PROCESS: Evaluating how the PRIME intervention worked in practice

[Project summary in Français / Português]

Scientific title: What is the process, context and impact of the PRIME health facility intervention and how can this explain the findings of the trial’s endpoints?  

What did we know before this research?

The PRIME intervention was designed by an ACT Consortium research study to improve health centre management, fever case management and patient centred services at Ugandan health centres.

A cluster randomised trial is evaluating the impact of the PRIME intervention on the health outcomes of community children and the appropriateness of antimalarial treatment they receive. The PROCESS project is a complementary evaluation study that runs alongside this trial.

This PROCESS study is evaluating the implementation, mechanisms of change, context and consequences of the PRIME intervention. Comprehensive process evaluations are often recommended, but less commonly undertaken. This research sets up a protocol which provides an example of an empirical study that puts this recommendation into practice.

What does this study add?

This study uses a theory-driven approach, aiming to articulate and evaluate the intended implementation of the PRIME intervention and its intended pathway of change.

The study uses a logic model to set out and test intended mechanisms and conditions for enabling or preventing change. The study also aims to interpret the impact of the intervention in the context of the daily lives of health workers and patients.

The study uses mixed methods, including in-depth interviews, questionnaires and focus group discussions to elicit the perspectives and experiences of different people who were part of or close to the intervention.

Our informants include health care workers, patients, community members, community stakeholders, district officials and implementers of the intervention.

The evaluation is being conducted over two years from the start of the intervention. This will allow us to interpret how the intervention is incorporated, adjusted or discarded over time. This will inform future programmes on how interventions can stimulate behavior change in health services.

The research team

Principal Investigator

• Dr. Sarah Staedke, London School of Hygiene & Tropical Medicine 

Email: Sarah.staedke@lshtm.ac.uk

• Prof Moses Kamya, Professor, Makerere University, Uganda

Other Investigators:

• Dr Grant Dorsey, Associate Professor, University of California, San Francisco
• Dr Clare Chandler, Lecturer, London School of Hygiene & Tropical Medicine