Privacy WHO U, UNFPA WBG, the United Nations Population Division. 0000005323 00000 n Mobile health messaging service and helpdesk for south African mothers (MomConnect): history, successes, and challenges. [48] focused on Mobile Video intervention, which stipulates that the changes in attitude that predict a desired behavioral outcome such as exclusive breastfeeding can be explained in two pathways. These reminders were sent to the CHWs who in turn contact the clients, resulting in an increase in routine care attendance and facility deliveries. Damian DJ, Njau B, Lisasi E, et al. Barron P, Peter J, LeFevre AE, et al. Critical Realism (CR) is a branch of philosophy that distinguishes between the 'real' world and the 'observable' world. Massyn N. Maternal, Child & Women’S Health Barometer, 2016: Health System Trust; 2018. p. 116. https://www.hst.org.za/publications/HST%20Publications/MCWH%20Publication%20Final%20web%20(04%2006%202018).pdf#search=Massyn%20N%2E%20Maternal%2C%20Child%20%26%20Women%E2%80%99S%20Health%20Barometer%2C%202016%2E%20Health. Document analysis as a qualitative research method. Sage Publ 2004; 1–36. Dr. Anna Tickle provided supervision and guidance throughout the project and was responsible for peer-reviewing the themes derived from the thematic analysis. https://doi.org/10.1186/s12874-020-01164-y, DOI: https://doi.org/10.1186/s12874-020-01164-y. 2016;106:3. Manage cookies/Do not sell my data we use in the preference centre. In this chapter I list and describe various innovative methodological contributions made in recent years by realists. According to Taplin et al. 2004;10:58–76. Mukumbang FC, Marchal B, Van Belle S, et al. Our document analysis was informed by the ToC and RE approaches [24]. The 'real' can not be observed and exists independent from human perceptions, theories, and constructions. Article  Reflexive TA | the basics ... »Why are we critical of the notion that ‘themes emerged’ from data? More inductive, semantic and (critical) realist approaches tend to cluster together; ditto more deductive, latent and constructionist ones. Realist qualitative analysis, despite its potential for exploring complex generative relationships in data, has rarely been outlined as an analytic technique. 2019. https://doi.org/10.1177/1468794119881985 Epub ahead of print. Blamey and Mackenzie [30] propose that the ToC can be used as a means of explicating intervention implementation theory for program planning, improvement, and the development of robust monitoring systems at a whole program level; while RE can be used to examine, in detail, how and why the different aspects of the program leads to the observed or intended outcome – program theory (Fig. Modi D, Gopalan R, Shah S, et al. 2019;19:1–14. All authors held discursive weekly meetings to conceptualize and finalize the ToC and initial program theory. With an institutional MMR of 133.3% per 100,000 live births in 2013/2014 [3] and 105.9 in 2018/2019 [4], South Africa (SA) has made notable progress in reducing its MMR. Themes are patterns across data sets that are necessary for explainin… Maternal Mortality 2000 to 2017. %PDF-1.4 %���� Evidence suggests that communicating with pregnant women and new mothers via regular SMS and/or voice-based messages supports the adoption of healthy behaviors and increases the uptake of health services [12]. Trop Med Int Health. Our initial program theory aligns in part with the ELM in the sense that ELM explains how the attitude can influence users’ motivation to process the message. Using thematic analysis in psychology Virginia Braun 1 and Victoria Clarke 2 1 University of Auckland and 2 University of the West of England Thematic analysis is a poorly demarcated, rarely acknowledged, yet widely used qualitative analytic method within psychology. Callister LC, Edwards JE. 1988;31:154–5. Interaction with the health system (service rating and feedback) (I) is influenced by health system conditions such as facility readiness to provide care (C) and health care worker availability and buy-in (C). Firstly, the ToC model identified the various modalities of the MomConnect program, which are health information and education and the user query platform. 2015;30:119–42. Google Scholar. This study is part of a larger evaluation effort to elicit, test, and refine the program theory of the MomConnect program. 0000002825 00000 n MomConnect was rapidly rolled out with a limited understanding of how and why the program was expected to work even though studies had shown the effectiveness of the MomConnect program in improving the uptake of MCH services. 0000003024 00000 n Peter JE, Barron P, Pillay Y. 2014;30:512–8. volume 20, Article number: 282 (2020) Our finding is also consistent with the mHealth ImTeCHO intervention in India [43], which established a significant relationship between the use of mobile phone technology by HCPs and changes in the working environment. Goicolea I, Vives-Cases C, Hurtig AK, et al. It also aims to clearly discuss the approach to determining rigour and validly within thematic analysis as part of a research project. Sustainable development goals and the ongoing process of reducing maternal mortality. Terms and Conditions, Monitoring MAMA: Gauging the impact of MAMA South Africa. %%EOF Therefore, we considered adding elements of the Actors (A) and intervention (I) modalities to the original CMOs heuristic tool and adopted the intervention-context-actor-mechanism-outcomes (ICAMO) configuration [33]. 1989;12:299–306. trailer Like ToC, RE is also time and resource-intensive. Taplin DH, Clark H, Collins E, et al. 2018;14:64–87. Pawson R, Tilley N. Realistic evaluation: Sage; 1997.36. Garret R. Theory of change thinking in practice. FCM, PD, and EN assisted with comments that critically contributed to developing and refining the manuscript. By rating the services received at the facility level, women and mothers are expected to feel empowered (M), which in turn would result in improved quality of health care delivery (O) and improved uptake of MCH services (O). Google Scholar. However, this figure is still high and far from the SDG target. Our study identified three main contextual conditions – facility responsiveness to provide care including human resource availability, health system context such as political clout, and mobile connectivity related context – and four causal mechanisms – empowerment and perceived quality of MCH services, encouragements, motivation, and knowledge acquisition. Abstract. By combining the ToC and RE approaches we intended to unearth, in a systematic manner, the assumptions underlying the MomConnect program and speculate the changes likely to take place as a result of the intervention [40]. Critical realists also engage constructively with social theory, but they are more than just theorists. Use of scenario planning as a theory-driven evaluation tool. Realist evaluation model for MomConnect program. Thematic analysis was conducted by PT, in collaboration with JO, CSM and DH, and analysis was conducted from a critical realist perspective; acknowledging the subjective nature of experience, while also assuming the existence of an ‘external reality’ in order to facilitate practical application of the research. 2009;9:27–40. We conducted a document analysis using design- and implementation-related documents of the MomConnect program guided by the principles of Theory of Change (ToC) and Realist Evaluation (RE). They explained that improved knowledge about the need for services was likely to drive demand and hence utilization of maternal, neonatal, and child health services. The program theory and connection between mHealth, improved MCH services, and decision making is highlighted in our ToC and RE, and the implications for developers of mobile-based interventions are that the model provides a holistic approach to system thinking, systems analysis, and design. J Health Commun. Critical Realism (CR) is a philosophy of science that is based around a number of ontological principles. 2015;8. https://doi.org/10.3402/gha.v8.26769 Epub ahead of print. 2014;20:445–52. The benefit of combining the ToC and RE is shown by the fact that ToC makes it easier to trace causes if outcomes are not achieved at the management level. Aim To provide a detailed overview of Bhaskar’s critical realism and illustrate its methods with published examples. Glob Health Action. MAMA SA focused on the prevention of mother-to-child transmission (PMTCT) of HIV and consisted of a multi-channel mHealth approach to communicate healthy pregnancy and newborn child support including mobile phone-based chats and voice messages [16]. RE aims to unearth theories to explain how and why the intervention is supposed to trigger change [34]. The user’s emotional involvement in the content leads to peripheral attitude changes, which can positively influence the learner’s motivation to process the messaging via the central route. Procedural recommendations for researchers who may wish to conduct a critical realist thematic analysis were provided, alongside a further methodological innovation which related to the critical realist notion of theoretical generalisability. 2017;12:1–18. This iterative process combined elements of content and thematic analyses [23]. We then provide an example to illustrate the use of critical realism and outline the position’s key aspects to consider in future directions of CA. 2015;23:176–87. Overall, our study has established theoretical foundations and comprehensive requirements for the development of program theory in mHealth interventions (MomConnect), to support decision making, and decision support capabilities. Using Interpretative Phenomenological Analysis from a Realist Perspective . National Department of Health South Africa. Also, the merging of these two approaches promote a better understanding of the successes and challenges of the MomConnect program. from the year that MomConnect was implemented until the year the document review was initiated. ELM and eELM by Adam et al. This study illustrates the application of ToC and RE approaches to elicit an initial program theory of the MomConnect program. Our data analysis involved skimming (superficial examination), reading (thorough examination), and identifying themes within the documents associated with the elements of ToC and the concepts of RE theory formulation. Findings from the study revealed that if pregnant women and mothers receive pregnancy related information by ‘SMSs’, they will become sensitized about existing MCH services tailored to the stage of their pregnancy. Rolfe AS. 2012;17:22–9. Two global themes emerged; “negotiating systems” and “family processes”. Springer Nature. PNC visits within the first 6 days of delivery’ were 73.0% in (2013/2014) [10]. 0000005531 00000 n 2017;22:895–907. Screening of the documents for eligibility hence identified 22 documents, which were included in the final analysis (Fig. Unstructured interviews with use of academic grade documents as a point of reference. The process of constructing the ToC provided the platform for the development of the initial program theory, which identified three critical elements: (1) the central modalities of the MomConnect program; (2) the intended outcomes; and (3) the tentative causal links indicating, in a stepwise manner of, how the outcomes were intended to be achieved. The impact of an mHealth monitoring system on health care utilization by mothers and children: an evaluation using routine health information in Rwanda. The sustainable development goals as a network of targets. These findings are indicative of important contextual elements that can influence the success of the MomConnect program. Chen H-T, Rossi H. Issues in the theory-driven. Following critical realism (Fletcher, 2017) and thematic analysis techniques (Denzin and Lincoln, 2000), data analysis included abduction and retroduction to identify structural, cultural, and personal emergent properties, and how these influenced … We contend that applying the ToC approach and then moving on to the RE approach facilitated the process of developing the initial program theory. Content analysis was employed to organize information into categories while thematic analysis was applied to form patterns within the data, with emerging themes becoming the categories for analysis. Context (C) is the physical or perceived conditions, which allow the mechanisms to come into operation or remain inactive. Ruton H, Musabyimana A, Gaju E, et al. 2017, https://opendocs.ids.ac.uk/opendocs/bitstream/handle/20.500.12413/13566/mNutrition_Tanzania_final_23_Aug_2017.pdf?sequence=821&isAllowed=y. 528 0 obj <> endobj We examine the philosophical and theoretical position of critical realism with CA. E. District Health Barometer 2018/2019: Health System Trust; 2020. p. 1–462. Dalious SCWAR and M. Evaluation of the information and Communications Technology for Maternal and child health Project: I proving Access to Reproductive, Maternal, and Newborn Health Information and Services in Malawi. The book outlines critical realism and considers its implications for how we conceptualize meaning and culture, causation, and diversity. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Pawson R, Tilley N. Realistic evaluation. Abstract This chapter introduces a critical realist approach to qualitative research. The MomConnect program is a digital health communication program [13], which was informed by lessons, experiences, and successes of the MAMA SA program [14, 15]. Division of Health Systems and Public Health, Stellenbosch University, Cape Town, South Africa, South African Medical Research Council, Cape Town, South Africa, School of Public Health, University of the Western Cape, Cape Town, South Africa, Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium, You can also search for this author in BMC Medical Research Methodology However, we considered the two approaches together in our study to obtain a more robust initial program theory for the MomConnect program. 0000024671 00000 n »Why don’t . Mukumbang FC, Marchal B, Van Belle S, et al. The formulation of the ToC and initial program theory was achieved in an iterative process – moving back and forth between the data, the ToC, and developing the initial program theory. Achieving this ambitious goal will require a concerted effort from respective country health authorities due to the numerous challenges impeding the prevention of maternal mortality [2]. The article presents how a study that investigated the acquisition of second language academic literacy skills practised the qualitative methodology, interpretative phenomenological analysis (IPA), from a realist … Finally, the ToC provided tentative causal links in a stepwise manner to show how the outcome is to be achieved (Fig. 2019;8:1–13. Hategeka C, Ruton H, Law MR. Effect of a community health worker mHealth monitoring system on uptake of maternal and newborn health services in Rwanda. After screening by title and abstract, 358 documents and duplicates were removed. Qual Res J. Evaluation. 2) integrating the features of both ToC and RE approaches and how they complement each other to inform the elicitation of a robust and testable program theory. 0000006518 00000 n The pregnancy-related stage-based information was envisaged to encourage and empower (M) users through knowledge acquisition to motivate them (M) thus improving their health-seeking behavior (O). Pawson R, Manzano-Santaella A. BMJ Open. Glob Health Res Policy. The draft manuscript was written by EMK. 6), which links the Intervention (I), context (C), causal pathways of outcomes (O), and the mechanisms (M) describing the causal chains, or causal pathways that explain how, when and/or why the MomConnect program messages trigger the expected results. Combining realist evaluation and qualitative comparative analysis approaches. Towards a programme theory for fidelity in the evaluation of complex interventions. As highlighted in Fig. RE lacks substantive theory in some fields, multiple and conflicting theories in others, and uses inaccessible jargon. © 2020 BioMed Central Ltd unless otherwise stated. The MomConnect program was also guided by an emergent body of work around the use of mobile phones to enhance MCH programs [16,17,18,19,20,21]. While ToC illustrates ‘how’ change occurs through program implementation, RE goes deeper by establishing ‘why’ through a mechanism-based generative causal framework. Notably, the identification of mechanisms and contextual elements are critical to establishing a generative causality – how the intervention modalities are interpreted and acted upon by the actors (mechanisms) and under what conditions (context) leading to the hypothesized impact. PLoS One. Sage, 1997. https://uk.sagepub.com/en-gb/afr/realistic-evaluation/book205276. J Multidiscip Eval. A (critical) realist or essentialist way – focuses on reporting an assumed reality evident in the data; A constructionist way – focuses on looking at how a certain reality is created by the data. An outcome (O), which can be represented in short and intermediate terms, is what is observed resulting from the interaction between the context and mechanism that is triggered by the intervention, and could be measured as the impact of the intervention [39]. Curationis. We used the ToC and RE approaches to elicit the initial program theory [41]. Eveline M Kabongo. 2018;3:1–5. This paper is part of Phase 1 whereby we sought to glean the initial program theory of MomConnect based on analysis of program-related documents using a combined Theory of Change (ToC) and Realist Evaluation (RE) approaches. We also found that the interaction with the health system (service rating and feedback) provided by the MomConnect program is likely to empower users, since they feel that it can improve the quality of services offered at healthcare facilities, thus improving the perceived quality of MCH services and, in turn, the uptake of health services. Although no study has shown the effectiveness of the MomConnect program in improving the uptake of MCH services, there is evidence that the national ANC visits within 20 weeks of gestation rate have been increasing in the 3 years following the implementation of MomConnect [4, 10]. This conceptualization is achieved by formulating the Context-Mechanisms-Outcome configurations (CMOs) [35]. Thematic analysis is one of the most common forms of analysis within qualitative research. A study conducted by Hategeka et al. 2017;3:39. Eastwood JG, Woolfenden S, Miller E, et al. 0000005947 00000 n RE is a theory-driven approach to evaluation informed by principles of critical realism – social structures and agents having underlying causal powers that interact to cause an observed behavior [33]. We aimed to glean an initial program theory of the MomConnect initiative to understand how and why the program works (or not). Epistemologically, CR provides principles that can be applied by researchers developing theoretical explanations about phenomena in the world. Understanding the influence of the MomConnect programme on antenatal and postnatal care service utilisation in two south African provinces: a realist evaluation protocol. Our model shows that women are encouraged and empowered through the knowledge gained from MomConnect messages and this was thought to motivate them. The Theoretical Domains Framework (TDF) was developed to assess implementation problems, support intervention design, and investigate the fidelity of intervention delivery [49]. Our study contributes to the cumulative theory development activities, mHealth, MCH services, and decision support. Evaluation. Abstract. Using the ICAMO heuristic framework, we identified the contextual conditions and mechanisms that can influence whether pregnant women and mothers adopt favorable health-seeking behaviors. Udjo EO, Lalthapersad-Pillay P. Estimating maternal mortality and causes in South Africa: national and provincial levels. The TDF also considers the central role of context as captured by its social influences and environmental conditions/resources (C). We found that the application of both ToC and RE enhances learning and the unveiling of the initial program theory rather than delivering answers to questions of program effectiveness. While there is a pool of scholars that critical realists often draw upon (e.g. The widely-used version of ... contextualist/critical realist approaches (e.g., Ussher, 1997), or critical/constructionist The conceptual frameworks for each method are summarised below. 0000002987 00000 n It therefore functions at a level similar to that occupied by such philosophies as Positivism and Interpretivism. Can J Program Eval. TDF posits that a good understanding of psychological capability and reflective motivational processes in knowledge, skills, social/professional role and identity, beliefs about capabilities, optimism, beliefs about consequences, reinforcement, intentions, goals and memory, attention and decision processes can influence behavior. This study aimed to unearth the initial program theory of the MomConnect program based on explicit and implicit assumptions of how the program was organized and expected to work. California Privacy Statement, Musabyimana A, Ruton H, Gaju E, et al. Using the realist interview approach to maintain theoretical awareness in realist studies. By using this website, you agree to our ToC is also time and resource-intensive and has some difficulties in dealing with multiple perspectives, unexpected outcomes, and critical analysis. Dhillon L, Vaca S. Refining theories of change. BMJ Glob Health. Relationship between implementation theory and program theory. J Mob Technol Med. Realist data analysis is driven by the principles of realism: realist evaluation explains change brought about by an intervention by referring to the actors who act and change (or not) a situation under specific conditions and under the influence of external events (including the intervention itself). Tugas Translate Jurnal Assessing the Perspectives of Users and Beneficiaries of a Community Health Worker Mhealth Tracking System for Mothers and Children in Rwanda Pekerja Kesehatan Masyarakat Sistem Pelacakan Mhealth Untuk Ibu Dan Anak-Anak Di Rwanda Pe. The characteristics of the selected documents are summarized in Additional file 1. Thematic Analysis is a type of qualitative analysis. It minimally organizes and describes your data set in (rich) detail. Our model differs from the TDF in that the TDF offers little conceptual configurations (causal links) between the elements in their different domains. In keeping with the SDG 3 target, SA developed a strategic plan to reduce maternal and child mortality by improving the uptake of maternal and child (MCH) services. Combining the theory of change and realist evaluation approaches to elicit an initial program theory of the MomConnect program in South Africa. Atkins L, Francis J, Islam R, et al. meta-narrative, critical interpretive synthesis, meta-study, meta-ethnography, grounded formal theory, thematic synthesis, textual narrative synthesis, framework synthesis and ecological triangulation. A realist evaluation to identify contexts and mechanisms that enabled and hindered implementation and had an effect on the sustainability of a lean intervention in pediatric healthcare. in India [45], which used a ToC approach to explain how the use of mHealth supported and improved the quality of counseling delivered by HCPs. The aim of this thesis is to understand the important components of a set of sustainable interventions to prevent obesity at the community level by using realistic evaluation, which draws on the philosophy of critical realism. Article  ToC and RE-informed models illustrated how the MomConnect program was organized and expected to work. 0 Mmusi-Phetoe RMM. We performed a document analysis of MomConnect-related documents in South Africa, adopting three search strategies: (1) an electronic search of Google Scholar, (2) purposive search of the NDoH website, and (3) requesting relevant stakeholders’ meeting minutes and reports related to the design and implementation of the MomConnect program. A mechanism is also defined as the reasoning and responses that participants attribute to the resources, opportunities, and constraints of a program to bring about the observed outcomes [37, 38]. BMC Health Serv Res. Background. 0000000016 00000 n 0000023862 00000 n 2019;9:1–9. TDE/TBE are regarded as key to untangling the multiple processes between policy intent and outcomes by investigating program implementation, and the causal link processes that trigger outcomes [25, 26]. The second part (peripheral route) relies on clues embedded in the information delivery method, which contributes to its relative acceptability by the user. Understanding mHealth Impact among Aponjon (MAMA Bangladesh) Subscribers through a Phone Survey in Bangladesh. As a process, the ToC model shows how a goal will be reached [27]. Critical realism (CR) is a useful philosophical framework for social science; however, little guidance is available on which precise methods – including methods of data collection, coding, and analysis – are best suited to applied CR research. ... (realist/positivist) assumption that there is a reality in the data that can be accurately captured through coding, if appropriate techniques are used. A guide to using the theoretical domains framework of behaviour change to investigate implementation problems. Although applying ToC and RE approaches have challenges, they can still be practically employed together [30, 50]. 0000002594 00000 n Mobile Health evaluation methods: the Text4baby case study. It emphasizes identifying, analysing and interpreting patterns of meaning within qualitative data. Development and formative evaluation of an innovative mHealth intervention for improving coverage of community-based maternal, newborn, and child health services in rural areas of India. The Philani MOVIE study: a cluster-randomized controlled trial of a mobile video entertainment-education intervention to promote exclusive breastfeeding in South Africa. Blamey A, Mackenzie M. Theories of change and realistic evaluation: peas in a pod or apples and oranges? The description of analysis is embedded within the philosophical standpoint of critical realism and pragmatism, which adds depth to the utilisation of these methods in previous discussions [2, 7]. [46] in Rwanda on the impact of the RapidSMS program on the use of MCH services showed divergent results. A realist diagnostic workshop. As a product, its inquiry results in specific outcomes in a narrative and/or visual form and offers a framework for sense-making that needs to be used, revisited, and adapted as the project or program progresses. Masterson-Algar P, Burton CR, Rycroft-Malone J, et al. 0000002506 00000 n Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Atnafu A, Otto K, Herbst CH. Of synthesis methods using Interpretative Phenomenological analysis from a ToC to a realist evaluation approaches to elicit an initial theory... Challenges, they can still be practically employed together [ 30, 50 ] provided three critical features toward an..., RE is also critical realist thematic analysis and resource-intensive and has some difficulties in dealing with perspectives... Rather than end-point grant for this research from any funding agency in the public, commercial or...: national and provincial levels of scenario planning as a point of reference starting point for achieving universal coverage. Particularly around causality screening of the research topic Methodol 20, 282 ( 2020 ) Cite article. Have been usually applied in isolation H, Gaju E, et.! Anna Tickle provided supervision and guidance throughout the project and was responsible for peer-reviewing the themes from. Rather than end-point a good health-care response to intimate partner violence in Spain viable option B, Belle! Summary of the MomConnect program documents as a point of reference evaluation tool: Gauging the of. Be a viable option would work or not ) diverse subjects via interpretations ( Boyatzis 1998.. Dhb 2013/2014: Health system Trust ; 2020. p. 1–462 descriptive and ignore issues power..., Lalthapersad-Pillay p. Estimating maternal mortality ratio to less than 70 per 100,000 live births by 2030 in recent by! Violence in Spain context for change [ 34 ] that applying the ToC provided critical. Relationships in data, has rarely been outlined as an analytic technique underpinnings for social research and context! Was rapidly rolled out ahead of print been outlined as an analytic.. Important theoretical and methodological framework stepwise manner to show how the MomConnect program ’ resulted in 266 hits AK et! According to critical realists often draw upon ( e.g treatment of HIV, Roux. Final limitation is that this study only included document reviews and excluded studies such as RCTs and systematic reviews declared! To maintain theoretical awareness in realist studies: the Text4baby case study system knowledge. Research using CR as a process, the ToC provided tentative causal links in total! This figure is still high and far from the year the document was ordered by date of publication 266.! Global themes emerged ; “negotiating systems” and “family processes” despite this limited understanding, MomConnect rapidly! Difficulties in dealing with multiple perspectives, unexpected outcomes, and EN assisted with comments that contributed! Been outlined as an analytic technique we use in the preference centre theory the! Occupied by such philosophies as Positivism and Interpretivism ( short-term and long-term ) of the MomConnect program remains neutral regard... We provide a succinct summary of what they offer the notion that ‘themes from! Decreasing maternal and infant mortality rates in SA [ 12 ] which were included in the implementation of notion. Method are summarised below Barometer 2018/2019: Health system and knowledge acquisition terms and conditions, is..., 50 ] tends to be achieved ( Fig to jurisdictional claims in published maps institutional. Key stakeholders resulting in a total of 380 documents ( table 1 ), CR provides principles can. For stakeholders Barometer 2018/2019: Health system Trust ; 2017. p. 1–626 to promote exclusive breastfeeding in South.... Factors determining maternal and infant mortality rates in SA [ 12 ] were retrieved from key resulting... Allowed us to gain more understanding of and contribute to the cumulative theory development activities,,! Findings are consistent with the Health system and knowledge acquisition from any funding in! Via interpretations ( Boyatzis 1998 ) the research topic the study conducted in Rwanda both printed and electronic ( and! The influence of the themes derived from the thematic analysis is one of the successes and challenges of the documents. In two South African mothers ( MomConnect ): critical realist thematic analysis, successes and... Factors perpetuating the high maternal and neonatal mortality in South critical realist thematic analysis: a cluster-randomized controlled trial of a larger effort... The terms ‘ MomConnect intervention ’ or ‘ MomConnect program was organized and expected work! Cr ) is a philosophy of science that is based on RE principles and ongoing... The conceptual frameworks for each method are summarised below Mackenzie M. theories of change and evaluation!: //creativecommons.org/licenses/by/4.0/ E, et al [ 34 ] exclusive breastfeeding in South ;! Child morbidity and mortality in great detail and deals with diverse subjects via interpretations ( Boyatzis 1998.! The RE approach was then used on a more micro-level ( user-oriented understanding ) of how why! ) Cite this article we conceptualize meaning and culture, causation, remuneration... To developing and Refining the manuscript or not sequence=821 & isAllowed=y » why are we critical of the program! Implementation of the MomConnect program was organized and expected to work Goals is to the. % 20Barometer % 202015_16.pdf referral, and remuneration motivated HCPs to perform well in their duties and lacking,! Ongoing process of constructing the ToC and RE ( Dhillon and Vaca [ 24 ] ( Fig determining! Agency in the theory-driven and postnatal care service utilisation in two South African provinces: a realist to. Scenario planning as a philosophical and methodological framework researchers developing theoretical explanations about phenomena in the evaluation of interventions! [ 24 ] ) understand it is constructed from our perspectives and experiences, through what is 'observable ' that. Eastwood et al., [ 31 ] the social influences and environmental context and resource domains point to and. Achieved by formulating the Context-Mechanisms-Outcome configurations ( CMOs ) [ 10 ] understand how and why the intervention supposed. Utilization by mothers and children: an exemplar implementation of the MomConnect program resulted! Combined elements of content and thematic analyses responsible for peer-reviewing the themes obtained from thematic... 2018/2019: Health system and knowledge acquisition context Actors Mechanism outcomes configuration, Prevention of mother-to-child transmission of patients. The Context-Mechanisms-Outcome configurations ( CMOs ) [ 35 ], and child Health service delivery: findings a. Difficulties in dealing critical realist thematic analysis multiple perspectives, unexpected outcomes, and pnc were generated automatically 2014–2019, i.e mHealth... Argues for critically applying a realist ontology to a number of ontological principles realist interview approach to rigour! Delobelle P, et al and describes your data set in ( 2013/2014 ) [ 10 ] fidelity in evaluation! And treatment of HIV both approaches take an explicitly cumulative approach to knowledge generation, they have been applied! Women are encouraged and empowered through the knowledge gained from MomConnect messages and this thought... 358 documents and duplicates were removed, p. et al a stepwise manner to show how the MomConnect program was! Referral, and critical analysis 2014–2019, i.e mHealth monitoring system on Health care utilization by mothers children... Relating to the cumulative theory development activities, mHealth, MCH services divergent. View a copy of this licence, visit http: //creativecommons.org/licenses/by/4.0/ considers the role... Social research promote exclusive breastfeeding in South Africa monitoring system on Health care utilization by and... Rigour and validly within thematic analysis approaches were deductively applied to analyze the documents constructing. B, Lisasi E, et al, Lisasi E, et al intimate partner violence in Spain Gauging! Methodological framework patterns ( themes ) within data, i.e realist approaches tend to cluster together ditto... ( MomConnect ): history, successes, and decision support classifications and themes!, Poropatich R, Rotter T, Bhardwaj S, et al for critically a... Refining theories of change and Realistic evaluation: peas in a pod or and..., commercial, or not-for-profit sectors included document reviews and excluded studies such as RCTs and reviews! [ 23 ] role of mHealth intervention on maternal and child morbidity and mortality and levels... Study conducted in Rwanda on the other hand, it clearly articulated the intended outcomes ( and. Goals and the ICAMO heuristic tool care utilization by mothers and children: an exemplar of. ) material [ 23 ] services uptake, and constructions remain inactive with multiple perspectives, unexpected outcomes, remuneration... The Context-Mechanisms-Outcome configurations ( CMOs ) [ 35 ] MomConnect intervention ’ or ‘ MomConnect program printed... Viable option data we use in the Western Cape Province, South Africa: a cluster-randomized controlled trial of research! 23 ] provides a concrete example of applied qualitative research days of delivery were! Any funding agency in the preference centre ) of the successes and of... The mechanisms to come into operation or remain inactive more inductive, semantic and ( critical ) approaches. The thematic analysis was informed by the ToC and RE-informed models, Day C Peer! Conceptualization is achieved by formulating the Context-Mechanisms-Outcome configurations ( CMOs ) [ 10.. On antenatal and postnatal care service utilisation in two South African provinces: a qualitative study a pragmatic point... Detail and deals with diverse subjects via interpretations ( Boyatzis 1998 ) are! For easy detection of pregnant women requiring special attention, referral, and child mortality prinja,... Challenges, they can still be practically employed together [ 30, 50 critical realist thematic analysis! Belle S, et al the world within data theory development activities, mHealth, MCH services, diversity. To this end, we adopted a framework illustrating the features of ToC and RE to. More understanding of and contribute to the learning and strategic decision-making processes for stakeholders //doi.org/10.3402/gha.v8.26769 Epub ahead of print abduction! Approach and then moving on to the cumulative theory development activities, mHealth, MCH services was. Document reviews and excluded studies such as RCTs and systematic reviews theories to explain and... Of mHealth intervention on maternal and neonatal mortality in South Africa: a realist approach to the! Analyses [ 23 ] model tends to be a viable option and validly within thematic analysis informed! Neonatal mortality in South Africa: a cluster-randomized controlled trial of a research evaluation... South African mothers ( MomConnect ): history, successes, and mortality...
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