2023-09-28 14:46:10 +00:00
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abstract: 'There is a well-recognized need for empirical study of processes and
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factors that influence scale up of evidence-based interventions in
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low-income countries to address the `know-do'' gap. We undertook a
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qualitative case study of the scale up of chlorhexidine cleansing of the
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umbilical cord (CHX) in Bangladesh to identify and compare facilitators
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and barriers for the institutionalization and expansion stages of scale
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up. Data collection and analysis for this case study were informed by
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the Consolidated Framework for Implementation Research (CFIR) and the
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WHO/ExpandNet model of scale up. At the national level, we interviewed
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20 stakeholders involved in CHX policy or implementation. At the
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district level, we conducted interviews with 31 facility-based
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healthcare providers in five districts and focus group discussions
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(FGDs) with eight community-based providers and eight programme
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managers. At the community level, we conducted 7 FGDs with 53 mothers
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who had a baby within the past year. Expanded interview notes were
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thematically coded and analysed following an adapted Framework approach.
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National stakeholders identified external policy and incentives, and the
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engagement of stakeholders in policy development through the National
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Technical Working Committee for Newborn Health, as key facilitators for
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policy and health systems changes. Stakeholders, providers and families
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perceived the intervention to be simple, safe and effective, and more
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consistent with family preferences than the prior policy of dry cord
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care. The major barriers that delayed or decreased the public health
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impact of the scale up of CHX in Bangladesh''s public health system
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related to commodity production, procurement and distribution.
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Bangladesh''s experience scaling up CHX suggests that scale up should
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involve early needs assessments and planning for institutionalizing new
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drugs and commodities into the supply chain. While the five CFIR domains
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were useful for categorizing barriers and facilitators, additional
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constructs are needed for common health systems barriers in low-income
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settings.'
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affiliation: 'Callaghan-Koru, JA (Corresponding Author), Univ Maryland, Dept Sociol
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Anthropol \& Hlth Adm \& Policy, 1000 Hilltop Circle,PUP 233, Baltimore, MD 21250
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USA.
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Callaghan-Koru, Jennifer A.; Sowe, Ardy, Univ Maryland, Dept Sociol Anthropol \&
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Hlth Adm \& Policy, 1000 Hilltop Circle,PUP 233, Baltimore, MD 21250 USA.
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Callaghan-Koru, Jennifer A., Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth,
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615 N Wolfe St, Baltimore, MD 21205 USA.
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Islam, Munia; Khan, Marufa; Mannan, Imteaz Ibne; George, Joby, Save Children Int,
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MaMoni Hlth Syst Strengthening Project, House CWN A 35,Rd 43,Gulshan 2, Dhaka 1212,
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Bangladesh.
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Khan, Marufa, Pathfinder Int, 32 Gulshan Ave,Gulshan 2, Dhaka 1212, Bangladesh.
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Sowe, Ardy, Howard Univ, Coll Med, 520 W St NW, Washington, DC USA.
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Islam, Jahrul, Minist Hlth \& Family Welf, Dhaka, Bangladesh.
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Mannan, Imteaz Ibne, Jhpiego, House 71,Rd 4,Dist 4, Kabul, Afghanistan.'
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author: Callaghan-Koru, Jennifer A. and Islam, Munia and Khan, Marufa and Sowe, Ardy
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and Islam, Jahrul and Mannan, Imteaz Ibne and George, Joby and Stu, Bangladesh Chlorhexidine
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Scale
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author-email: jck@umbc.edu
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author_list:
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- family: Callaghan-Koru
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given: Jennifer A.
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- family: Islam
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given: Munia
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- family: Khan
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given: Marufa
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- family: Sowe
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given: Ardy
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- family: Islam
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given: Jahrul
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- family: Mannan
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given: Imteaz Ibne
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- family: George
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given: Joby
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- family: Stu
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given: Bangladesh Chlorhexidine Scale
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da: '2023-09-28'
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doi: 10.1093/heapol/czz156
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eissn: 1460-2237
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files: []
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issn: 0268-1080
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journal: HEALTH POLICY AND PLANNING
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keywords: Scale up; implementation; newborn health; Bangladesh; Chlorhexidine
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keywords-plus: 'HEALTH-SYSTEMS; SCIENCE; CARE; INITIATIVES; ADAPTATION; INNOVATION;
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LESSONS; DEATHS; TIME'
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language: English
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month: MAY
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number: '4'
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number-of-cited-references: '72'
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orcid-numbers: 'George, Joby/0000-0002-4791-901X
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Islam, Munia/0000-0002-7036-5318'
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pages: 440-451
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papis_id: d53b5341801c2b3b165b39a5b04062a7
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ref: Callaghankoru2020factorsthat
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researcherid-numbers: 'George, Joby/AAW-1365-2021
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Mannan, Imteaz/AAO-9935-2021
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'
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times-cited: '4'
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title: 'Factors that influence the scale up of new interventions in low-income settings:
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a qualitative case study of the introduction of chlorhexidine cleansing of the umbilical
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cord in Bangladesh'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000537392800007
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usage-count-last-180-days: '0'
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usage-count-since-2013: '3'
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volume: '35'
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web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
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year: '2020'
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