From Theory to Implementation: Adaptations to a Quality Improvement Initiative According to Implementation Context

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From Theory to Implementation: Adaptations to a Quality Improvement Initiative According to Implementation Context


JournalQualitative Health Research
Article typeJournal research article – Clinical research
Publication date – Nov – 2021
Authors – Abimbola A. Olaniran, Modupe Oludipe, Zelee Hill, Adedoyin Ogunyemi, Nasir Umar, Kelechi Ohiri, Joanna Schellenberg, Tanya Marchant
KeywordsLow-and middle-income countries, maternal health, neonatal health, quality improvement
Open access – Yes
SpecialityHealth policy
World region Western Africa
Country: Nigeria
Language – English
Submitted to the One Surgery Index on November 20, 2021 at 4:02 am
Abstract:

As countries continue to invest in quality improvement (QI) initiatives in health facilities, it is important to acknowledge the role of context in implementation. We conducted a qualitative study between February 2019 and January 2020 to explore how a QI initiative was adapted to enable implementation in three facility types: primary health centres, public hospitals and private facilities in Lagos State, Nigeria.

Despite a common theory of change, implementation of the initiative needed to be adapted to accommodate the local needs, priorities and organisational culture of each facility type. Across facility types, inadequate human and capital resources constrained implementation and necessitated an extension of the initiative’s duration. In public facilities, the local governance structure was adapted to facilitate coordination, but similar adaptations to governance were not possible for private facilities. Our findings highlight the importance of anticipating and planning for the local adaptation of QI initiatives according to implementation environment

OSI Number – 21354

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