-Based Maternal Death Reviews in Benin: Methodological Process, Challenges and Lessons Learned |
| title_fullStr | Eliciting the Initial Programme Theory in a Realist Evaluation of Facility-Based Maternal Death Reviews in Benin: Methodological Process, Challenges and Lessons Learned |
| title_full_unstemmed | Eliciting the Initial Programme Theory in a Realist Evaluation of Facility-Based Maternal Death Reviews in Benin: Methodological Process, Challenges and Lessons Learned |
| title_short | Eliciting the Initial Programme Theory in a Realist Evaluation of Facility-Based Maternal Death Reviews in Benin: Methodological Process, Challenges and Lessons Learned |
| title_sort | eliciting the initial programme theory in a realist evaluation of facility based maternal death reviews in benin methodological process challenges and lessons learned |
| url | https://doi.org/10.1177/16094069241309277 |
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