Table 4 Process evaluation objectives, methods and data sources
OBJECTIVE | INDICATORS & ISSUES | METHODS | DATA SOURCE |
|---|---|---|---|
1. To describe the context in which the intervention was delivered | |||
| Â | 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 |
| Â | 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 |
| Â | 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 | |||
| Â | Intervention plan | Â | Trial protocol |
| Â | 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 |
| Â | 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 |
| Â | Meeting site | Quantitative compilation | Discussion with ASHAs and cluster coordinators at the end of each intervention phase |
| Â | Group characteristics | Quantitative analysis | Group description format held by cluster coordinators (name, location, n of meetings, month/year of formation) |
| Â | 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 |
| Â | 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) |
| Â | Identification and prioritization of strategies | Quantitative analysis | Strategies format (meeting specific) M&E data |
| Â | 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) |
| Â | Support given to members for community meetings Methods for obtaining and using resources for the community meetings | Qualitative summary | Review meeting notes |
| Â | Members' phase-wise evaluation of intervention | Quantitative analysis | Phase-wise evaluation chart |
| Â | 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 | |||
| Â | 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 |
| Â | 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 | |||
| Â | Â | 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 | |||
| Â | Perception of group members regarding behaviour change among themselves and non-group members | 5 group discussions with group members | FGD transcripts Case studies |
| Â | Population coverage of groups & coverage of pregnant women as compared with Ekjut trial intervention | Â | Census data Register M&E |
| Â | Coordinators' and cluster coordinators' perceptions of intervention mechanisms | Discussion incorporating results of FGDs with group members to obtain coordinators' feedback | Discussion notes |
| Â | Workload analysis of facilitators in ASHAs in JOHAR trial | Qualitative summary | Documents from review meetings with ASHAs |