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
	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

* M&E refers to the main trial monitoring and evaluation questionnaire