Table 2.

Framework for process evaluation

Framework domain	Research domain	Research questions	Data collection methods and sources
Implementation	Fidelity	How did implementation vary from the protocol that is (a) offering STI screening, (b) undertaking STI screening, (c) providing comprehensive case management including partner notification, (d) training and supervision of staff? What were the barriers and facilitators to implementation? What adaptations were made?	Routine monitoring data Structured observation FGDs with clinic staff (1–2 per PHC) and IDIs with research team (all members), pregnant women (8–10 per PHC), partners (3–4 per PHC) and clinic staff (4 per PHC)* IDIs with pregnant women who decline STI screening (3–4 per PHC) to explore reasons for this
	Coverage	What proportion of: (a) pregnant women attending antenatal care were offered STI screening, (b) pregnant women who were offered STI screening took it up, (c) positive STI cases were treated, (d) partners of positive cases were treated? How equitable was this coverage? What were the barriers and facilitators to each step?
Mechanisms of impact	Responses to and interactions with the intervention	Which components of the intervention were best accepted and adopted by pregnant women and HCWs and why? What challenges and barriers were faced?	Structured observation FGDs and IDIs with pregnant women, partners and HCWs*
	Interactions and consequences	How did various components of the intervention interact? Were there any unanticipated pathways or consequences?
Context	Proximal and distal	What social, cultural, political and logistical factors impede or facilitate how the intervention was implemented, and how were HCWs able to engage with and adopt aspects of the intervention? What were contextual reasons for adaptations to the intervention and its delivery?	FGDs and IDIs with pregnant women, partners and HCWs* Structured and unstructured observations Key informant interviews with local health authorities and community leaders Context diaries to record external events

*Number of IDIs/FGDs listed is approximation.

FGDs, focus group discussions; HCWs, healthcare workers; IDIs, in-depth interviews; PHC, primary healthcare clinic; STI, sexually transmitted infection.