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01.12.2013 | Research article | Ausgabe 1/2013 Open Access

BMC Pregnancy and Childbirth 1/2013

Lessons learned from stakeholders in a facilitation intervention targeting neonatal health in Quang Ninh province, Vietnam

Zeitschrift:
BMC Pregnancy and Childbirth > Ausgabe 1/2013
Autoren:
Leif Eriksson, Duong M Duc, Ann Catrine Eldh, Vu Pham N Thanh, Tran Q Huy, Mats Målqvist, Lars Wallin
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-2393-13-234) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

LW, LE and TQH designed the intervention while DMD and TQH were responsible for training and supervision of facilitators. LE, DMD, TQH, MM and LW designed this study where VPNT and LE moderated the focus group discussions with assistance from DMD. VPNT, DMD and TQH assured that translations were correct. LE was responsible for data analysis and drafted the manuscript, with assistance of ACE and LW. All authors have read and approved the final manuscript.

Abstract

Background

In northern Vietnam the Neonatal health - Knowledge Into Practice (NeoKIP, Current Controlled Trials ISRCTN44599712) trial has evaluated facilitation as a knowledge translation intervention to improve neonatal survival. The results demonstrated that intervention sites, each having an assigned group including local stakeholders supported by a facilitator, lowered the neonatal mortality rate by 50% during the last intervention year compared with control sites. This process evaluation was conducted to identify and describe mechanisms of the NeoKIP intervention based on experiences of facilitators and intervention group members.

Methods

Four focus group discussions (FGDs) were conducted with all facilitators at different occasions and 12 FGDs with 6 intervention groups at 2 occasions. Fifteen FGDs were audio recorded, transcribed verbatim, translated into English, and analysed using thematic analysis.

Results

Four themes and 17 sub-themes emerged from the 3 FGDs with facilitators, and 5 themes and 18 sub-themes were identified from the 12 FGDs with the intervention groups mirroring the process of, and the barriers to, the intervention. Facilitators and intervention group members concurred that having groups representing various organisations was beneficial. Facilitators were considered important in assembling the groups. The facilitators functioned best if coming from the same geographical area as the groups and if they were able to come to terms with the chair of the groups. However, the facilitators’ lack of health knowledge was regarded as a deficit for assisting the groups’ assignments. FGD participants experienced the NeoKIP intervention to have impact on the knowledge and behaviour of both intervention group members and the general public, however, they found that the intervention was a slow and time-consuming process. Perceived facilitation barriers were lack of money, inadequate support, and the function of the intervention groups.

Conclusions

This qualitative process evaluation contributes to explain the improved neonatal survival and why this occurred after a latent period in the NeoKIP project. The used knowledge translation intervention, where facilitators supported multi-stakeholder coalitions with the mandate to impact upon attitudes and behaviour in the communes, has low costs and potential for being scaled-up within existing healthcare systems.
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