Community health workers (CHW) programmes are inherently complex and their outcome is mediated by how interventions are implemented, the availability and quality of local health services, preferences of service users and the context of the health system. In March 2015, the University of Leeds was awarded a 5-year MRC grant to use a realist evaluation framework and mixed methods design to assess the extent to which and under what circumstances, a novel CHW programme in Nigeria, promotes equitable access to quality services and improves maternal and child health outcomes. As background to the evaluation, the Government of Nigeria launched a social protection initiative (SURE-P) in 2012, to invest revenues from fuel subsidy reduction for improving the lives of its most vulnerable populations. The SURE-P programme comprises of supply and demand components. The first aims to broaden access to quality maternal health services and improve MCH outcomes through recruiting CHWs, improving infrastructure development and increasing availability of supplies and medicines. The second aims to increase utilization of health services during pregnancy and at birth through the use of a conditional cash transfer (CCT) programme. CCTs are given to pregnant women who register at a primary health care (PHC) centre, where they get health check-ups while pregnant, deliver at a health facility, and take their baby for the first series of vaccinations. The methodology for evaluation involves three steps: 1) initial programme theory development, 2) theory validation and 3) refining theory and developing lessons learned. This paper aims to report the process of using ‘logic map’ as a tool for developing the initial programme theory for SURE-P programme. To achieve this, we have used the logic map to graphically deconstruct our group’s (i.e. researchers, policymakers and implementers) current thinking of how SURE-P programme should work in the context of Nigeria by illustrating complex relations between stakeholders, context, implementation process, outputs and outcomes of SURE-P interventions. The logic map will also serve as a focal point for discussions about data collection and programme evaluation by displaying when, where, and how we will obtain information most needed to manage the SURE-P programme and determine its effectiveness.
CORE (COnnecting REpositories)
CORE (COnnecting REpositories)