Table 2 Enabling factors for the dissemination, diffusion, scale up, or sustainability of DMPA by AIDED model components
Enabling factor | # sources citing factor | AIDED model component(s) to which factor was mapped |
|---|---|---|
Development of delivery system supports (training of health workers/field motivators, creation of training manuals or checklists, supply chain improvements, recruitment of women, chart tracking) | 10 | Develop |
Tailoring innovation to existing system capacity (community-based distribution systems already in place, women in community health worker roles, other existing program infrastructure (e.g., well-baby clinics, current supply chain flows)) | 9 | Innovate, Devolve |
Landscape or stakeholder assessment | 6 | Assess |
Collaboration with stakeholders to identify or create supportive structures in the economic, political and technological spheres | 6 | Assess, Develop |
Use of social networks | 5 | Devolve |
Dialogue with community at early stages | 5 | Assess, Engage |
Effective education through social marketing regarding risks and instructions (including community input) | 4 | Develop, Engage |
Piloting to determine feasibility | 3 | Assess |
Innovation design features (e.g., injectable at 3 month intervals) | 3 | Innovate |
Ensuring ‘fit’ with cultural norms (e.g., allowing women to take injections in strict confidence without being observed) | 3 | Assess, Innovate |
Use of data to improve program performance | 3 | Engage |
Nationalistic messaging (e.g., population control) | 2 | Develop |
Adherence to religious norms (e.g., support of leaders) | 1 | Innovate, Develop, Engage |
Identifying potential sources of resistance, such as from the professional medical community | 1 | Assess |
Creating structures to ensure use of assessment findings through implementation and scale up (e.g., the same individuals that conducted the assessment remained involved throughout the process of scaling) | 1 | Assess |