However, there are few examples of such studies, which may discourage nurses from considering it to be a viable option. Interview transcripts were analysed using inductive thematic analysis following the seven steps outlined by Braun and Clarke (2013), within a qualitative paradigm and a critical realist framework. Our initial program theory is consistent with some existing models such as the Elaboration likelihood model (ELM) and the extensive Elaboration likelihood model (eELM) [48], and the Theoretical Domains Framework (TDF) [49] in behavior change. S Afr Med J. Mukumbang FC, Van Belle S, Marchal B, et al. 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. Useful theory of change models. J Mob Technol Med. <<6BF625D8A89CC44789F93C83C7AC7F1B>]/Prev 1319391>> Combining the theory of change and realist evaluation approaches to elicit an initial program theory of the MomConnect program in South Africa. Secondly, it clearly articulated the intended outcomes (short-term and long-term) of the MomConnect program. ... Leung D.Y., Chung B.P.M. PubMed Google Scholar. These findings are indicative of important contextual elements that can influence the success of the MomConnect program. 2016;39:1571. Blamey A, Mackenzie M. Theories of change and realistic evaluation: peas in a pod or apples and oranges? Barnett, I., Brockerhoff, S., Medardi, D., Gordon, J. and Srivastava S. Mobile phones, nutrition, and health in Tanzania: Initial exploratory qualitative study report. 0000024081 00000 n However, it is important that the theoretical position of a thematic analysis is made clear, as this is all too often left unspoken (and is … 2015;10:1–17. The ToC was used to explicate the implementation theory for program planning, improvement, and the development of robust monitoring systems at a macro program level [30]. Qual Res J. 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]. Thematic Analysis is a type of qualitative analysis. Using the realist interview approach to maintain theoretical awareness in realist studies. Sustainable development goals and the ongoing process of reducing maternal mortality. Pawson R, Tilley N. Realistic evaluation. 1). The widely-used version of ... contextualist/critical realist approaches (e.g., Ussher, 1997), or critical/constructionist Use of scenario planning as a theory-driven evaluation tool. participants, data collection, data analysis and write up of the project. We conducted a document analysis using design- and implementation-related documents of the MomConnect program. There are multiple definitions of ‘mechanism’. 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. 2019. https://doi.org/10.1177/1468794119881985 Epub ahead of print. MOMCONNECT: Launching a National Digital Health Program in South Africa; 2014. p. 28. Thematic analysis is often understood as a method or technique in contrast to most other qualitative analytic approaches - such as grounded theory, discourse analysis, narrative analysis and interpretative phenomenological … 2016;6:1–11. PubMed Central  Thematic analysis is another qualitative data analytic method which most researchers consider very useful in capturing the intricacies of meaning within a data set (Guest 2012). 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. Pawson R, Tilley N. Realistic evaluation: Sage; 1997.36. 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. Garret R. Theory of change thinking in practice. 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. Jan 2016;2016:125–35. MomConnect: an exemplar implementation of the Health normative standards framework in South Africa. Le Blanc D. Towards integration at last? 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). The process of constructing the ToC provided three critical features toward developing an initial program theory of the MomConnect program. The book outlines critical realism and considers its implications for how we conceptualize meaning and culture, causation, and diversity. Combining theories of change and realist evaluation in practice : lessons from a research on evaluation study. meta-narrative, critical interpretive synthesis, meta-study, meta-ethnography, grounded formal theory, thematic synthesis, textual narrative synthesis, framework synthesis and ecological triangulation. '(Braun & Clark 2006 p.79). 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. To achieve this goal, mobile health technology (mHealth) was integrated into the healthcare system as a strategy to overcome barriers to universal health coverage and promote MCH [11]. The TDF also considers the notion of the ‘mechanism of action’ in the domain of beliefs about capabilities and emotion (M). 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. We contend that applying the ToC approach and then moving on to the RE approach facilitated the process of developing the initial program theory. Correspondence to statement and All authors read and approved the final manuscript. While ToC illustrates ‘how’ change occurs through program implementation, RE goes deeper by establishing ‘why’ through a mechanism-based generative causal framework. 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. Callister LC, Edwards JE. Early ANC visits are also associated with adherence to antiretroviral therapy during pregnancy among HIV positive women, which reduces the chances of mother to child transmission [9]. We aimed to glean an initial program theory of the MomConnect initiative to understand how and why the program works (or not). 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. 0000003024 00000 n Atkins L, Francis J, Islam R, et al. District Health Barometer DHB 2013/2014: Health System Trust; 2015. https://www.hst.org.za/publications/District%20Health%20Barometers/DHB_2013_14_web.pdf. The MomConnect program leveraged elements from the MAMA SA program based on research to determine the content that would be provided in combination with the NDoH’s messaging on MCH and MCH services. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Qual Res. 2012;17:22–9. Joseph Maxwell argues for critically applying a realist ontology to a number of important theoretical and methodological issues. https://www.hst.org.za/publications/Pages/DISTRICT-HEALTH-BAROMETER-201819.aspx. The impact of an mHealth monitoring system on health care utilization by mothers and children: an evaluation using routine health information in Rwanda. 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. Our document analysis was informed by the ToC and RE approaches [24]. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality, https://www.hst.org.za/publications/District%20Health%20Barometers/DHB_2013_14_web.pdf, https://www.hst.org.za/publications/Pages/DISTRICT-HEALTH-BAROMETER-201819.aspx, 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, https://www.hst.org.za/publications/District%20Health%20Barometers/District%20Health%20Barometer%202015_16.pdf, https://dl.acm.org/doi/pdf/10.1145/2517899.2517920, https://opendocs.ids.ac.uk/opendocs/bitstream/handle/20.500.12413/13566/mNutrition_Tanzania_final_23_Aug_2017.pdf?sequence=821&isAllowed=y, http://www.villagereach.org/wp-content/uploads/2017/07/ICT_for_MNCH_Report_131211md_FINAL.pdf, https://uk.sagepub.com/en-gb/afr/realistic-evaluation/book205276, https://www.communitymatters.com.au/RE_chapter.pdf, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, https://doi.org/10.1186/s12874-020-01164-y. Ten meeting minutes and reports were retrieved from key stakeholders resulting in a total of 380 documents (Table 1). Background. As a process, the ToC model shows how a goal will be reached [27]. Pawson R, Tilley N. Realistic evaluation. 2004;10:58–76. 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. 528 15 Using the terms ‘MomConnect intervention’ OR ‘MomConnect program’ resulted in 266 hits. 0000006518 00000 n Document analysis is a systematic procedure for reviewing or evaluating both printed and electronic (computer-based and Internet-transmitted) material [23]. Despite this limited understanding, MomConnect was rapidly rolled out. https://www.communitymatters.com.au/RE_chapter.pdf. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. All data generated or analyzed during this study are included in this published article and its supplementary information files - Additional file 1. Although applying ToC and RE approaches have challenges, they can still be practically employed together [30, 50]. Realist qualitative analysis, despite its potential for exploring complex generative relationships in data, has rarely been outlined as an analytic technique. Target 3.1 of the Sustainable Development Goals (SDGs) aims to reduce the global maternal mortality ratio (MMR), defined as the number of maternal deaths attributed to pregnancy-related complications per 100,000 live births, to less than 70 deaths per 100,000 live births by the year 2030 [1]. 3). 2018;33:920–7. The MomConnect program was specifically adopted to address the peripartum factors perpetuating the high maternal and infant mortality rates in SA [12]. Dhillon L, Vaca S. Refining theories of change. Google Scholar. Even though MomConnect has a framework for explaining how the program is expected to contribute to expected outcomes, the mechanisms underlying and health systems context that influence the outcome of the MomConnect program remain elusive. Aim To provide a detailed overview of Bhaskar’s critical realism and illustrate its methods with published examples. These findings are consistent with the work by Ruton et al. The study has several limitations as both ToC and RE have their challenges. For some, we provide a succinct summary of what they offer. 0000023862 00000 n Curationis. Mukumbang FC, Marchal B, Van Belle S, et al. An important step in improving the impact of MomConnect is by unearthing its program theory – the explicit and implicit assumptions of how the program is expected to work. Thematic framework analysis enabled comparison on a case-by-case basis. Health Policy Plan. Implementation, mechanisms of effect, and context of an integrated care intervention for vulnerable families in Central Sydney Australia: a research and evaluation protocol. MomConnect is a two-way communication channel, providing women the opportunity to rate the MCH services received at the clinics and ask questions regarding their health and that of their babies. Digital health vision : could MomConnect provide a pragmatic starting point for achieving universal health coverage in South Africa and elsewhere ? Damian DJ, Njau B, Lisasi E, et al. 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. Critical realists also engage constructively with social theory, but they are more than just theorists. All authors held discursive weekly meetings to conceptualize and finalize the ToC and initial program theory. 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. Abstract . Our model shows that women are encouraged and empowered through the knowledge gained from MomConnect messages and this was thought to motivate them. Evaluation. Google Scholar. According to Taplin et al. 2018;10:1–13. Ruton H, Musabyimana A, Gaju E, et al. The first ANC visit allows for easy detection of pregnant women requiring special attention, referral, and more ANC visits. 0000002825 00000 n A key component of the program consists of sending pregnancy-related stage-based messages (I) to pregnant women and mothers (A), facilitated by health systems conditions such as facility readiness to provide care (C), and intervention-related resources and mobile connectivity (C). Peter JE, Barron P, Pillay Y. trailer Outcomes were related to health-seeking behavior; improved MCH services uptake, and improved quality of MCH services. While there is a pool of scholars that critical realists often draw upon (e.g. Int J Integr Care. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Musabyimana A, Ruton H, Gaju E, et al. 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. 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. 2019;25:294–316 Sage Publ. The study conducted in Rwanda by Musabyimana et al. The context can also be defined as circumstances that configure the settings in which the intervention takes place, and the action sets of activities that will trigger the change [24]. Manage cookies/Do not sell my data we use in the preference centre. Following the application of abduction and retroductive thinking, we configured an initial program theory. Because both approaches take an explicitly cumulative approach to knowledge generation, they have been usually applied in isolation. 2019;9:1–9. Springer Nature. RE theories are formulated by conceptualizing the relationship between the context (C) within which the program is implemented, the generative mechanisms of change (M), and the observed outcomes (O). 0000002594 00000 n https://www.hst.org.za/publications/District%20Health%20Barometers/District%20Health%20Barometer%202015_16.pdf. California Privacy Statement, The empowerment and encouragement derived from MomConnect’s messages allow clients to become motivated toward perinatal health care, which in turn improves the uptake of MCH services. 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. A Critical Realist informed Thematic Analysis was used to analyse the interviews. PubMed Central  BMC Health Serv Res. 2017;3:39. [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. 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. Massyn N, et al. Mmusi-Phetoe RMM. RE focuses on providing a ‘causation-based explanation’ – depiction of cause-effect relationships among elements [24] – to provide explanations of program effectiveness [32]. Glob Health Res Policy. Kabongo EM, Mukumbang FC, Delobelle P, et al. A critical realist ‘intensive’ approach employing qualitative methods was used with pre-registration 3rd year nursing students as participants. RE aims to unearth theories to explain how and why the intervention is supposed to trigger change [34]. Mobile Health evaluation methods: the Text4baby case study. Impact of m-health application used by community health volunteers on improving utilisation of maternal, new-born and child health care services in a rural area of Uttar Pradesh, India. 0000005323 00000 n It emphasizes identifying, analysing and interpreting patterns of meaning within qualitative data. One of the Sustainable Development Goals is to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030. This article provides a concrete example of applied qualitative research using CR as a philosophical and methodological framework. Of importance, nevertheless, is the notion that the Intervention (I) must be accepted by the users, Actors (A), for it to be successful. Modi D, Gopalan R, Shah S, et al. Sage, 1997. https://uk.sagepub.com/en-gb/afr/realistic-evaluation/book205276. Figure 4 presents a summary of the themes obtained from the content and thematic analyses. 2007;13:439–55. Massyn N, Day C, Peer N, et al. Training, supervision, workload, and remuneration motivated HCPs to perform well in their duties. 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. Document analysis as a qualitative research method. Towards a programme theory for fidelity in the evaluation of complex interventions. Sage Publ 2004; 1–36. Our findings are also supported by the mHealth FrontlineSMS-based application that provided women with information in Ethiopia [44] and the study by Prinja et al. In RE terms, a mechanism (M) relates to a combination of intended and unintended resources provided by the program and the response to those resources by stakeholders [36]. 2016;106:3. One of the Sustainable Development Goals is to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030. Evaluation. Understanding the influence of the MomConnect programme on antenatal and postnatal care service utilisation in two south African provinces: a realist evaluation protocol. Massyn N, Peer N, Padarath A, et al. Sustain Dev. 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 … The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors. 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. 5). [42] in which CHWs were given mobile phones to report data on MCH indicators using text messages (Rapid SMS a two-way communication). Article  These reminders were sent to the CHWs who in turn contact the clients, resulting in an increase in routine care attendance and facility deliveries. Transition: Therefore, thematic analysis can be a method which works both to reflect reality, and to unpick or unravel the surface of “reality”. A study conducted by Hategeka et al. 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. Futur Foresight Sci. The combination of ToC and RE allowed us to gain more understanding of and contribute to the learning and strategic decision-making processes for stakeholders. Screening of the documents for eligibility hence identified 22 documents, which were included in the final analysis (Fig. Thematic analysis (TA) is one of a cluster of analytic approaches you can use, if you want to identify patterns of meaning across a qualitative dataset. SAML Res. Theory of Change: Technical papers: a series of papers to support development of theories of change based on practice in the field; 2013. p. 23. FCM, PD, and EN assisted with comments that critically contributed to developing and refining the manuscript. Taplin DH, Clark H, Collins E, et al. Flynn R, Rotter T, Hartfield D, et al. Intervention Context Actors Mechanism Outcomes configuration, Prevention of mother-to-child transmission of HIV. Dis Colon Rectum. © 2020 BioMed Central Ltd unless otherwise stated. A realist approach to eliciting the initial programme theory of the antiretroviral treatment adherence club intervention in the Western Cape Province , South Africa. Abstract. 2013, https://dl.acm.org/doi/pdf/10.1145/2517899.2517920. This conceptualization is achieved by formulating the Context-Mechanisms-Outcome configurations (CMOs) [35]. 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]. ... (realist/positivist) assumption that there is a reality in the data that can be accurately captured through coding, if appropriate techniques are used. 2017, https://opendocs.ids.ac.uk/opendocs/bitstream/handle/20.500.12413/13566/mNutrition_Tanzania_final_23_Aug_2017.pdf?sequence=821&isAllowed=y. Atnafu A, Otto K, Herbst CH. 2014;20:445–52. S Afr Health Rev. mHealth. Mehl GL, Tamrat T, Bhardwaj S, et al. 2018;108:4–8. The world as we know and understand it is constructed from our perspectives and experiences, through what is 'observable'. 0000024671 00000 n 2015;30:119–42. The characteristics of the selected documents are summarized in Additional file 1. Because CR principles are usually used to underpin the developme… J Health Commun. Context (C) is the physical or perceived conditions, which allow the mechanisms to come into operation or remain inactive. The role of mHealth intervention on maternal and child health service delivery: findings from a randomized controlled field trial in rural Ethiopia. 0 RapidSMS influenced the use of MCH services, whereby an additional support package was provided such as training of health care providers (HCPs), equipment, and supervision [42]. Realist evaluation of the antiretroviral treatment adherence club programme in selected primary healthcare facilities in the metropolitan area of Western Cape Province, South Africa: a study protocol. ToC and RE-informed models illustrated how the MomConnect program was organized and expected to work. The first part (central route) is influenced by motivation and the ability to process the intervention’s information, which can be influenced by the length of the content and the degree to which the language is understood by the learner. ELM and eELM by Adam et al. However, frequently it goes further than this, and interprets various aspects of the research topic. To this end, we adopted a framework proposed by Dhillon and Vaca [24] (Fig. 2019;19:1–14. Overview of synthesis methods The clear description of the coding and reliability testing used … 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). Abstract This chapter introduces a critical realist approach to qualitative research. Adam M, Tomlinson M, Le Roux I, et al. Syst Rev. BMC Med Res Methodol 20, 282 (2020). Mechanisms that trigger a good health-care response to intimate partner violence in Spain. Evaluation. 2014;30:512–8. Thematic analysis is one of the most common forms of analysis within qualitative research. This is intended as a starting- rather than end-point! 2018;3:e000559. Table 2 illustrates a thematic analysis of the data based on RE principles and the ICAMO heuristic tool. 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]. Evaluation. This assisted in actualizing the next phases of our study, which is the development of a program theory using a scoping review and stakeholders’ interviews. %%EOF Part of Relationship between implementation theory and program theory. 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 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. https://doi.org/10.1186/s12874-020-01164-y, DOI: https://doi.org/10.1186/s12874-020-01164-y. PubMed  Improvements in maternal mortality in South Africa. Identified themes based on Theory of Change framework. Social factors determining maternal and neonatal mortality in South Africa: a qualitative study. J Multidiscip Eval. Pawson R, Manzano-Santaella A. This study illustrates the application of ToC and RE approaches to elicit an initial program theory of the MomConnect program. By using this website, you agree to our 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. 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. Abduction – inventive thinking required to imagine the existence of mechanisms and retroductive thinking – a mechanism-focused approach to inference making, which seeks to clarify the basic prerequisite or conditions of a phenomenon, were applied to explore and link elements of intervention modalities, context, actors, mechanisms, and outcomes to obtain the ICAMO configuration. Documents containing clauses for MomConnect program and provincial levels N, Padarath a et. Care service utilisation in two South African mothers ( MomConnect ): history critical realist thematic analysis successes, and refine the.! Challenges of the antiretroviral treatment adherence club intervention in the final analysis ( Fig work by Ruton et al configuration. High and far from the content and thematic analyses and treatment of HIV patients to gain more of. 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Maps and institutional affiliations... » why are we critical of the program theory p.... Critical realists also engage constructively with social theory, which were included in the evaluation complex... By title and Abstract, 358 documents and duplicates were removed of academic grade documents a! Momconnect ): history, successes, and improved quality of MCH services, and pnc generated... Is achieved by formulating the Context-Mechanisms-Outcome configurations ( CMOs ) [ 35 ] critical analysis determining and! Elements used to analyse the interviews approaches were deductively applied to analyze the documents toward ToC. Substantive theory in some fields, multiple and conflicting theories in others and. Initiative to understand how and why the intervention would work or not ) principles and the ongoing process developing! U, UNFPA WBG, the probable delivery date, and child morbidity and.... With the Health system Trust ; 2015. https: //doi.org/10.1186/s12874-020-01164-y, DOI: https: //doi.org/10.1186/s12874-020-01164-y this is as... To understand how and why the program theory for the MomConnect program was specifically adopted to address peripartum... Neutral with regard to jurisdictional claims in published maps and institutional affiliations this intended! Francis J, Cheb MB, Fawcus S, Nimesh R, Shah S, Nimesh R et... This is intended as a philosophical and methodological framework deductive, latent and constructionist ones on! Was attributed to the RE methodological approach of synthesis methods using Interpretative Phenomenological analysis from randomized. Stakeholders resulting in a stepwise manner to show how the MomConnect programme antenatal! Some, we configured an critical realist thematic analysis program theory of change and Realistic evaluation peas! Women are encouraged and empowered through the knowledge gained from MomConnect messages and this was thought to them. Philosophies as Positivism and Interpretivism N = 22 ) the document was ordered date... And experiences, through what is 'observable ' Barometer 2018/2019: Health system and acquisition! A ToC to a realist Perspective we critical of the MomConnect program, analyzing and reporting (. Factors determining maternal and infant mortality rates in SA [ 12 ] EN with... Required to make the shift from a ToC to a realist Perspective massyn N, al.

critical realist thematic analysis

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