Table 2.

Summary of objectives, key research questions, data collection techniques, data sources and analytical approaches used

Subparts of the objectives	Key research question Key themes	Data collection techniques/tools	Level, data source and sample	Analysis
Analysing the policy agenda setting	How did user fee for CSs get the government’s attention, as a priority problem to address? Problem stream, policy stream and political stream	Semistructured interviews with policymakers Observation in meetings using an observation grid Document review	Actors at the national, regional and international levels 1 conference and 10 agency meetings observed 24 informants interviewed 32 online media publications screened	Thematic analysis
Analysing the policy formulation and legitimation	How were the objectives of the policy defined? How was the cost calculated? What effects were anticipated? How were the policy instruments selected? How did policy makers ensure support for the policy and its instruments? Context, actors, process and content of the policy	Observation in meetings using an observation grid Structured discussion with key informants Document review Observation of implementing facilities	Actors at the national, regional and international levels 1 conference and 10 agency meetings observed 24 informants interviewed 7 implementing hospitals observed	Thematic analysis
Assessing the policy implementation fidelity	To what extent was the Policy implemented as it was designed in the original policy decree? Number of CS elements provided for free (in accordance with the policy) Remaining charge for households for a CS	Document review Semistructured interview with key informants Exit surveys Routine data extraction	Policy documents at national, regional and local levels Facility health routine data supports Regional and district medical officers, health workers, facility users and community representatives	Triangulation of the data from the different sources and transformation of qualitative data into quantitative data to compute the number of CSs elements provided for free (in accordance with the policy). A descriptive statistical analysis has been conducted to compute the remaining charge for households for a CS.
Assessing the policy results	To what extent was the policy successful in relation to its desired and expected effects? Impact on CS utilisation Remaining fees charged for women who delivered by CS as a proportion of GDP per capita Equity of utilisation: trends in CS rates for different socioeconomic groups	Document review and data extraction Exit interviews (EI)	Routine data in national health statistics from 2001 to 2015 Demographic and Health Survey (DHS) data for Benin from 1993 to 2011 (n=36 375) EI conducted with 294 with a CS	Interrupted Time Series particularly the Segmented regression analysis41, of data from routine annual statistics and DHS data The model was specified as: Yt=β0 + β1*time + β2*policy + β3*postslope + εt Yt=outcome variable (caesarean delivery) at time t; time is a continuous variable; policy is a dummy variable indicating whether or not the policy has been implemented at time t; and postslope is coded 0 up to the last point before the introduction of the policy and coded sequentially from 1 thereafter. Analysis of the EI extracted specific data related to costs for a CS delivery for families, inside and outside hospitals. The expenditures have been computed as a proportion of the GDP per capita in Benin in 2012. The GDP per capita data in local current unit are extracted from the World Bank Open Data website. We used Microsoft Excel 2011 (V.14.6.7) for these analyses.

CS, caesarean section; GDP, gross domestic product.