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Table 1 Anticipated outputs and outcomes and their likely policy influence

From: A system approach to improving maternal and child health care delivery in Kenya: innovations at the community and primary care facilities (a protocol)

Major research outputs/ products

Expected outcomes

Likely policy influence – outcome challenges on targeted audience

Reports (3)

Mapping of gaps from baseline indicators and benchmarking for priority interventions in various contexts

EHC through FLTR strategy contextualized (if necessary)

Case studies and best practices for the intervention defined

Community/beneficiaries sensitized for ownership and effective participation in programme

Stakeholders sensitized on benchmarks and priority interventions from baseline findings

Policy makers sensitized innovations around implementation of the EHC / FLTR strategy

Evaluation findings packaged to reveal best practices for possible scale up to other areas

Phase 1: baseline report

Phase II: Intervention report

Phase III: Evaluation report

Policy briefs (4)

Documentation on how implementation of EHC through the FLTR strategy (1st arm of the intervention) and innovations through CORPs (2nd arm of the intervention) lead to improvements

access to and quality of care by pregnant women, neonates and infants

reductions in morbidity among pregnant women, neonates and infants

referral services for MNNH at county level (tier 1 to 3)

It is anticipated that the three briefs aimed at policy makers should demonstrate

*How investments in EHC through the FLTR strategy triggers health system changes that lead to improvements in access and quality of care for pregnant women, newborn and infants.

*How innovations in resourcing CORPs can incentivize CHWs, CHCs and CHEWs, enhance access via innovative transport arrangements through sustainable birth preparedness plans at tier 1 of the health system

*How application of ICT / mobile health at tier 1 to improve quality of care through efficient clinical decision support systems that are cadre specific and aligned to MOH DHIS tools

*CORPs used as birth companions leading to timely and appropriate referrals that minimize maternal and newborn morbidity and mortality between tier 1 and 3

Abstracts and posters (12) presented at Moi University annual scientific conference and other conferences by project staff (6) and post graduate students (6)

Demonstrated effect of interventions on intermediate (access and quality of care) as well as long-term outcomes (Maternal, neonatal and infant health indicators) as per study objectives

The abstracts will communicate to national and international audience of policy makers, planners and implementers on best practices and share lessons as per programme objectives

Peer reviewed Journal articles(7)

Several publications from study:

1. Document situation analysis (at baseline) on maternal, neonatal and child health

2. How FLTR strategy and EHC lead to improvements in access

3. How FLTR strategy and EHC improve quality of care

4. How interventions lead to improvements in maternal, neonatal and infant health

5. How innovations incentivize CORPs and lead to their sustainable engagement

6. How integrating eHealth using mobile phone technology improves HMIS and quality of care

7. systematic reviews from masters and doctoral students

Publishing peer reviewed articles will help policy makers articulate quality of evidence from the study and lead to evidence-based planning, policy making and practice

Help raise the profile and role of University as partner in health towards achieving the Vision 2030

Thesis at masters level (6)

Dissertations at doctoral (2)

Raise the knowledge base and skills of students and health workers in health systems research (HSR)

Encourage placement and internships with policy making institutions (public and private)

Policy makers to invest in health systems research and support university chair in future HSR initiatives

Improve ranking and image of University as a hub/centre for excellence in HSR

3 Guidelines / SOPs on EHC using the FLTR strategy

Efficiency of County referral services for MNH and referral strategy

New guidelines will help implementers improve performance and policy makers decide on approaches to scaling up intervention after the pilot phase

will benefit from improvements

3 Curricula:

New doctoral level (HSM) – 2 students

Revised MPH (HSM) – 6 students

Revised short course (HSR) – 10 students

Enhanced competencies – knowledge, skills and attitudes in HSR through the short course, MPH in HSM, and Doctoral programme in HSM

Competent and performing graduates placed appropriately in the health system

Policy makers will lobby for and support scholarships in HSR relevant training –

Implementers will be motivated to come and study – certificate, masters, doctoral level

Document best practices in curriculum for HSR - core competencies and share with network of academic institutions implementing HSR relevant curriculum

Advocacy materials include:

 • pamphlets on programme interventions & practices – (produced bi-annually);

 • project web page to link to Moi University website updated regularly;

 • Press releases – TV and print media

 • Talks through bazaars etc.

Effective communication of stakeholders in the project planning, implementation and evaluation;

Effective and sustained community engagement through the talks and other press releases;

Enhances project governance - transparency & accountability to stakeholders

Policy makers can monitor and engage in analysis of policy such as Community health strategy

Share programme knowledge with communities enhancing the learning curve from best practices and lessons for scale up of interventions in similar or other contexts