Guideline Adherence in Slums Project - Template-based documentation and decision support for primary healthcare clinics in the private sector. (360G-Wellcome-110321_Z_15_Z)

This study employs an exploratory sequential mixed methods research design with phased, concurrent data collection. The challenges of providing quality healthcare are highly complex especially in LMICs that face multiple health system shortcomings. Phase 1 (Exploration): Understanding the challenges in implementing currently prescribed national (or international/WHO) guidelines in low-resource urban settings. This aspect will be addressed by a set of in-depth interviews (IDIs) with the following set of stakeholders involved in the implementation of guideline recommendations: Phase 2 (Implementation): This phase includes two intervention elements: a) Developing CPG-based templates (in rubber stamp format) for a set of commonly encountered conditions in adults. b) A clinical audit and feedback system to review and aid providers in their adherence to CPGs (and templates). Phase 3 (Paths to scale): This phase will explore scaling of the intervention using IDIs with clinic managers, managers of social enterprise clinic chains and FBOs, health managers of county governments, healthcare financiers, funders and policy makers. This research approach explores both, the technical aspects of quality improvement interventions and also issues that affect the adoption of such interventions. Understanding the context in which the research is being conducted (eg. clinic financing, provider incentives, etc.), and also the paths to scale (and impact) is a central to our proposal and aims to maximise the chances of success of any larger research and/or implementation project in the future.