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Table 4 Process evaluation objectives, methods and data sources

From: Community mobilisation with women's groups facilitated by Accredited Social Health Activists (ASHAs) to improve maternal and newborn health in underserved areas of Jharkhand and Orissa: study protocol for a cluster-randomised controlled trial

OBJECTIVE INDICATORS & ISSUES METHODS DATA SOURCE
1. To describe the context in which the intervention was delivered
  Information on terrain, infrastructure and health service provision Discussions with facilitators, NGO and government staff
Quantitative analysis of formats
Context notes and formats
M&E data*
Meeting reporting formats collated by co-facilitators
HSS mapping format
Process evaluation manager notes
  Profile of intervention and control communities, cultural practices including health practices, livelihoods including seasonal occupation, and migration Quantitative analysis
Qualitative analysis of discussions with ASHAs and observation notes of project staff
M&E data (including baseline data)
Context format
Process evaluation manager notes
  Profile of clusters
(Population composition, number of ASHAs, population size and spread of ASHA catchment area, number of villages, hamlets and total population)
Quantitative analysis M&E data
Population Census, 2001
Context format
Objective 2: to describe the intervention in theory and in practice
  Intervention plan   Trial protocol
  Profile of ASHAs
category, n of training modules completed)
Profile of co-facilitators
Profile of cluster coordinators
Quantitative analysis ASHA profile register
Cluster coordinator reports
ASHA profile register
  ASHA and cluster coordinator recruitment process and training Qualitative review of recruitment process of cluster coordinator and co-facilitators
Qualitative summary of training reports
Interview schedules and process evaluation manager notes
District-level training reports (6 × 5), training schedule, materials and games
  ASHAs', cluster coordinators' and co-facilitators' perception of the intervention Qualitative analysis Discussion with ASHAs and cluster coordinators at the end of each intervention phase
Discussions with co-facilitators by cluster coordinators at the end of the cycle
  Meeting site Quantitative compilation Discussion with ASHAs and cluster coordinators at the end of each intervention phase
  Group characteristics Quantitative analysis Group description format held by cluster coordinators (name, location, n of meetings, month/year of formation)
  Meeting duration, attendance, member characteristics & group discontinuation Quantitative analysis Meeting reporting format
Process evaluation manager notes of review meetings with cluster coordinators (for HR issues with ASHAs and co-facilitators)
District-level HR register for cluster coordinators, ASHAs & co-facilitators
M&E data
  Identification and prioritization of problems Quantitative analysis Prioritised problem format (meeting specific)
Women's group observation notes (5 groups followed from start to end of cycle)
  Identification and prioritization of strategies Quantitative analysis Strategies format (meeting specific)
M&E data
  Village-level and cluster-level community meetings
(ASHAs' and cluster coordinators' perception)
Qualitative summary Discussion with ASHAs and cluster coordinators at the end of each intervention phase (1-4)
Community meeting format (use for 1st and 2nd community meetings)
  Support given to members for community meetings
Methods for obtaining and using resources for the community meetings
Qualitative summary Review meeting notes
  Members' phase-wise evaluation of intervention Quantitative analysis Phase-wise evaluation chart
  Group members' perception of the intervention and its impact Qualitative analysis of 10 focus group discussions with group members (2 per district) FGD transcripts
Objective 3: To identify factors that facilitate or prevent the delivery of this intervention by ASHAs and its implementation at scale
  Enablers and barriers to ASHAs delivering the intervention Qualitative analysis of 5 FGDs (1 per district) at the end of the PLA cycle and women's group case studies
Qualitative summary
FGD transcripts and case study notes
Reports of ASHAs, coordinators and cluster coordinator
  HR lessons for scaling-up Qualitative summary Costing formats (Rajesh Sinha)
Notes from review meetings with ASHAs and coordinators
Objective 4: To develop hypotheses about the mechanisms through which the intervention may have worked
   Group discussion with Ekjut team members to review the process evaluation findings and generate a list of hypotheses about the intervention mechanisms FGD transcripts
Quantitative analyses
Case studies notes
Observation notes
Facilitators' registers
Objective 5: To compare the mechanisms linked to the success of the facilitator-led intervention with those of the ASHA-led intervention
  Perception of group members regarding behaviour change among themselves and non-group members 5 group discussions with group members FGD transcripts
Case studies
  Population coverage of groups & coverage of pregnant women as compared with Ekjut trial intervention   Census data
Register
M&E
  Coordinators' and cluster coordinators' perceptions of intervention mechanisms Discussion incorporating results of FGDs with group members to obtain coordinators' feedback Discussion notes
  Workload analysis of facilitators in ASHAs in JOHAR trial Qualitative summary Documents from review meetings with ASHAs
  1. * M&E refers to the main trial monitoring and evaluation questionnaire