Table 1.
Data sources and analyses approaches mapped against our adapted process evaluation framework
| Framework | Description of framework item | Data source | Analysis approach |
|---|---|---|---|
| Context | Description of geographical location and summary of perinatal and maternal mortality in the intervention districts | Malawi Ministry of Health data | Descriptive summary |
| Reach | Description of the trainees and the pool of NPCs from which they were recruited | Malawi Ministry of Health data | The distribution of trainees across the districts |
| Dose delivered | Delivery of training sessions and training support | Course documentation Interviews with obstetricians who provided support |
Interrogation of data for variation from intended delivery of training, for example, non-attendance |
| Dose received | Participation in training by NPCs and their perceptions of what they learn | Course attendance registers First set of interviews with opportunistic sample of 19 NPCs |
Attendance counts Thematic analysis of NPC responses to question ‘what did you learn that was new to you?’ |
| Early implementation | Implementation of initial learning in the NCP's own clinical working context particularly leadership skills | Interviews undertaken with an opportunistic sample of 12 NPCs from the seven intervention districts 6 months after module 2 | Interrogation of interviews for spontaneously given examples of change in their working style |
| Evidence of cascading of learning by NPCs | Interviews with an opportunistic sample of 10 cascadees | Thematic analysis of what was taught by the NPCs to cascadees | |
| Evidence of cascading of learning from the perspective of DMOs | Interviews with an opportunistic sample of five DMOs | Interrogation of interviews for examples of cascading of training | |
| Later implementation | Implementation of training up to attending modules 5 and 6 | Interviews with 39 NPCs when attending modules 5 and 6 | Thematic analysis of actual use of skills used by NPCs |
The opportunistic samples are based on the presence and availability (eg, not interfering with normal workload) of individuals at the time of the researcher's (WC) visit to the facilities.
DMO, District Medical Officers; NPC, non-physician clinician.