Group Care in the first 1000 days: implementation and process evaluation of contextually adapted antenatal and postnatal group care targeting diverse vulnerable populations in high-, middle- and low-resource settings

Nele Martens; Mathilde R Crone; Ashna Hindori-Mohangoo; Manodj Hindori; Ria Reis; Ilir S Hoxha; Jedidia Abanga; Shanaaz Matthews; Lizette Berry; Rianne M J J van der Kleij; M Elske van den Akker-van Marle; Astrid van Damme; Florence Talrich; Katrien Beeckman; Christine Mc Court; Sharon Schindler Rising; Deborah L Billings; Marlies Rijnders

doi:10.1186/s43058-022-00370-7

Group Care in the first 1000 days: implementation and process evaluation of contextually adapted antenatal and postnatal group care targeting diverse vulnerable populations in high-, middle- and low-resource settings

Implement Sci Commun. 2022 Nov 24;3(1):125. doi: 10.1186/s43058-022-00370-7.

Authors

Nele Martens¹, Mathilde R Crone², Ashna Hindori-Mohangoo³, Manodj Hindori³, Ria Reis^{2

4

5}, Ilir S Hoxha^{6

7}, Jedidia Abanga⁸, Shanaaz Matthews⁵, Lizette Berry⁵, Rianne M J J van der Kleij², M Elske van den Akker-van Marle², Astrid van Damme⁹, Florence Talrich⁹, Katrien Beeckman^{9

10}, Christine Mc Court¹¹, Sharon Schindler Rising¹², Deborah L Billings¹², Marlies Rijnders¹³

Affiliations

¹ Leiden University Medical Centre, Leiden, Netherlands. n.martens@lumc.nl.
² Leiden University Medical Centre, Leiden, Netherlands.
³ Foundation for Perinatal Interventions and Research in Suriname, Paramaribo, Suriname.
⁴ Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam, Netherlands.
⁵ University of Cape Town, Cape Town, South Africa.
⁶ Evidence Synthesis Group Prishtina, Prishtina, Republic of Kosovo.
⁷ Action for Mothers and Children, Prishtina, Republic of Kosovo.
⁸ Presby Health Services, Accra, Ghana.
⁹ Vrije Universiteit Brussel (VUB), Universitair ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.
¹⁰ Universiteit Antwerpen, Antwerp, Belgium.
¹¹ City University of London, London, UK.
¹² Group Care Global, Philadelphia, USA.
¹³ Netherlands Organisation for Applied Scientific Research, The Hague, Netherlands.

Abstract

Background: Group care (GC) improves the quality of maternity care, stimulates women's participation in their own care and facilitates growth of women's social support networks. There is an urgent need to identify and disseminate the best mechanisms for implementing GC in ways that are feasible, context appropriate and sustainable. This protocol presents the aims and methods of an innovative implementation research project entitled Group Care in the first 1000 days (GC_1000), which addresses this need.

Aims: The aim of GC_1000 is to co-create and disseminate evidence-based implementation strategies and tools to support successful implementation and scale-up of GC in health systems throughout the world, with particular attention to the needs of 'vulnerable' populations.

Methods: By working through five inter-related work packages, each with specific tasks, objectives and deliverables, the global research team will systematically examine and document the implementation and scale-up processes of antenatal and postnatal GC in seven different countries. The GC_1000 project is grounded theoretically in the consolidated framework for implementation research (CFIR), while the process evaluation is guided by 'Realistic Evaluation' principles. Data are gathered across all research phases and analysis at each stage is synthesized to develop Context-Intervention-Mechanism-Outcome configurations.

Discussion: GC_1000 will generate evidence-based knowledge about the integration of complex interventions into diverse health care systems. The 4-year project also will pave the way for sustained implementation of GC, significantly benefitting populations with adverse pregnancy and birthing experiences as well as poor outcomes.

Keywords: Antenatal group care; Consolidated Framework for Implementation Research (CFIR); Contextual adaptation; Implementation; Postnatal group care; Realist evaluation; Vulnerable populations.