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The average progress of implementation was perceived at 54 % (data not presented).
However, their mandate from senior surgical management to carry out the implementation was perceived by staff as unclear.
This article reports how the implementation was perceived by the different professionals, and discusses how professional subcultures in health care influence implementation.
For many participants, NIMART implementation was perceived as empowering as it enabled them to develop and use systems that worked within their local context.
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Qualitative analysis of the open questions revealed that lack of knowledge, fear, resistance to change, and difficulty in implementation were perceived as barriers to the adoption of reporting guidelines by journals.
The lack of a strategic national implementation plan was perceived as the main obstacle for future implementation of CDS-eP in their clinical practice (Table 2), followed by the lack of financial incentives and of acceptable, standardized software products.
The use of a structured model to guide the implementation project was perceived as useful by the project team.
The implementation process was perceived to be difficult because the guidelines were not clear in terms of targets, extension (period of time) and drugs covered by the policy.
In Mbarali district, the project focal person who was stationed full time in the district became part of the implementation team, and was perceived as an expert in the AFR approach to priority setting.
The implementation of the tool was perceived as threatening, and GPs behaviour was characterized by reluctance.
The implementation of both recommendations was perceived to have progressed by an average of 30%%.
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com