What are the implementation steps for either setting up or improving the supply chain?
Both methods have obvious (e.g., frequency-based measures take longer to complete and invoke more participant fatigue) and potential (e.g., contextualizing instruments is time-consuming and may affect psychometric properties) drawbacks that, in light of our findings, should give practitioners pause regarding the widespread implementation of either method for operational use.
Although each of the 21 SCALE-UP implementations we studied had unique initiation and implementation stories, we saw patterns that provide useful information for either future implementations or those wanting to improve current implementations.
While pLSA can achieve very low values of the objective function (the lowest objective value for pLSA was far lower than for either implementation of the piES), the large proportion of runs that fail to reach good solutions increases the mean final objective value to above that of the piES.
Some may affect the design requirements for successful implementation, in either positive or negative ways, compared with the typical high-income country case.
Where such plans did and do exist, for example, the consecutive HRH plans of 2006 [ 33] and 2011 [ 34], their systematic implementation for various reasons either lags behind or fails [ 16].
We recognise that failure of any current implementation for a given scenario is either (a) an opportunity to learn, or (b) an opportunity to identify unusual/inexplicable behaviour.
On-site assistance can provide rapid implementation for a new capability – either in installing a new technology or implementing a new management practice – and can offer faster time-to-market than sourcing from a new supplier.
Suggestions that there has to be simultaneous global implementation for the idea to work are either disingenuous or misinformed.
Participants included two midwives who had worked previously in a BFHI accredited hospital and it may be that their experiences of BFHI could have influenced the views of those participants involved in implementation for the first time, either prior to or during the focus group.
