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Whilst individual elements of the GTC programme have been shown to be of benefit in individual sites, implementation of the package of resources and the ability of the GTC database to track and benchmark healthcare improvements had not been evaluated.
For example, to solicit support for the implementation of the Package of Essential NCD interventions in Pateros, the project leader engaged key stakeholders in the health care system and policy makers in Pateros.
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Jorg Asmussen, German deputy finance minister, said full implementation of the package must be swift.
The composition of the package was rightly dictated by economic considerations; we should not let the implementation of the package be dictated by political considerations.
Successful implementation of the package therefore requires in-depth knowledge of the local context and tailored behaviour change communication.
The secondary hypotheses are that the implementation of a package of dietary and lifestyle advice to overweight and obese women during pregnancy to limit gestational weight gain will reduce the risk of morbidity from other adverse outcomes for the infant; and reduce the risk of maternal morbidity from pregnancy complications and adverse outcomes.
The primary hypothesis is that the implementation of a package of dietary and lifestyle advice to overweight and obese women during pregnancy to limit gestational weight gain will reduce the risk of the infant born large for gestational age (defined as infant birth weight ≥ 90th centile for gestational age and infant sex).
As a good practice example the Kenyan Round 4 tuberculosis proposal plans the implementation of a package of incentives to retain staff in hard-to-reach areas.
"While the consultations did identify policy packages to be adopted by each participant, it is fair to say that implementation of the packages fell short of the intentions," write the IMF's Jonathan Ostry and Atish Ghosh.There is a further irony.
We shall estimate the cost of training for the Back to Fitness exercise package and include it in our evaluation of the widespread implementation of the packages in the trial.
The aims of this randomised controlled trial are to assess whether the implementation of a package of dietary and lifestyle advice to overweight and obese women during pregnancy to limit gestational weight gain is effective in improving maternal, fetal and infant health outcomes.
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